JPS63305857A - Laser probe for treating thrombus - Google Patents

Abstract

PURPOSE:To eliminate danger such that a blood vessel is punctured by laser beam and to sufficiently delate a constriction part, by mounting a leading end tip having a leading end part heated by laser beam and a cutter driver so as to slide to remove an object to be removed. CONSTITUTION:Laser beam irradiates and heats the leading end part 14 of the leading end tip 11 position in front of an optical fiber 5. A laser probe 3 is further advanced and the leading end part 14 is pressed to a thrombus (k) and the heated part of said thrombus is destructed to dilate a blood vessel (b). The leading end part 14 of the leading end tip 11 is advanced to the front of the thrombus (k) to position the trombus (k) remaining in the blood vessel (b) to the space part 15 between the base part 12 and leading end part 14 of said tip. When a guide tube 18 is slid in the advance direction, the blade 17 provided to the leading end of a cutter 16 slides to cut off the thrombus (k). There is no danger in such a case that the thrombus (k) is irradiated with laser beam at be removed and the blood vessel (b) can be sufficiently dilated as compared with a case removing the thrombus only by the leading end chip 11.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Field of Application] This invention relates to a laser probe for thrombus treatment for removing thrombi generated in blood vessels.

[Prior Art] When a constriction occurs in a blood vessel due to a thrombus, a method is known for removing the thrombus.The first method involves introducing a laser probe into the blood vessel. , the thrombus is irradiated and cauterized with laser light emitted from this laser probe.

In addition, as a second method, as shown in Japanese Patent Application Laid-Open No. 61-73644, a metal tip is provided in front of the laser beam emission end, the tip is heated by the laser beam, and the tip is heated by the laser beam to cause the blood clot to form. It is used to expand narrowed blood vessels by applying pressure.

[Problems to be Solved by the Invention] However, according to the first method, high-power laser irradiation must be performed in order to vaporize the thrombus with laser light. There was a risk of perforation.

In addition, the second method uses a heated tip to destroy blood clots and expand blood vessels, and because it does not have a structure that actively removes blood clots, it is not possible to expand blood vessels beyond the outer diameter of the tip. Something happened.

This invention was made in view of the above circumstances, and its purpose is to provide a laser for thrombus treatment that eliminates the risk of perforation of blood vessels due to laser light and that enables sufficient dilation of the stenosed area. The purpose is to provide probes.

[Means and effects for solving the problems] In order to solve the above problems, the present invention includes an optical fiber that guides a laser beam, and an optical fiber that is provided at the output side end of the optical fiber and projects in front of the output end of the optical fiber. The present invention includes a tip having a tip that is heated by the laser beam, and a cutter that is slidably provided with respect to the tip and is driven to slide to remove the object to be removed. Then, the blood vessel is dilated to some extent with the distal end of the distal tip heated by the laser beam, and then further dilated with the cutter.

[Embodiment] An embodiment of the present invention will be described below with reference to FIGS. 1 and 2. Reference numeral 1 in FIG. 2 indicates a laser device, and this laser device 1 is provided with a connecting portion 2. As shown in FIG. A base end of a laser probe 3 is detachably connected to this connecting portion 2. This laser probe 3 is formed by inserting an optical fiber 5 covered with a jacket 4 through a flexible sheath 6, as shown in FIG. A slot 7 is formed at one end of the distal end of the sheath 6, and one end of a distal tube 8, which has a collar 8a having the same diameter as the sheath 6, is fitted and fixed on the outer circumferential surface of the midway portion in the axial direction. The tip of the optical fiber 5 is fitted and fixed at one end. Note that the tip of the optical fiber 5 is exposed from the jacket 4.

A male thread is formed on the outer peripheral surface of the other end of the tip tube 8, and a tip 11 is screwed into this male thread 9.

This distal tip 1 is provided at a tubular base 12 screwed onto the distal tube 8 and at the distal end of a connecting portion 13 extending from the distal end surface of the base 12, facing the distal end surface of the optical fiber 5. It is formed from a cup-shaped tip 14. A space 15 is formed between the distal end portion 14 and the base portion 1, into which a thrombus k, which is an object to be removed, generated in the blood vessel enters, as will be described later.

A cylindrical cutter 16 is provided at the tip of the laser probe 3.
is fitted on the outside so that it can slide freely. The tip of this cutter 16 is formed into a sharp blade 17, and the tip of a guide tube 18 is connected to the rear end. This guide tube 18
The rear end is connected to a movable handle 19 that constitutes a drive mechanism. This movable handle 19 is slidably provided on the sheath 6. Further, a fixed handle 21 is fixed to the sheath 6 via a fixing member 22. The movable handle 19 is rotatably connected at its midpoint to a connecting member 23 protruding from the fixed handle 21, and at one end is connected to the arrow by a tension spring 24 interposed between the handles. It is biased in the direction shown.

Therefore, by rotating the other end of the movable handle 19 against the biasing force of the tension spring 24, the guide tube 8 can be slid in the forward direction.

Ru. First, once the laser probe 3 is introduced endoscopically into the thrombus in the blood vessel y, the laser device 1 is activated to emit a laser beam from the optical fiber 5. Then, the laser beam irradiates and heats the tip 14 of the tip 1 located in front of the optical fiber 5. Once the tip 14 is heated in this way, the laser probe 3 is further advanced and the tip 14 is pressed against the thrombus k. As a result, the portion of the thrombus heated by the tip 14 is destroyed and the blood vessel is dilated.

Once the blood vessel has been expanded to a certain extent by the distal end 14 in this manner, the distal end 14 of the distal tip 11 is advanced forward toward the thrombus, as shown in FIG. k is the space 15 between the base 12 and the tip 14
to be located. In this state, the movable handle 19 is gripped against the biasing force of the tension spring 24 and the guide tube 18 is moved forward, so that the thrombus k located within the space 15 can be removed.

In other words, according to this method of removing a thrombus, the distal tip 11 heats and destroys the thrombus, and then the cutter 16 removes it, so there is not only no risk of removing it by direct irradiation with laser light. , distal tip] 1, the blood vessel can be expanded sufficiently compared to the case where the blood vessel is removed using only the tip 1.

In addition, at that time, if air is blown into the sheath 6 and flows out through the slot 7 of the tip tube 8, the smoke generated from the thrombus k can be extinguished by treatment with laser light, and the tip tip 11 can be cooled. .

FIG. 3 shows a second embodiment of the present invention, in which a small hole 31 is made in the center of the distal end 14 of the distal tip 11, and when the distal end 14 is abutted against the thrombus k, the small hole 31 is opened. Laser light can be irradiated from 31. In this way, when the blood vessel is completely constricted by the thrombus k, the thrombus can be removed by first making a hole with a laser beam and then removing the thrombus in the same manner as in the first embodiment.

FIG. 4 shows a second embodiment of the invention, which includes a cutter 16.
It is not cylindrical but arcuate.

5 to 9 show a fourth embodiment of the present invention, in which the cutter 16 is slid while being rotated. That is, the collar 8a of the tip tube 8 has a seventh
As shown in the figure, a circumferential groove 32 is formed. Further, as shown in FIG. 8, the cutter 16 has a stopper 33 formed on its inner circumferential surface at its proximal end, which rotatably engages with the circumferential groove 32, and a portion of the circumferential wall is formed as shown in FIGS. As shown in the figure, it is notched along the axial direction, and one end surface thereof is formed into a blade 17. Furthermore, a cam groove 33a is provided on the outer peripheral surface of the cutter 16.
is formed in a spiral shape. In addition, the guide tube 18
A cylindrical drive member 34 is connected to the tip. As shown in FIG. 6, a protrusion 35 is provided on the inner surface of the tip end of the drive member 34, and this protrusion 35 engages with the cam groove 33a of the cutter 16.

According to such a structure, when the guide tube 18 is slid in the forward direction, the protrusion 35 of the drive member 3 that is interlocked with the guide tube 18 moves into the helical cam of the cutter 16. Try to move 833a. Since the cutter 16 is rotatably connected to the tip tube 8, it is slid in the rotational direction by the protrusion 35 of the drive member 34. Therefore, the thrombus k located in the space 15 between the base [2] of the distal tip 11 and the distal end 14 can be removed by the blade 17 of the cutter 16 that slides in the rotational direction.

〔Effect of the invention〕

As described above, the present invention provides a tip having a tip that is heated by a laser beam at the output end of an optical fiber, heats the tip to remove the object, and then heats the tip to remove the object. The remaining material to be removed is further removed using a cutter that is slidably provided against the cutter. Therefore, not only can the object to be removed be reliably and sufficiently removed by the tip and the cutter, but there is no risk of removing the object by directly irradiating the object with a high-power laser beam.

[Brief explanation of drawings]

FIG. 1 is a sectional view of the tip of a probe showing a first embodiment of the present invention, FIG. 2 is a schematic diagram of a laser probe connected to a laser device, and FIG. 3 is a cross-sectional view of a probe tip showing a first embodiment of the invention. FIG. 4 is a half-sectional view of the distal tip shown in FIG.
FIG. 5 is a cross-sectional view of the tip of the probe showing the fourth embodiment of the invention, FIG. 6 is a cross-sectional view of the driving member, and FIG. 7 is a cross-sectional view of the tip tube. 8 is a half sectional view of the cutter, and FIG. 9 is a sectional view taken along line IX--IX in FIG. 8. 5... Optical fiber, 11... Tip tip, 14.
...Tip, 16...cutter. Applicant's agent Patent attorney Jun Tsuboi Figure 6 Figure 7 Figure 9

Claims (1)

[Claims] an optical fiber that guides a laser beam; a tip tip that is provided at the output end of the optical fiber and has a tip that protrudes in front of the output end of the optical fiber and is heated by the laser beam; and a tip tip that is slidable with respect to the tip tip. What is claimed is: 1. A laser probe for thrombus treatment, comprising: a cutter that removes an object to be removed by sliding the cutter.