JPH11262527A - Blood vessel brossage balloon catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood vessel brossage balloon catheter which is a new means to enable relatively simple treatment of varicosis even in blood vessel of a relatively large diameter. SOLUTION: A blood vessel brossage balloon catheter 1 consists of a balloon 10, a catheter shaft 12, tip end chip 14, a marker 16, a Y-connector 18. etc., and many protrusions 20 constituting the scraping part are formed as a unit. When this blood vessel brossage balloon catheter 1 is inserted into a blood vessel, and the inner wall of the blood vessel is brossaged with the protrusions 20 of the expanded balloon 10, thrombi are formed on the inner wall of the injured blood vessel, or smooth muscle cells in blood vessel wall propagate to prevent varicosis from becoming worse as a result.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

The present invention relates to an intravascular abrasion balloon catheter suitable for use in treating varicose veins.

[0002]

BACKGROUND OF THE INVENTION Primary varicose veins have been a common disease of foreigners in the past, but the number of Japanese patients has increased rapidly in recent years. Patients with primary varicose veins are mainly women, and in many cases, they are caused by pregnancy or standing work. The varicose veins do not often cause a subjective symptom such as pain even if they occur, and there is almost no serious problem even if they are left as they are. However, it may be accompanied by symptoms such as easy fatigue of the feet, and if it ruptures for some reason, it may cause internal bleeding, damage the subcutaneous tissue and lead to inflammation. In addition, in the case of women, many patients hope for treatment with the expectation of improvement in beauty.

[0003] As a treatment for such primary varicose veins, surgical operations such as saphenous vein extraction (stripping operation) and medical treatments such as sclerotherapy have been conventionally performed. The saphenous vein extraction is a method of removing a saphenous vein, which is a diseased part of a varicose vein. Sclerotherapy is a method in which a drug (blood sclerosing agent) is administered into a blood vessel to artificially occlude the blood vessel and obstruct the varicose vein.

[0004]

However, the above-mentioned conventional methods for treating varicose veins have the following problems. First, the above-mentioned saphenous vein extraction is usually performed by incising the root of the thigh, incising with the great saphenous vein, closing it, and removing the vein. Has several problems, such as the possibility of causing neuropathy and the fact that blood vessels are cut off when the vein is removed and remain in the body, and there is much bleeding in surrounding tissues. In addition, since hospitalization is required for about one week after the operation, there is a problem that the cost for the treatment including the operation cost and the hospitalization cost is relatively high.

[0005] On the other hand, the above-mentioned sclerotherapy is a method of medically administering a drug, and therefore can be easily treated.
It is less invasive than the saphenous vein extraction and the like, and hospitalization is not essential, so low-cost treatment is possible. However, sclerotherapy has a problem that it can treat only a part having a relatively small blood vessel diameter. For example, the saphenous vein main trunk has a large blood vessel diameter of about 8 mm or more, so it is difficult to harden blood instantaneously and occlude the blood vessel. Therefore, when the diseased part of the varicose vein is a part having a relatively large blood vessel diameter, there is a problem that it is necessary to end up with a highly invasive surgical operation.

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problems, and an object of the present invention is to provide a method for treating varicose veins relatively easily even in a portion having a relatively large blood vessel diameter. Another object of the present invention is to provide an intravascular abrasion balloon catheter.

[0007]

In order to achieve the above object, an intravascular abrasion balloon catheter according to claim 1 expands / contracts according to the pressure of a fluid supplied to the inside. An intravascular abrasion balloon catheter comprising a balloon and a catheter shaft having a lumen communicating with the balloon and capable of supplying a fluid to the interior of the balloon through the lumen, wherein the balloon has a balloon inside a blood vessel. A rubbing portion is provided on the outer peripheral surface of the balloon, which rubs the inner wall of the blood vessel and damages the tissue of the inner wall of the blood vessel when the balloon is operated in an expanded state.

The intravascular abrasion balloon catheter is percutaneously inserted into a blood vessel while the balloon is in a contracted state, and the balloon is left at a target position. Then, in this state, fluid is supplied and discharged from the proximal end side of the catheter shaft, and the balloon is in an expanded state. In this state, when the balloon is moved back and forth or the balloon is rotated, the scraping portion provided on the outer peripheral surface of the balloon scrapes the inner wall of the blood vessel and damages the tissue of the inner wall of the blood vessel. Also,
If the treatment is performed over a wider area than the size of the balloon, the abrasion is performed while shifting the position of the balloon little by little. After completing the necessary operations in this way, the balloon is deflated and the intravascular abrasion balloon catheter is withdrawn outside the body.

When the tissue of the inner wall of a blood vessel (eg, saphenous vein) is damaged using such an intravascular abrasion balloon catheter, a thrombus may be formed at the damaged portion, or smooth muscle in the damaged blood vessel wall may be damaged. The cells proliferate and cause vascular occlusion. As a result, the blood flow in the varicose vein-related portion is blocked, and the varicose vein can be prevented from becoming more severe than the current situation.

Therefore, according to this intravascular abrasion balloon catheter, the varicose vein can be treated only by inserting the intravascular abrasion balloon catheter through a small incision and ligating the same. It is minimally invasive and does not place a significant burden on the patient as in the saphenous vein extraction described above. In addition, no hospitalization or the like is required, and the cost of the treatment is lower than that of the saphenous vein extraction.

In addition, unlike the above-mentioned sclerotherapy, in which a drug is easily flowed into the bloodstream, the blood vessel can be surely occluded at the damaged portion of the inner wall of the blood vessel. Therefore, the outer diameter of the balloon is selected according to the diameter of the blood vessel, or Is adjusted by the internal pressure, for example, a treatment can be performed from a portion having a relatively large diameter to a portion having a relatively small blood vessel diameter, such as a main trunk of a saphenous vein.

Incidentally, in this intravascular abrasion balloon catheter, the specific structure of the abrading portion is not particularly limited as long as it has a structure capable of damaging the tissue of the inner wall of the blood vessel when the inner wall of the blood vessel is abraded. However, for example, as in the intravascular abrasion balloon catheter according to claim 2, if the abrasion portion is provided with a projection on the outer peripheral surface of the balloon, the projection is a blood vessel when the inner wall of the blood vessel is abraded by the balloon. Since the tissue of the inner wall is damaged, a desired effect can be obtained.

As a method of providing such a protrusion on the outer peripheral surface of the balloon, a method of forming a protrusion on the surface of the balloon itself when forming the balloon itself, and a method of bonding or melting another member serving as a protrusion to the surface of the balloon. How to wear,
Any means can be employed.

Incidentally, the rubbing portion in the intravascular rubbing balloon catheter of the present invention cannot be constituted only by the above-mentioned projections. That is, as described in claim 1, if the abrading part is such as to scratch the inner wall of the blood vessel and damage the tissue of the inner wall of the blood vessel when operated in a state where the balloon is expanded in the blood vessel, for example, Alternatively, the surface properties of the outer peripheral surface of the balloon may be rough (that is, there may be microscopically equivalent projections, but macroscopically, no projections).

Furthermore, it is desirable that the projections do not contact the blood vessel wall when the intravascular abrasion balloon catheter is inserted into the blood vessel. As in the case of an inner rubbing balloon catheter, the protrusion may be a hollow protrusion that expands and protrudes with the balloon.

With such an intravascular abrasion balloon catheter, when the balloon is deflated, the projection also contracts. Therefore, when the intravascular abrasion balloon catheter is inserted into the blood vessel, the projection is formed on the blood vessel wall. There is no contact. In addition, as another means for preventing the protrusion from coming into contact with the blood vessel wall when the intravascular abrasion balloon catheter is inserted into the blood vessel, the protrusion may be provided by a folded balloon when the balloon is deflated. There is also a method in which an intravascular abrasion balloon catheter is inserted into a blood vessel, or a guide catheter into which an intravascular abrasion balloon catheter can be inserted is first inserted into a blood vessel, and the intravascular abrasion balloon catheter is moved through the lumen of the guide catheter.

Further, means other than the above-mentioned protrusions may be provided as the rubbing part. For example, as in the intravascular abrasion balloon catheter according to the fourth aspect, the abrasion portion may be formed by forming a bellows-like step on the outer peripheral surface of the balloon.

Even with such an intravascular abrasion balloon catheter, the bellows-like step damages the tissue of the inner wall of the blood vessel when the inner wall of the blood vessel is scratched by the balloon, so that the desired effect can be obtained. Alternatively, as in the intravascular abrasion balloon catheter according to the fifth aspect, the abrading portion may be a metal wire fixed to the outer peripheral surface of the balloon.

Even with such an intravascular abrasion balloon catheter, the desired effect can be obtained because the metal wire damages the tissue of the inner wall of the blood vessel when the inner wall of the blood vessel is rubbed with the balloon.

[0020]

Next, embodiments of the present invention will be described with reference to some examples. [Embodiment 1] As shown in FIG. 1, an intravascular abrasion balloon catheter 1 comprises a balloon 10, a catheter shaft 1
2, a tip 14, a marker 16, a Y connector 18, and the like.

The balloon 10 is made of polyurethane, and has a plurality of projections 20 constituting a rubbing part integrally formed on the outer peripheral surface thereof. In FIG. 1, the shape of the projection 20 is
Although a substantially hemispherical shape is shown, the shape of the projection 20 may be a pointed conical shape, or a non-rotating shape such as a spherical shape or a conical shape, specifically, a pyramidal shape. Any shape of projection, such as a pillar, a wire, a mesh, or any other irregular shape, can be used as long as it can form at least irregularities that can function as a scraping portion. Good. Instead of the projection 20, a balloon 10 having a rough surface property may be employed. Such a balloon 10 microscopically has a projection on the outer peripheral surface, and has a sufficient function as a rubbing part.

The catheter shaft 12 is made of nylon and is a double tube comprising an outer tube 22 and an inner tube 24. On the distal end side of the outer tube 22, the rear end side of the balloon 10 is joined, and on the proximal end side,
The Y connector 18 is joined. Further, the inner tube 24 is disposed so as to penetrate the inside of the balloon 10 and the outer tube 22, and the distal end side of the inner tube 24 is joined to the distal end side of the balloon 10 and the distal tip 14. The Y connector 18 is joined to the side.

In this state, the gap between the inner peripheral surface of the outer tube 22 and the outer peripheral surface of the inner tube 24 communicates with the balloon expansion port 26 of the Y connector 18 on the proximal end side, and of the balloon 10 on the distal end side. Communication to the inside, balloon expansion port 2
A fluid supply / discharge path capable of supplying the fluid (for example, physiological saline) supplied from 6 to the inside of the balloon 10 is formed. On the other hand, the lumen of the inner tube 24 communicates with the guide wire insertion port 28 of the Y connector 18 on the proximal end side, communicates with the distal end of the distal tip 14 on the distal end side, and is inserted into the blood vessel in advance. A passage through which the indwelled guidewire can be inserted is formed.

Although the catheter shaft 12 is partially cut away and not shown, it is actually 50-100 c.
It is a long one having a length of about m. Next, a method of using the above intravascular abrasion balloon catheter 1 will be described. First, the inside of the balloon 10 is set to a negative pressure through the balloon expansion port 26, and the balloon 10 is contracted in advance. Then, the intravascular abrasion balloon catheter 1 is inserted into the blood vessel such that a guide wire (not shown) previously placed in the blood vessel is passed through the inner tube 24, and the intravascular abrasion balloon catheter 1 is inserted into the guide wire. 2 to move the balloon 10 to the aneurysm B (FIG. 2).
(See (a))). Note that whether or not the balloon 10 has reached the expected position is determined by confirming the position of the marker 16 by X-ray.

Next, when the balloon 10 reaches the target position, physiological saline is injected from the balloon expansion port 26. As a result, as shown in FIG.
0 expands and the protrusion 20 on the outer periphery of the balloon 10 becomes
The state comes into contact with the inner wall of the blood vessel A. In this state, when the balloon 10 is moved back and forth or rotated as indicated by arrows at both ends in the drawing, the projections 20 damage the inner wall of the blood vessel A.

Such an operation is performed in a range where at least the vicinity of the aneurysm B is completely included while gradually bringing the position of the balloon 10 closer to the insertion site side of the intravascular abrasion balloon catheter 1. When the treatment is completed,
Physiological saline is sucked from the balloon expansion port 26 to deflate the balloon 10, and then the intravascular abrasion balloon catheter 1 is pulled out of the body.

As shown in FIG. 2B, a thrombus is formed on the inner wall surface of the injured blood vessel A, or smooth muscle cells in the blood vessel wall proliferate, as a result, as shown in FIG. Then, a stenosis part C is formed and the blood flow to the aneurysm part B is blocked. As shown in FIG. 2 (c), the stenotic portion C eventually becomes an occluded portion D, and the blood flow of the blood vessel A is completely shut off, so that the varicose vein can be prevented from becoming more severe than the current condition. .

As described above, according to the intravascular abrasion balloon catheter 1, the varicose vein can be treated only by inserting the intravascular abrasion balloon catheter 1 through a small incision and ligating the same. Varicose veins can be treated with as little invasive procedures as therapy. In addition, unlike sclerotherapy, in which a drug is easily flowed into the bloodstream, the blood vessel can be surely occluded at the damaged portion of the inner wall of the blood vessel, so that treatment can be performed even at a relatively large blood vessel. Also, side effects due to drug injection can be prevented.

Next, another intravascular abrasion balloon catheter will be described. In addition, below, the intravascular abrasion balloon catheter described as Embodiments 2 to 4,
Since only a part of the structure is different from that of the intravascular abrasion balloon catheter 1 described in the first embodiment, members having the same function are denoted by the same reference numerals in the drawings, and the description of completely equivalent functions will be omitted. Omitted.

[Embodiment 2] As shown in FIG. 3, the intravascular abrasion balloon catheter 2 is composed of a balloon 10, a catheter shaft 12, a distal tip 14, a marker 16, a Y connector 18, and the like. As a simple configuration, a hollow projection 30 constituting a rubbing part is integrally formed on the outer peripheral surface of the balloon 10. This hollow projection 30
Expands / deflates with the balloon 10, and functions in the expanded state in the same manner as the protrusion 20 of the intravascular scraping balloon catheter 1.

Therefore, even with the intravascular abrasion balloon catheter 2 having such a structure, the varicose vein can be treated by inserting it through a small incision and rubbing the inner wall of the blood vessel, so that it is as invasive as sclerotherapy. Can treat varicose veins. In addition, unlike sclerotherapy, in which a drug is easily flowed into the bloodstream, the blood vessel can be surely occluded at the damaged portion of the inner wall of the blood vessel, so that treatment can be performed even at a relatively large blood vessel.

[Embodiment 3] As shown in FIG. 4, the intravascular abrasion balloon catheter 3 is composed of a balloon 10, a catheter shaft 12, a distal tip 14, a marker 16, a Y connector 18, and the like. As a simple configuration, a bellows-like step 32 forming a rubbing part is integrally formed on the outer peripheral surface of the balloon 10. This step 32
Functions similarly to the protrusion 20 of the intravascular abrasion balloon catheter 1.

Therefore, even with the intravascular abrasion balloon catheter 3 having such a structure, the varicose vein can be treated by inserting it through a small incision and rubbing the inner wall of the blood vessel, so that it is as invasive as sclerotherapy. Can treat varicose veins. In addition, unlike sclerotherapy, in which a drug is easily flowed into the bloodstream, the blood vessel can be surely occluded at the damaged portion of the inner wall of the blood vessel, so that treatment can be performed even at a relatively large blood vessel.

[Embodiment 4] As shown in FIG. 5, the intravascular abrasion balloon catheter 4 includes a balloon 10, a catheter shaft 12, a distal tip 14, a marker 16, a Y connector 18, and the like. As a special configuration, a metal wire 34 forming a rubbing part is fixed to the outer peripheral surface of the balloon 10. The metal wire 34 expands / contracts together with the balloon 10, and in the expanded state,
It functions similarly to the protrusion 20 of the intravascular abrasion balloon catheter 1.

Therefore, even with the intravascular abrasion balloon catheter 4 having such a structure, the varicose vein can be treated by inserting it through a small incision and rubbing the inner wall of the blood vessel, so that it is as invasive as sclerotherapy. Can treat varicose veins. In addition, unlike sclerotherapy, in which a drug is easily flowed into the bloodstream, the blood vessel can be surely occluded at the damaged portion of the inner wall of the blood vessel, so that treatment can be performed even at a relatively large blood vessel.

Although the embodiments of the present invention have been described above, various specific embodiments other than those described above are conceivable for the embodiments of the present invention. For example, in the above-described embodiment, the catheter shaft of each intravascular abrasion balloon catheter is configured to be a double tube so that a guidewire can be inserted.However, an intravascular abrasion balloon catheter can be inserted into a blood vessel without using a guidewire. It is also possible to insert into the case, in which case, without adopting a structure for passing the guide wire,
A thinner catheter shaft can also be used.

[Brief description of the drawings]

FIG. 1 is a side view showing an intravascular abrasion balloon catheter according to a first embodiment.

FIG. 2 is a schematic diagram showing a use state of the intravascular rubbing balloon catheter of the first embodiment.

FIG. 3 is a side view showing an intravascular abrasion balloon catheter according to a second embodiment.

FIG. 4 is a side view showing an intravascular abrasion balloon catheter according to a third embodiment.

FIG. 5 is a side view showing an intravascular abrasion balloon catheter according to a fourth embodiment.

[Explanation of symbols]

1-4: intravascular abrasion balloon catheter, 10 ...
・ Balloon, 12 ・ ・ ・ Catheter shaft, 14 ・ ・
・ Tip tip, 16 ・ ・ ・ Marker, 18 ・ ・ ・ Y connector, 20 ・ ・ ・ Protrusion, 22 ・ ・ ・ Outer tube, 24
... Inner tube, 26 ... Balloon expansion port,
28: guide wire insertion port, 30: hollow projection, 32: step, 34: metal wire.

Claims (5)

[Claims] 1. A balloon that expands / contracts in response to the pressure of a fluid supplied to the inside thereof, and has a lumen communicating with the balloon, and can supply a fluid to the inside of the balloon through the lumen. An intravascular abrasion balloon catheter comprising a catheter shaft, wherein the abrading portion for abrading the inner wall of the blood vessel and damaging the tissue of the inner wall of the blood vessel when the balloon is operated in an expanded state in the blood vessel, wherein the balloon has the balloon. An intravascular abrasion balloon catheter provided on the outer peripheral surface of a balloon. 2. The intravascular abrasion balloon catheter according to claim 1, wherein a projection is provided on an outer peripheral surface of the balloon as the abrading portion. 3. The intravascular abrasion balloon catheter according to claim 2, wherein the projection is a hollow projection that expands and protrudes with the balloon. 4. The intravascular abrasion balloon catheter according to claim 1, wherein a bellows-like step is formed on the outer peripheral surface of the balloon as the abrading portion. 5. The intravascular abrasion balloon catheter according to claim 1, wherein a metal wire is fixed to an outer peripheral surface of the balloon as the abrading portion.