JPWO2007007560A1 - catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a catheter capable of accurately and easily recognizing or measuring a length other than the effective length of a balloon (for example, measuring the length of a lesion length). A balloon catheter C1 includes an elongated and double tubular catheter body 2. The catheter body 2 includes an outer tube 3 as an outer tubular member and an inner tube 4 as an inner tubular member disposed inside the outer tube 3. The tip of the inner tube 4 protrudes slightly from the tip of the outer tube 3, one end of the balloon 6 is fixed to the tip edge of the inner tube 4, and the other end of the balloon 6 is fixed to the tip edge of the outer tube 2. Has been. The inner tube 4 is provided with three or more (here, seven) markers 10. [Selection] Figure 2

Description

  The present invention relates to a catheter provided with a marker that does not transmit radiation.

  The conventionally known balloon catheters of the following Patent Documents 1 and 2 are each provided with a marker that does not transmit radiation, but this is to make it possible to recognize the effective length of the balloon during the operation, and therefore the number thereof is There are usually two per balloon catheter and the placement is limited to the tip and end of the balloon.

Japanese Patent Publication No. 4-067991 Japanese Patent Publication No. 6-026576

  However, in the conventional balloon catheter, conversely, only the effective length of the balloon can be recognized. Further, the conventional balloon catheter can recognize only the effective length of the balloon catheter itself, and has no concept of measuring a length other than itself.

  In general, the following two methods are used to grasp the lesion length of an affected area for the purpose of acquiring data for treatment. That is, a first method is to inject a contrast medium into a blood vessel and visually determine the length of a shadow on a radiographic image. A second method is to measure a lesion length from a cross-sectional image obtained by analyzing the application result after applying the catheter with an ultrasonic diagnostic apparatus.

  However, the accuracy may not be sufficient in the former of these length grasping methods, and the application and analysis in advance are required in the latter, which takes enormous effort.

  SUMMARY OF THE INVENTION An object of the present invention is to provide a catheter that can easily and accurately recognize or measure lengths other than the effective length of a balloon (for example, measurement of the length of a lesion length). It is a thing.

  To achieve the above object, the invention described in claim 1 includes an elongated tubular member, and in the tubular member, three or more markers that do not transmit radiation are arranged in the axial direction. The external length can be measured by these arranged markers.

  The invention according to claim 2 includes an elongated tubular member, and an elongated guide wire tubular member disposed adjacent to the elongated tubular member and extending over at least a tip edge portion. In the tubular member, three or more markers that do not transmit radiation are arranged in the axial direction, and the external length can be measured by these arranged markers.

  The invention according to claim 3 further includes a catheter body including an elongated outer tubular member and an elongated inner tubular member disposed inside the elongated tubular member, and the distal end of the inner tubular member is an outer tubular member. A balloon is provided that protrudes slightly from the tip of the member, one end is fixed to the tip edge of the inner tubular member, and the other end is fixed to the tip edge of the outer tubular member, and the inner tubular member transmits radiation. Three or more markers are arranged in the axial direction, and the outside length can be measured by these arranged markers.

  Furthermore, the invention described in claim 4 is the above invention, wherein the markers are regularly arranged.

  In addition, the invention according to claim 5 is the above-mentioned invention, characterized in that the invention is regularly arranged on the proximal side from the effective length portion of the balloon.

  The invention according to claim 6 is the above invention, wherein the marker is a metal, a resin, which is tubular, coiled, ring-shaped or spiral-shaped.

  Furthermore, the invention according to claim 7 is the above invention, wherein a part of the three or more markers has an axial length different from the others.

  In addition, the invention described in claim 8 is the above invention, wherein the outer surface of the marker is continuous with the outer surface of the tubular member.

  In addition, the matter of “not transmitting radiation” in the present invention is not limited only to the meaning of completely blocking radiation, but within a range that can be identified on an image that shows light and shade according to the degree of transmission of radiation. This includes the case where the light is slightly transmitted and most of the light is blocked.

  According to the present invention, since it is possible to measure the length by arranging three or more markers in the axial direction, recognition or measurement of a length other than the effective length of the balloon (for example, measurement of the length of the lesion length). ) Can be executed accurately and easily, and the catheter can be made extremely easy to use.

  Hereinafter, a catheter according to an embodiment of the present invention will be described with reference to the drawings as appropriate.

[First Embodiment]
FIG. 1 is an overall explanatory view of a balloon catheter C1 according to the first embodiment, and FIG. 2 is an explanatory view of the distal end side of the balloon catheter C1, and the balloon catheter C1 includes an elongated and double tubular catheter body 2. ing. The catheter body 2 includes an outer tube 3 as an outer tubular member and an inner tube 4 as an inner tubular member disposed inside the outer tube 3. The outer tube 3 and the inner tube 4 are formed using polyethylene.

  A hub 5 for connecting a contrast medium injector, a balloon expansion air injector, or the like is provided at the proximal end portion of the outer tube 3. The tip of the inner tube 4 slightly protrudes from the tip of the outer tube 3, one end of the balloon 6 is fixed to the tip edge of the inner tube 4, and the other end of the balloon 6 is fixed to the tip edge of the outer tube 2. Is fixed. The balloon 6 is formed using a polyether block amide copolymer.

  The inner tube 4 has an outer diameter smaller than the inner diameter of the outer tube 3 and is disposed in the outer tube 3 and the balloon 6. Between the outer tube 3 and the inner tube 4 is a sub-lumen 7 communicating with the inside of the balloon 6. Moreover, the inner side of the inner tube serves as a main lumen 8 that slidably receives the guide wire G.

  As shown in FIG. 2, the inner tube 4 is provided with three or more (here, seven) markers 10. As shown in FIG. 4, each marker 10 is formed in a short tubular shape, and uses a material that does not transmit radiation, such as a resin mixed with a radiopaque material, a resin deposited with a radiopaque material, or a metal. Is formed. Preferably, a platinum-iridium alloy (for example, weight ratio of platinum: iridium = 90: 10), gold, tungsten, tantalum, or a combination thereof is selected as the metal, and the above metal is vapor-deposited as a resin or barium sulfide. A mixture of contrast agents such as

  As shown in FIG. 3, the outer diameter of each marker 10 is the same as the outer diameter of the inner tube 4 other than the portion where the marker 10 is installed. Therefore, the outer surface (cylindrical surface) of the marker 10 and the outer surface (same diameter) of the inner tube 4. The cylindrical surface) is continuous. Each marker 10 is fixed in a non-adhered state by being caulked after passing through the inner tube 4. The marker 10 is temporarily fixed on the inner tube 4 immediately before being caulked, and is further inserted into the groove of the mold having a groove having a U-shaped cross section, and is compressed through the mold, so that the inner tube 4 is It is caulked against.

  All the markers 10 have the same axial length. Further, as shown in FIG. 2, the seven markers 10 are arranged at equal intervals, and five of them are arranged in the balloon 6, and the other two are based on the balloon 6. It is arranged on the end side. The first and fourth markers 10 counted from the distal end side also indicate the effective length of the balloon 6.

  Such a balloon catheter C1 is used as shown below, for example. That is, first, a practitioner (physician) introduces the balloon catheter C1 into the blood vessel 40 using a guiding catheter, a guide wire, or the like, and places the balloon 6 in the narrowed portion 50 of the blood vessel 40 according to a known method. In this state, the practitioner injects a contrast medium into the blood vessel 40 through the guiding catheter. In this state, the practitioner can recognize the shape of the stenosis 50 and the seven markers 10 by looking at an image that shows light and shade according to the degree of radiation transmission, and the seven markers 10 are equal. Since it is the interval, the practitioner can actually measure the length of the narrowed portion 50 by visually confirming how many of the markers 10 correspond.

  In the above balloon catheter C1, since three or more (seven) markers 10 are arranged on the inner tube 4 and the length can be measured, the length of the stenosis 50 etc. outside the balloon catheter C1 can be accurately determined. It can be measured well and easily, and a lesion length and the like important for determining various treatment indices including selection of a stent size can be obtained very easily and accurately. Further, since the seven markers 10 are equally spaced or have the same axial length, it is easy to grasp the length of the narrowed portion 50 or the like.

  Furthermore, since the outer surface of the marker 10 and the outer surface of the inner tube 4 are continuous, the outer diameter of the balloon 6 before expansion can be reduced, and the balloon 6 can be easily sent to the stenosis 50 or the like. A larger auxiliary lumen formed between the inner tube 4 and the outer tube 3 can be secured without impairing the operation performance when the catheter C1 is moved along the guide wire.

  Since the marker 10 is fixed to the inner tube 4 in a non-adhesive state, the marker 10 does not completely bind the inner tube 4 on the inner side, and the marker 10 fixing portion of the inner tube 4 is somewhat from the marker 10. Can move independently. Therefore, even if many markers 10 are installed adjacent to each other in the balloon catheter C1, it is possible to prevent the inner tube 4 from being completely bound to these markers 10 and being restrained in a straight line. Flexibility and followability can be maintained (similar to the outer tube 3).

[Second Embodiment]
FIG. 6 is a schematic view of the distal end side of the balloon catheter C2 according to the second embodiment of the present invention. This balloon catheter C2 is different from the balloon catheter C1 according to the first embodiment only in the marker. That is, the marker 60 according to the second embodiment is formed in the same manner as the marker 10 of the first embodiment, but the intervals in the axial direction of the marker 60 are regularly arranged with small intervals A and large intervals B alternately. Are arranged in a simple pattern. Even with the balloon catheter C2 having such an arrangement of the markers 60, the lesion length and the like can be easily measured with high accuracy.

[Third Embodiment]
FIG. 7 is a schematic view of the distal end side of the balloon catheter C3 according to the third embodiment of the present invention. This balloon catheter C3 is different from the balloon catheter C1 according to the first embodiment only in the marker. That is, as the cylindrical marker according to the third embodiment, there are two types of the marker 10a having a relatively long length L1 and the marker 10b having a relatively short length L2, and the markers 10a and 10b. Are arranged alternately. The balloon catheter C3 having such an arrangement of the markers 10a and 10b can also easily measure the lesion length and the like with high accuracy.

[Fourth Embodiment]
FIG. 8 is a schematic view of the distal end side of a balloon catheter C4 according to the fourth embodiment of the present invention. This balloon catheter C4 is different from the balloon catheter C1 according to the first embodiment only in the marker. In other words, there are two types of cylindrical markers according to the fourth embodiment: a marker 60a with a relatively long length L1 and a marker 60b with a relatively short length L2, and the marker 60a is a balloon. The marker 60b is arranged at a position indicating the effective length 61, and a plurality of markers 60b are arranged on the proximal end side of the marker 60a. Even with the balloon catheter C4 having such an arrangement of the markers 60a and 60b, it is possible to easily and accurately measure the lesion length and the like by moving the balloon catheter C4 further forward from the lesion, and the length in the axial direction. The effective length of the balloon 61 can be easily recognized by the long marker 60a.

[Other Embodiments Related to Balloon Catheter]
In addition, each embodiment of this invention formed by changing the said embodiment which concerns on a balloon catheter is illustrated, respectively. There are three or more marker intervals and axial lengths. The number of markers is 4, 5, 6, 8 or more. The marker is adhered to the inner tube with an adhesive. The shape of the marker is a ring shape as shown in FIG. 9 (a), a coil shape that is wound without a gap as shown in FIG. 9 (b), or an interval as shown in FIG. 9 (c). The spiral is wound or a combination thereof. By forming the marker in a coil shape or a spiral shape, it is possible to prevent a decrease in flexibility of the catheter, and in particular, it is possible to prevent a decrease in flexibility even when the marker is bonded to the inner tube.

  Three or more markers are provided on a non-vascular catheter. Alternatively, three or more markers may be provided in an over-the-wire type balloon catheter instead of the rapid exchange type balloon catheter of FIG. Or provided on an infusion catheter for infusion.

  The inner tube or outer tube is made of polyolefin such as polypropylene, ethylene-propylene copolymer, and ethylene-vinyl acetate copolymer, and thermoplastic resin such as polyvinyl chloride, polyurethane, polyamide, polyamide elastomer, and polyester elastomer. Form. Balloon made of polyethylene, polyethylene terephthalate, polypropylene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, polyvinyl chloride, cross-linked ethylene-vinyl acetate copolymer, polyurethane, polyamide, polyamide elastomer, polyimide, or polyimide It is formed using an elastomer.

[Fifth Embodiment]
FIG. 10 is a schematic view of the distal end side of the suction catheter C5 according to the fifth embodiment of the present invention. The suction catheter C5 includes an elongated suction tubular member 70 for sucking a thrombus and the like. The suction tubular member 70 has a length that reaches the narrowed portion 72 of the blood vessel 71 from the introduction portion, and a hub (not shown) is provided at the end portion (base end) on the introduction portion side. A suction device or the like is connected to the hub.

  Further, an elongated guide wire tubular member 74 is provided outside the distal end edge of the suction tubular member 70. The guide wire tubular member 74 receives the guide wire G in a slidable manner. In the guide wire tubular member 74, three or more (five here) markers 76 that do not transmit radiation are arranged at equal intervals in the axial direction, and the length outside the distal end edge of the suction catheter C5 is measured. It is possible. The outer surface of the guide wire tubular member 74 and the outer surface of each marker 76 are continuous with each other so that the blood vessel 71 and the like are not damaged.

  In the suction catheter C5 described above, three markers 76 are arranged on the guide wire tubular member 74 so that the external length can be measured. Therefore, the length of the stenosis 72 can be easily measured with high accuracy. In addition, an important therapeutic index can be easily obtained even when the tissue around the stenosis 72 is sucked.

[Other Embodiments]
In addition, the embodiment of the present invention which is mainly obtained by changing the above embodiment will be exemplified. In the suction catheter, the marker arrangement is changed to the same as in the second to fourth embodiments. The guide wire tubular member may be extended to the base edge, may be another lumen provided in the suction tubular member, or may be integrally formed with the guide wire tubular member. In addition, in a suction catheter used for vessels other than blood vessels, markers are arranged so that the external length can be measured. Alternatively, the markers are arranged so that the external length can be measured in any tubular member of the other catheter.

1 is an overall explanatory view of a balloon catheter according to a first embodiment of the present invention. It is explanatory drawing of the front end side of the balloon catheter in FIG. It is explanatory drawing of the cross section along the axial direction of the inner tube in FIG. It is explanatory drawing of the marker in FIG. It is explanatory drawing which shows an example of the use condition of the balloon catheter which concerns on 1st Embodiment of this invention. It is explanatory drawing of the front end side of the balloon catheter which concerns on 2nd Embodiment of this invention. It is explanatory drawing of the front end side of the balloon catheter which concerns on 3rd Embodiment of this invention. It is explanatory drawing of the front end side of the balloon catheter which concerns on 4th Embodiment of this invention. (A)-(c) is explanatory drawing of the example of a change of the marker of FIG. It is explanatory drawing of the front end side of the suction catheter which concerns on 5th Embodiment of this invention.

Explanation of symbols

C1-C4 balloon catheter C5 suction catheter 2 catheter body 3 outer tube 4 inner tube 6 balloon 10, 10a, 10b, 60, 60a, 60b, 76 marker 70 tubular member for suction 74 tubular member for guide wire

Claims (8)

Including an elongated tubular member;
In the tubular member, three or more markers that do not transmit radiation are arranged in the axial direction,
An external length can be measured with these arranged markers. An elongated tubular member, and an elongated guide wire tubular member disposed adjacent to the elongated tubular member and extending over at least the tip edge portion;
In the guide wire tubular member, three or more markers that do not transmit radiation are arranged in the axial direction,
An external length can be measured with these arranged markers. A catheter body including an elongated outer tubular member and an elongated inner tubular member disposed inside the elongated tubular member;
The tip of the inner tubular member protrudes slightly from the tip of the outer tubular member;
A balloon having one end fixed to the distal end edge of the inner tubular member and the other end fixed to the distal end edge of the outer tubular member;
In the inner tubular member, three or more markers that do not transmit radiation are arranged in the axial direction,
An external length can be measured with these arranged markers. The catheter according to any one of claims 1 to 3, wherein the markers are regularly arranged. 4. The balloon catheter according to claim 3, wherein the markers are regularly arranged on the proximal side of the effective length portion of the balloon. The catheter according to any one of claims 1 to 5, wherein the marker is a tubular, coiled, ring-shaped or spiral metal or resin. The catheter according to any one of claims 1 to 6, wherein some of the three or more markers have different axial lengths from the others. The catheter according to any one of claims 1 to 7, wherein an outer surface of the marker is continuous with an outer surface of the tubular member.

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