JPH1189938A - Insertion aid - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an insertion aid which can keep only a specific linear element operable when a tubular passage is closed liquid-tight with packing intimately pressed against the outer peripheries of plural linear elements passed into the tubular passage. SOLUTION: An insertion aid 1 includes a first tubular part 3 which does not collapse readily even when exerted with pressure from its outer periphery, a second tubular part 5 which collapses readily when exerted with pressure from its outer periphery, and the like, with one lumen 9 so formed to pass through the tubular parts 3, 5. When the first tubular part 3 is placed inside packing 7, the first tubular part 3 does not collapse even when a valve 70 is closed, so that a guide wire 56 becomes free to move axially (Figure (a)). When the second tubular part 5 is placed inside the packing 74, the second tubular part 5 collapses with the closing of the valve 70 and makes intimate contact with the outer periphery of the guide wire 56, thus fixing the guide wire 56 in place and completely stopping the spill of blood from the lumen 9 (Figure (b)).

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a plurality of linear bodies, a tubular passage through which the plurality of linear bodies are inserted in parallel, and a part of an inner peripheral surface of the tubular passage. The present invention relates to an insertion aid used together with a medical device provided with a sealing device capable of being deformed to a state in which it is in close contact with the outer periphery of the linear body and closing a gap with the linear body in a liquid-tight manner.

[0002]

2. Description of the Related Art Conventionally, as a balloon catheter for PTCA (percutaneous coronary angioplasty), a rapid exchange type balloon catheter 51 as illustrated in FIG.
(Hereinafter, simply referred to as a balloon catheter 51) is known.

[0003] This balloon catheter 51 is made of another PT.
Like the CA balloon catheter, the balloon 54 attached to the outer peripheral portion of the distal end of the catheter shaft 52 is expanded to perform a dilation procedure for a stenosis in the blood vessel. Part 51a
The guide wire 56 passed through the inside of the catheter shaft 52 is led out to the side surface of the catheter shaft 52 at a side surface portion 51b about 10 to 100 cm away from the distal end portion 51a of the balloon catheter 51, and extends from there to the hand side. Then, the catheter shaft 52 and the guide wire 5
6 are arranged in parallel.

When the balloon catheter 51 is used, as shown in FIG. 5, instruments such as a sheath 60, a guide catheter 62, and a Y connector 64 are simultaneously used. When inserting the balloon catheter 51 into the blood vessel, first, the sheath 60 is inserted into the blood vessel of the patient, and the guide catheter 62 is introduced into the blood vessel through the lumen of the sheath 60, and then the guide catheter 62 is inserted.
To reach the coronary artery entrance, and then place the balloon catheter 51 with the guidewire 56 inserted into it.
The balloon catheter 51 and the guide wire 5 are inserted into the guide catheter 62 from the Y connector 64 side.
When the guide wire 6 reaches the vicinity of the stenosis, only the guide wire 56 is advanced first to pass through the stenosis, and the guide wire 5
By advancing the balloon catheter 51 along 6, the balloon 54 reaches the inside of the stenosis.

[0005]

At the end of the Y connector 64, a valve 70 is provided. As shown in FIGS. 6A and 6B, the valve 70 includes a tubular body 66 through which a catheter is inserted, an operation member 72 screwed to the outer periphery of the tubular body 66, and a tubular body 66. When the valve 70 is closed, the inner diameter of the packing 74 is reduced by the pressing force from the operating member 72 when the valve 70 is closed, as shown in FIG. When deformed, the packing 74 closes the gap between the balloon catheter 51 and the Y connector 64 in a liquid-tight manner, so that the outflow of blood from the tubular body 66 can be prevented.

However, when the valve 70 is closed, the balloon catheter 51 and the guide wire 56 which are arranged in parallel are simultaneously fixed by the packing 74. Therefore, unless the valve 70 is opened, the balloon catheter 51 is not opened. Alternatively, there is a problem that the guide wire 56 cannot be moved.

When the valve 70 is opened, the balloon catheter 51 and the guide wire 5 are opened as shown in FIG.
6 can be moved, but since the inner diameter of the packing 74 is widened to such an extent that the balloon catheter 51 and the guide wire 56 can be moved together, there is a problem that a considerable amount of blood flows out of the cylindrical body 66. Was.

Of course, it is not impossible to suppress the outflow of blood to some extent by finely adjusting the degree of closing of the valve 70 within a range where the operation of the balloon catheter 51 and the guide wire 56 is not hindered. It is not always easy to optimally adjust the degree of closing of the valve 70 instantaneously by relying on the pressure, and if the adjustment of the valve 70 is troublesome, there is a problem that blood flows out during that time.

[0009] Such a problem, as described above,
This is a problem that occurs not only when the balloon catheter and the guide wire are inserted in parallel through the packing. For example, when two or more linear bodies are passed through one packing in parallel, such as when two catheters are inserted through one packing in parallel, it is necessary to move only one linear body. Even if it does, the tightening by the packing must be loosened, causing the same problem as above.

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 sealing means such as packing from the outer periphery of a plurality of linear bodies inserted into a tubular passage. When a medical device having a structure for sealing a tubular passage in a liquid-tight manner is used, only a specific linear body can be kept in an operable state even when a sealing means is brought into close contact. Is to do.

[0011]

Means for Solving the Problems and Effects of the Invention In order to achieve the above object, according to the present invention, as described in claim 1, a plurality of linear bodies are inserted in parallel. A part of the inner peripheral surface of the tubular passage, and the tubular passage, and can be deformed to a state in which it is in close contact with the outer periphery of the linear body as necessary, so that a gap with the linear body can be sealed in a liquid-tight manner. A plurality of linear bodies, wherein the tubular passages are parallel to the remaining parts of the plurality of linear bodies in a state where a part of the plurality of linear bodies is inserted inside. A first tubular portion that can be inserted into the first tubular portion. Even when the first tubular portion is pressed from the outer periphery by the sealing means, the state in which the linear body is relatively movably inserted can be maintained. It is characterized by having a structure.

According to this insertion aid, when a medical device having the above-described linear body, tubular passage, and sealing means is used, a plurality of linear bodies are placed inside the first tubular portion. The first tubular portion is inserted into the tubular passage in parallel with the remaining part of the plurality of linear bodies in this state. In the medical device, the gap between the tubular passage and the linear body can be sealed in a liquid-tight manner by a sealing means as needed, and the sealing means is in close contact with the outer periphery of the linear body and the first tubular portion at the time of closing. To compress the linear body and the first tubular portion.
Even when the tubular part is pressed from the outer periphery by the sealing means, the linear body has a structure capable of maintaining a state in which the linear body is relatively movably inserted, even if the sealing by the sealing means is performed, at least Only the linear body inserted into the first tubular portion is maintained in a state where it is relatively movable in the axial direction.

Therefore, of the plurality of linear members, only the linear member for which the operation of independently moving is performed is the first member of the insertion assisting tool.
If it is inserted through the tubular portion, only the specific linear body can be arbitrarily moved even when the gap is closed by the sealing means. In addition, the inner diameter of the first tubular portion can be prepared in advance in accordance with the diameter of the linear body inserted therein, so that the linear body is moved by unsealing the seal itself by the sealing means. The outflow of the sealed liquid (eg, blood) is also suppressed. In addition, even if it is not necessary to finely adjust the degree of sealing by the sealing means, if it is desired to move the entire linear body, completely closing the sealing by the sealing means, while fixing only a part of the linear body, If it is desired to make the rest movable, it is sufficient to completely seal with the sealing means, so that it is not necessary to adjust the degree of sealing by the sealing means, and the adjusting operation can be performed quickly.

In this insertion aid, the first tubular portion has a structure capable of maintaining the state in which the linear member is inserted so as to be relatively movable even when the first tubular portion is pressed from the outer periphery by the sealing means. , An ideal example of such a structure would be
Although the first tubular portion may have a high rigidity that does not collapse at all even when pressed from the outer periphery, in practice,
If it is crushed enough not to hinder the movement of the internal linear body,
There is no particular problem that slight collapse occurs. Further, the allowable amount of the crushing can also vary depending on the magnitude of the frictional resistance in the first tubular portion. Various metals such as stainless steel and hard resins such as polyimide can be used as materials which have relatively low frictional resistance and can easily secure high rigidity. If these materials are formed into a tube, the first tubular portion can be formed. It can be suitably used as

In the case where a catheter is inserted into a blood vessel as in the case described above, the sealing means mainly functions as a means for preventing outflow of blood. However, the present invention also functions as a means for preventing backflow of a drug solution or the like during infusion.

Next, the insertion assisting device according to a second aspect of the present invention includes a second tubular portion which forms one tubular body continuously with the first tubular portion, and the second tubular portion is provided as required. And a structure capable of closing the gap with the linear body in a liquid-tight manner by deforming to a state in which the linear body is in close contact with the outer periphery of the linear body.

According to this insertion aid, the second tubular portion is
Since the gap between the linear body and the linear body is deformed to a state where it is in close contact with the outer periphery of the linear body, the gap between the linear body and the liquid body is sealed in a liquid-tight manner. Even in such a state, the gap is closed in the second tubular portion, so that outflow of the liquid can be completely prevented.

Therefore, the liquid-tightness can be improved more than that of the first aspect, as well as the same effect as that of the first aspect. Further, since the liquid tightness is enhanced by the second tubular portion, the first tubular portion may have a structure with extremely low liquid tightness.
A sufficient gap between the tubular portion and the internal linear body can be ensured to further enhance the penetrability.

The second tubular portion has a structure which can be deformed to a state in which the second tubular portion is brought into close contact with the outer periphery of the linear body as required, so that a gap with the linear body can be closed in a liquid-tight manner. For example, when the second tubular portion is pressed from the outer periphery by the sealing means, as in the insertion aid of claim 3,
Any material may be used as long as it deforms to a state in which it is in close contact with the outer periphery of the linear body and closes the gap with the linear body in a liquid-tight manner.

According to this insertion assisting tool, the insertion assisting tool is moved relative to the tubular passage so that the first tubular portion is pressed by the sealing means. Can move the linear body
On the other hand, only by setting the second tubular portion to be pressed by the sealing means, the gap inside the insertion assisting tool is closed.

Therefore, the intended insertion assisting device can be formed very simply by using only two kinds of tubular bodies having different rigidities.
In addition, the tubular body which is softly crushed by pressing from the outer periphery may be a tubular body made of a flexible resin material. For example, if a tubular material is formed from a resin material such as polyethylene or nylon, the second tubular body is formed. It can be suitably used as a unit.

Further, for example, as in the insertion assisting device according to the fourth aspect, the second tubular portion has a packing capable of closing a gap with the linear body in a liquid-tight manner, and applies a pressure to the packing. A pressurizing member for deforming the linear body to a state in which it is in close contact with the outer periphery of the linear body, the packing is deformed using the pressurizing member, and the gap between the linear body and the packing is deformed by the packing. Can be closed tightly.

Accordingly, in changing the state of sealing by the second tubular portion, there is no need to release the sealing by the sealing means, and the sealing means and the second tubular portion can be individually operated. It should be noted that which of the structures of claims 3 and 4 should be adopted may be appropriately selected in consideration of usability, manufacturing cost, and the like.

Further, as long as the second tubular portion is capable of closing the gap between the inner linear member and the inner linear member in a liquid-tight manner, the inner linear member may not be particularly firmly held. As in the case of the insertion assisting device according to claim 5, when the second tubular portion is in a state in which the linear body cannot be relatively moved when the second tubular portion is in close contact with the outer periphery of the linear body, the second tubular portion is configured as follows. Since the linear body inserted inside the tubular portion can be fixed at a desired position, if it is desired to fix the linear body at a specific position,
It is not necessary to prepare another fixing tool to fix the linear body.

[0025]

Next, an embodiment of the present invention will be described with reference to an example. As shown in FIG. 1, the insertion assisting tool 1 includes a first tubular portion 3 made of stainless steel, which is not easily crushed even when pressure is applied from the outer periphery, and a second tubular portion made of polyethylene, which is easily crushed when pressure is applied from the outer periphery. 5 and the connector section 7 are arranged in series, and
A lumen 9 for the book is formed.

In the lumen 9 of the insertion assisting device 1 thus configured, a portion of the guide wire 56 passed through the rapid exchange type balloon catheter 51 shown in FIG. Is passed through, and FIG.
(A), as shown in FIG. 7 (b), the insertion assisting tool 1 and the catheter shaft 52 of the balloon catheter 51 are arranged inside the Y connector 64 in a state of being arranged in parallel. Since the Y connector 64 is the same as that shown in FIGS. 5 and 6, detailed description is omitted here.

In such an arrangement state, if the insertion assisting tool 1 is moved along the guide wire 56, FIG.
2, the first tubular portion 3 can be arranged inside the packing 74, and as shown in FIG. 2B, the second tubular portion 5 can be arranged inside the packing 74.

Here, when the first tubular portion 3 is arranged inside the packing 74, as shown in FIG. 2A, the first tubular portion 3 does not collapse even when the valve 70 is closed. 56 is in a state where it can freely move in the axial direction. In addition, in FIG. 2A, for convenience of clearly illustrating both the lumen 9 of the insertion assisting tool 1 and the guide wire 56,
Although the gap between the lumen 9 of the insertion assisting tool 1 and the guide wire 56 is drawn relatively large, in practice, the guide wire 56
The inner diameter of the lumen 9 of the insertion assisting tool 1 is set according to the outer diameter of the insertion assisting tool 1, and the gap between them is extremely small. Therefore, the amount of blood flowing out through the lumen 9 of the insertion assisting tool 1 is extremely small, and the outflow of blood is suppressed as compared with the conventional case where the guide wire 56 is moved after the valve 70 is opened. be able to.

Further, when the second tubular portion 5 is disposed inside the packing 74, as shown in FIG. 2B, when the valve 70 is closed, the second tubular portion 5 is crushed and the guide wire 56 is collapsed.
, So that a very small amount of blood can be prevented from flowing out from the lumen 9. In addition, since the inner peripheral surface of the second tubular portion 5 has an appropriate frictional resistance, the guide wire 56 cannot move in the axial direction. Therefore, when it is desired to fix the guide wire 56 at a specific position, the guide wire 56 can be fixed using the pressing force from the packing 74 without preparing a separate fixture.

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 insertion assisting tool 1, the second tubular portion 5 has the packing 7 on the Y connector 64 side.
When pressed from the outer circumference by the outer periphery 4, the inner cavity 9 is flexibly collapsed.
Was sealed in a liquid-tight manner, but the insertion assisting tool itself may be provided with a packing so as to stop the bleeding.

More specifically, for example, as shown in FIG. 3 (a) and FIG. 3 (b), the first tubular member made of stainless steel which does not easily collapse even when pressure is applied from the outer periphery thereof. At the end of the portion 15, a second tubular portion 17 that can optionally stop the outflow of blood is provided, and a single lumen 19 is formed so as to penetrate them. The second tubular portion 17 includes a tubular portion 20 that is continuous with the first tubular portion 15, an operating member 22 that is screwed to the outer periphery of the tubular portion 20, and an interposition between the tubular portion 20 and the operating member 22. If the packing 24 is deformed by the pressing force from the operating member 22 so that the inner diameter of the packing 24 is reduced, the packing 24 comes into close contact with the guide wire 56 and the outflow of blood is prevented. You.

Therefore, if the first tubular portion 15 of the insertion assisting tool 11 is disposed inside the packing 74 of the Y connector 64 and the valve 70 of the Y connector 64 is closed, the operation member By simply operating 22, the guide wire 56 can be moved, and the outflow of blood through the lumen 19 of the insertion assisting tool 11 can be stopped.
It is not necessary to perform an operation of opening the valve 70 and moving the insertion assisting tool 11 as in the insertion assisting tool 1 described above.

[Brief description of the drawings]

FIG. 1 is a side view of an insertion aid illustrated as an embodiment.

FIG. 2 is a sectional view showing a use state of the insertion assisting tool.

3A and 3B are insertion assisting tools exemplified as another embodiment, wherein FIG. 3A is a side view thereof, and FIG. 3B is a cross-sectional view of a main part thereof.

FIG. 4 is a side view of a rapid exchange type balloon catheter and a guide wire.

FIG. 5 is a schematic configuration diagram of a balloon catheter and related devices.

FIG. 6 is a sectional view showing the internal structure of the Y connector.

[Explanation of symbols]

1, 11 ... insertion aid, 3, 15 ... first tubular part, 5, 17 ... second tubular part, 7 ... connector part,
9, 19 ... lumen, 20 ... cylindrical part, 22 ... operation member, 24 ... packing.

Claims (5)

[Claims] 1. A plurality of linear bodies, a tubular passage through which the plurality of linear bodies are inserted in parallel, and a part of an inner peripheral surface of the tubular passage, and an outer periphery of the linear body as necessary. An insertion aid that is used together when using a medical device having a sealing means capable of closing a gap between the linear body and the linear body in a liquid-tight manner by deforming to a state in which the plurality of linear bodies are in close contact with each other. A first tubular portion that can be inserted into the tubular passage in parallel with the remaining portions of the plurality of linear bodies while partially penetrating the inside of the plurality of linear bodies; The insertion assisting tool has a structure capable of maintaining a state in which the linear body is relatively movably inserted even when the linear body is pressed from the outer periphery. 2. The insertion assisting device according to claim 1, further comprising: a second tubular portion that forms one tubular body continuously with the first tubular portion, wherein the second tubular portion is provided as necessary. An insertion assisting tool having a structure capable of deforming to a state in which it is in close contact with the outer periphery of the linear body so as to close a gap with the linear body in a liquid-tight manner. 3. The insertion assisting device according to claim 2, wherein the second tubular portion is deformed to a state in which the second tubular portion is in close contact with the outer periphery of the linear body when pressed from the outer periphery by the sealing means. An insertion aid characterized in that a gap between the wire and the linear body is closed in a liquid-tight manner. 4. The insertion assisting device according to claim 2, wherein the second tubular portion is a packing capable of closing a gap with the linear body in a liquid-tight manner, and by applying pressure to the packing. A pressurizing member for deforming the linear body to a state in which it is in close contact with the outer periphery of the linear body. 5. The insertion assisting device according to claim 2, wherein the second tubular portion is in close contact with an outer periphery of the linear body.
An insertion aid, wherein the linear body is in a state in which it cannot be relatively moved.