WO1997030746A1 - Instrument medical facilitant l'insertion - Google Patents

Instrument medical facilitant l'insertion Download PDF

Info

Publication number
WO1997030746A1
WO1997030746A1 PCT/JP1997/000479 JP9700479W WO9730746A1 WO 1997030746 A1 WO1997030746 A1 WO 1997030746A1 JP 9700479 W JP9700479 W JP 9700479W WO 9730746 A1 WO9730746 A1 WO 9730746A1
Authority
WO
WIPO (PCT)
Prior art keywords
sheath
lumen
dilator
diameter
distal end
Prior art date
Application number
PCT/JP1997/000479
Other languages
English (en)
Japanese (ja)
Inventor
Kyoko Minami
Osamu Egawa
Original Assignee
Nippon Zeon Co., Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Nippon Zeon Co., Ltd. filed Critical Nippon Zeon Co., Ltd.
Publication of WO1997030746A1 publication Critical patent/WO1997030746A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A61M2025/0687—Guide tubes having means for atraumatic insertion in the body or protection of the tip of the sheath during insertion, e.g. special designs of dilators, needles or sheaths
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00—Dilators with or without means for introducing media, e.g. remedies

Definitions

  • the present invention relates to a medical insertion aid. More specifically, the present invention relates to a medical insertion aid which comprises a sheath and a dial, has a low insertion resistance, has a good insertion property into a blood vessel, and can perform examination and treatment without causing pain to a patient. About the tool. Background art
  • Cardiac catheterization which advances the catheter to the heart under fluoroscopy, measures intracardiac pressure and collects blood, contrast diagnostic imaging of cerebral, abdominal, and peripheral blood vessels, heart chamber
  • treatment methods for large intravascular foreign bodies, patent ductus arteriosus, abnormal blood vessels, and valvular stenosis are widely used.
  • a medical insertion aid In order to advance the catheter percutaneously to the target position of the blood vessel, it is necessary to first insert a medical insertion aid into the blood vessel.
  • a medical insertion aid To insert a medical insertion aid into a blood vessel, first make a small incision of 2-3 mm in the skin above the blood vessel, puncture the target artery or vein with a Teflon needle or Seldinger needle, and insert the needle into the inner cylinder. And introduce the guidewire. Next, remove the Teflon force neur or Seldinger mantle tube, insert the dilator into the sheath, fit the dilator of the medical insertion aid with the distal end protruding, and assist the medical insertion along the guide wire. Advance the tool to the desired location in the vessel. At this time, if the tip of the medical insertion aid collides with the living tissue, the resistance of the insertion increases, which may not only cause discomfort and pain to the patient but also may damage the living tissue.
  • the distal end is tapered as sharply as possible, and the distal end of the sheath is hidden behind a barbed shape, so that there is no step between the outer diameter of the sheath and the outer diameter of the sheath. In this way, it is intended to reduce the resistance when the distal end of the sheath collides during insertion.
  • the distal end of the sheath is connected to the distal end of the sheath due to the force applied to the medical insertion aid and the bending of the sheath cannot follow the bending of the sheath. There was a step in the outer diameter away from the outer wall, and the insertion resistance did not decrease as expected.
  • the present inventors have previously proposed a medical insertion aid capable of bringing the distal end of the sheath into close contact with a portion of the bulge of the dailey that is shrunk from the distal end to the proximal end of the bulge.
  • Kaihei 6—3 3 5 5 3 1) although a great reduction in resistance during insertion into living tissue has been achieved, there is a need for a medical insertion aid that can be inserted even more smoothly.
  • the conventional medical insertion aid was straight. Since the medical insertion aid is inserted along the blood vessel, the straight medical insertion aid is inserted obliquely with respect to the outer skin. Therefore, when pulling out the dilator after insertion and inserting a force catheter or the like through the lumen of the sheath, bend the sheath and raise it vertically with respect to the outer skin.
  • the inside of the tube may be deformed into an elliptical shape or may be crushed and bent, a phenomenon called kink. Therefore, the space when the catheter is inserted through the sheath is reduced, and the insertion resistance is increased.
  • An intravascular indwelling device that stores a bent or straight shape using a shape memory alloy or shape memory resin (a device that is left in a blood vessel for a long period of time and infuses a drug solution) is known for patients. Its shape transition near body temperature is very slow, and is unsuitable for a medical insertion aid as a highly urgent medical device. Therefore, there is a need for a medical insertion aid that does not cause kink and has low insertion resistance of a catheter.
  • the present invention provides a medical insertion aid that has low resistance at the time of insertion into living tissue, does not cause discomfort or pain to a patient, does not damage living tissue, and a catheter without kink.
  • the purpose of the present invention is to provide a medical insertion aid having a low insertion resistance. Disclosure of the invention
  • the present inventors have proposed a structure in which the insertion resistance of the medical insertion aid increases due to the step between the sheath and the delay when bent, so that the step does not occur.
  • the insertion resistance can be significantly reduced by making the part hard to bend.
  • the sheath has a curved tube shape
  • the dilator has a straight tube shape
  • the sheath has a straight tube shape.
  • a tubular sheath having a lumen
  • a sheath hub having a hollow portion connected to the proximal end of the sheath and communicating with the lumen of the sheath
  • a tubular dilator having a lumen
  • a proximal end of the dialey A dilator hub that has a hollow portion that is connected to the lumen of the sheath and is connected to the lumen of the sheath, and when the sheath is inserted into the lumen of the sheath and the sheath and the sheath are bent, the distal end of the sheath also A medical insertion aid characterized in that the inner wall is in close contact with the outer wall of the dailey,
  • the second enlarged diameter part that gradually expands more gradually than the diameter part, the reduced diameter part that gradually decreases in diameter, and the outer diameter are almost constant.
  • a curved tube-shaped sheath having a lumen
  • a sheath hub having a hollow portion connected to the proximal end of the sheath and communicating with the lumen of the sheath
  • a straight tube-shaped die tray having a lumen
  • a proximal end of the diet tray A dilator hub having a hollow portion connected to the lumen and communicating with the lumen of the die tray.
  • Medical insertion aid characterized in that it is restored to
  • the material of the sheath is an elastic polymer material having a flexural modulus of 2,000 to 30,000 OkgZcm 2 and a Shore hardness in the range of A80 to D80.
  • the length of the first enlarged part of the dielay is 0.1 to 20 and the length of the second enlarged part is 4.5 to 90 mm.
  • the sum of the first enlarged part and the second enlarged part The medical insertion aid according to item (2), wherein the length of the medical insert is 4.6 to 110, and the length of the reduced diameter portion is 0.5 to 50 faces.
  • the outer diameter of the die is 0.5 to 3 strokes at the start end of the first enlarged part, 0.6 to 4 at the boundary between the first enlarged part and the second enlarged part, and the second enlarged diameter Item (2) is 0.7 to 8 mm at the boundary between the reduced diameter portion and the reduced diameter portion, and the outer diameter at the boundary between the reduced diameter portion and the reduced diameter portion is equal to the outer diameter of the reduced diameter portion, and is 0.5 to 7.5 bandits. Medical insertion aids, and
  • FIG. 1 is a cross-sectional view of a sheath portion of the medical insertion aid
  • FIG. 2 is a perspective view of a hemostatic valve
  • FIG. 3 is a cross-sectional view of a dilator portion of the medical insertion aid.
  • FIG. 4 is a cross-sectional view showing a state in which the medical device is inserted into the lumen of the sheath
  • FIG. 5 is a partial cross-sectional view near the distal end of the medical device.
  • Fig. 6 is a partial cross-sectional view near the distal end of the dialey with the dialy inserted into the lumen of the sheath.
  • Figs. 7 (a) and 7 (b) show the medical insertion, respectively.
  • FIG. 8 is a perspective view of a sheath portion and a dialer portion of the assisting tool.
  • FIG. 8 is a perspective view showing a state in which a dilator is inserted into a lumen of the sheath
  • FIGS. 9 (a) and 9 (b). ) are illustrations of the use of the medical insertion aid
  • FIG. 12, FIG. Figure 14 and Figure 15 is a perspective view of a sheath portion of a medical insertion assisting tool
  • FIG. 16 is a view to explaining the state of use of a medical insertion assisting tool shown in Figure 15.
  • reference numerals 1 are lumens
  • 2 is a sheath
  • 3 is a hollow portion
  • 4 is a sheath hub
  • 5 is a distal end of a sheath
  • 6 is a diary insertion port
  • 7 is a branch tube
  • 8 is a hemostatic valve
  • 9 is a disk.
  • Elastic body, 10 is a slit, 11 is a lumen, 12 is a dilator, 13 is a hollow part, 14 is a dilator hub, 15 is the distal end of the dialer, 16 is the first enlarged portion, and 17 is the second
  • the enlarged diameter part, 18 is the reduced diameter part, 19 is the small torso part
  • 20 is the proximal end of the sheath
  • 21 is the proximal end of the dialey
  • 22 is the opening
  • 23 is the medical insertion aid
  • 24 is the blood vessel
  • 25 is The outer skin
  • 26 is a guide wire
  • 27 is a balloon catheter
  • 28 is a balloon.
  • the sheath portion has a tubular sheath 2 having a lumen 1 communicating from the proximal end to the return end, and a hollow connected to the proximal end of the sheath and communicating with the lumen of the sheath. It comprises a sheath hub 4 having a part 3. It is preferable that the distal end 5 of the sheath has a smaller tube diameter than the proximal end side in order to enhance the close contact with the force dial. In addition, it is preferable to make the thickness of the distal end of the sheath thinner than that of the proximal end in order to eliminate a step in the outer diameter.
  • the sheath hub can be provided with a dilator insertion 6, a branch pipe 7 and a hemostatic valve 8.
  • an elastic polymer material can be used as the material of the sheath.
  • the elasticity is such that the flexural modulus is 2,000 to 30,000 O kgZcm 2 and the Shore hardness is in the range of A80 to D80.
  • a polymer material can be particularly preferably used. If the Shore hardness is less than A80, the distal end of the sheath may be turned upside down because the shape is not stable. If desired, a material that is harder than the middle can be used at the distal end of the sheath. If the Shore hardness exceeds D80, the sheath may have poor flexibility and easily kink.
  • the material of the sheath preferably has a residual strain of 0.1% or less, more preferably 0.01% or less, in 5% stretching for 10 minutes at room temperature. Materials with large residual strain are liable to creep, and when the medical insertion aid is installed in the body, the tightness of the tight contact at the distal end of the sheath decreases, causing the distal end of the sheath to move away from the dilator surface. May rise.
  • examples of the material of the sheath include polyurethane, polyamide, polyester, polyethylene, polypropylene, polyisoprene rubber, polyamide elastomer, and fluorine resin.
  • the material of the sheath hub is not particularly limited, but is preferably a material having appropriate elasticity and hardness for providing a branch tube and a hemostatic valve and fitting the same to the director hub.
  • the material include polyamide, polycarbonate, polyacetal, polyethylene, polypropylene, polyvinyl chloride, and ABS resin.
  • the sheath hub is preferably provided with a branch pipe and a hemostatic valve.
  • the branch tube can be used for injecting a drug into a body through a sheath and collecting blood from the body.
  • the hemostasis valve maintains a watertight state, allows a dilator, a catheter, etc. to be inserted into the sheath, and prevents blood from leaking when the sheath is placed in a blood vessel.
  • the hemostatic valve is made of a disc-shaped elastic body 9 and has slits 10 penetrating both sides of the disc.
  • the material of the hemostatic valve preferably has a Shore hardness of A20 to A60, and more preferably A30 to A50.
  • Examples of such an elastic body include silicone rubber, natural rubber, polyurethane, polybutadiene, polyurethane elastomer, styrene-butadiene copolymer, polyamide elastomer, and fluoro rubber.
  • the dilator section has a tube-shaped dilator 12 having a lumen 11 communicating from the proximal end to the distal end, and is connected to the lumen at the proximal end of the dilay section. It is composed of a dilator hub 14 having a hollow portion 13 formed therein.
  • the first enlarged portion 16 gradually increases in diameter from the distal end to the proximal end, and gradually expands more gradually than the first enlarged portion.
  • a second enlarged diameter portion 17 and a gradually decreasing diameter portion 18 are formed, and the outer diameter reaches a proximal end through a small body portion 19 having a substantially constant outer diameter.
  • the dailey is inserted into the lumen of the sheath.
  • the Shore hardness of the material of Daile is A85 or more. Examples of such a material include fluororesin, polyamide, polyester, polyethylene, polypropylene, and stainless steel. It is preferable to change the hardness of the material used according to the outer diameter of the die. For example, for an outer diameter of 1.5 rara, the Shore hardness is 75 D, for an outer diameter of 3.0 mm, the Shore hardness is 55 D, and for an outer diameter of 4.0, the Shore hardness is 50 D. That is, appropriate hardness is required depending on the outer diameter. If the diameter is too soft, the tip is easily deformed and cannot be inserted properly if the die is too soft. Conversely, if the die is too hard and the guide does not follow the guide wire during insertion.
  • the material of the dilator hub is not particularly limited, but is preferably a material having appropriate elasticity and hardness for fitting with the sheath hub.
  • a material having appropriate elasticity and hardness for fitting with the sheath hub examples include polyamide, polyacetal, polycarbonate, polyethylene, polypropylene, polyvinyl chloride, and ABS resin.
  • the dilator hub 14 and the sheath hub 4 are fitted together, and the dilator 12 is inserted into the lumen 1 of the sheath through the dilator insertion port 6 and the hemostatic valve 8.
  • the distal end 15 of the dailey protrudes from the distal end 5 of the sheath, and the inner wall of the distal end of the sheath is in close contact with the outer wall of the constricted portion 18 of the dailey.
  • the first enlarged portion 16 gradually increases in diameter from the distal end toward the proximal end, and is more gradual than the first enlarged portion.
  • a second enlarged part 17 that gradually expands and a reduced diameter part 18 that gradually reduces the diameter are formed, and further, the outer diameter part 19 that has a substantially constant outer diameter is connected.
  • the size and shape of the dialy can be appropriately selected according to the diseased part to be used, but usually, the length of the first enlarged portion is 0.1 to 20 and the length of the second enlarged portion.
  • the length of the first enlarged diameter portion and the second enlarged diameter portion is 4.6 to 110 mm, and the length of the reduced diameter portion is 0. It is preferable to be a 5-50 bandit.
  • the outer diameter of the die-lay is 0.5 to 3 at the beginning of the first enlarged part, 0.6 to 4 mm at the boundary between the first and second enlarged parts, and It is preferable that the ratio be between 0.1 and 8 at the boundary between the enlarged diameter portion and the reduced diameter portion.
  • the outer diameter at the boundary between the reduced diameter portion and the small torso portion is equal to the outer diameter of the small torso portion, is preferably 0.5 to 7.5 hidden, and more preferably 1.5 to 7.5 mm. preferable.
  • the difference between the outer diameters at both ends of the first enlarged portion, that is, the amount of expansion at the first enlarged portion is 0.1 to 1 and the difference between the outer diameters at both ends of the second enlarged portion, that is, the second enlarged diameter.
  • the diameter expansion amount at the portion is 0.1 to 4; the outer diameter at both ends of the diameter reduction portion, that is, the diameter reduction amount at the diameter reduction portion is preferably from 0.01 to 3; It is more preferable that the amount of diameter reduction per minute is 0.03 to 0.07.
  • the start end of the first enlarged section, the boundary between the first enlarged section and the second enlarged section, and the boundary between the second enlarged section and the reduced section continue on a gentle curved surface without forming a ridge line. Is preferred. By connecting the starting end and the boundary with a gentle curved surface, the insertion resistance when inserting the medical insertion aid into the blood vessel can be reduced by t. As shown in FIG.
  • the distal end 15 of the die tray protrudes from the distal end 5 of the sheath. However, it is in close contact with the outer wall of the reduced diameter part 18 of the Dailey. It is preferable that the length of the portion where the inner wall at the distal end of the sheath and the outer wall of the shroud portion of the dailey stick closely together is not less than one recitation.
  • the reason why the insertion resistance of the medical insertion assisting device of the present invention is reduced at the time of insertion into the living tissue is that the distal end of the sheath is inserted without colliding with the hole wall of the living tissue.
  • the sheath portion has a curved tubular sheath 2 having a lumen, the distal end 5 of the sheath serves as an opening of the lumen, and the sheath 20 has a sheath at the proximal end 20.
  • One shub 4 is connected.
  • the sheath hub has a hollow portion communicating with the lumen of the sheath, a dilator insertion port 6, and a branch pipe 7.
  • the dilator section has a straight tube-shaped die tray 12 having a lumen, and a distal end 15 of the die tray has a lumen opening portion.
  • a dilator hub 14 is connected to the evening proximal end 2 1.
  • the dialay hub has a hollow portion and an opening 22 that communicate with the lumen of the dialey.
  • the first radially expanding portion gradually expands from the distal end to the proximal end
  • the second radially expanding portion gradually expands gradually from the first radially expanding portion, and gradually increases.
  • Diameter reduction It consists of a diameter part and a dimensioned body part whose outer diameter is almost constant.
  • the dilator can be inserted into the lumen of the sheath, and when the dilator is inserted into the lumen of the sheath, the curved tubular sheath is deformed into a straight tube.
  • the dilator hub and sheath hub can fit together. When the pallet is removed from the lumen of the sheath, the sheath returns to a curved tube shape.
  • the curved tubular sheath is deformed into a straight tubular shape along the die tray.
  • the dilator hub 14 and the sheath hub 4 are fitted with each other, and the distal end 15 of the dilator projects beyond the distal end 5 of the sheath.
  • the inner wall at the distal end of the sheath and the outer wall of the shrunken part at the distal end of the dailey are brought into close contact.
  • an elastic polymer material can be used as the material of the sheath.
  • a polymer material can be particularly preferably used. If the Shore hardness is less than A80, the resilience when the dilator is removed from the lumen of the sheath may be insufficient. If the Shore hardness exceeds D80, the flexibility is poor, and it may be difficult to insert a dilator into the lumen of the sheath to form a straight tube.
  • the material of the sheath preferably has a residual strain of 0.1% or less, and more preferably 0.01% or less, in 5% elongation at room temperature for 10 minutes.
  • a material with a large residual strain will cause cleaving, and if a dilator is inserted into the lumen of the sheath for a long period of time, the sheath may not be completely restored to the curved tube shape when the dialer is removed.
  • the material of the die layer is a material having higher rigidity than the material of the sheath.
  • the dilator of the medical insertion aid 23 of the present invention is inserted into the lumen of the sheath to make the sheath straight, and the distal end of the die Protrude the end to form a straight pipe.
  • Seldinger from hull 2 5 on blood vessel 2 4 Insert guidewire 26 by one method.
  • a medical insertion aid 23 having a straight pipe shape is obliquely inserted into the outer skin 25 according to the guidance of the guide wire 26, and the distal end 5 of the sheath is inserted. Place it in vessel 24. After that, when the dialy tube is removed from the lumen of the sheath, the sheath may be restored to a curved tube shape as shown in FIG.
  • the distal end 5 of the sheath is located within the blood vessel 24.
  • the proximal end 20 of the sheath and the sheath hub 4 face in a direction perpendicular to the outer skin 25, and are in a state convenient for subsequent treatment and treatment.
  • the main lumen of the balloon catheter 27 is fitted to the guide wire 26, and the balloon catheter 27 is connected to the guide wire 26 as shown in FIG. 11 (b).
  • the treatment can be performed by guiding the balloon 28 to the affected part in the blood vessel 24 via the lumen of the sheath 2 along the lumen 26 and inflating the balloon.
  • the bent shape of the sheath portion can be appropriately selected depending on the patient's body type and the insertion site.
  • the bent shape of the sheath portion include a J-shape and a Z-shape.
  • the bent portion may be the entire sheath or a part thereof. For example, it may be bent in a Z-shape near the sheath hub or bent at the sheath distal end.
  • Fig. 12 shows the J-shaped sheath
  • Fig. 13 shows the Z-shaped sheath
  • Fig. 14 shows the long Z-shaped sheath
  • Fig. 15 shows the shaped sheath. Are shown respectively.
  • the dilator of the medical insertion aid is inserted into the lumen of the sheath to make the sheath straight, and the distal end of the die tray is projected from the distal end of the sheath.
  • a guide wire 26 is prepared from the outer skin 25 above the blood vessel 24 by the Seldinger method.
  • a medical insertion aid in the form of a straight tube is obliquely inserted into the outer skin according to guidance of the guide wire, and the distal end 5 of the sheath is positioned in the blood vessel. Then, when the dilator is removed from the lumen of the sheath, as shown in Fig.
  • Case 2 is restored to a ⁇ : shaped curved tube shape, and the distal end of the sheath remains in the blood vessel.
  • the proximal end 20 of the sheath and the sheath hub 4 are positioned so as to bend along the blood vessel, and are in a state convenient for subsequent treatment and treatment.
  • the sheath bends at the sheath hub By marking the direction in which the seat is pulled, it is possible to control the sheet to bend in the desired direction when the dailey is removed.
  • the distal end of the sheath does not separate from the outer wall of the dilator in the bent state, and the distal end of the sheath does not collide with the living tissue.
  • the patient's resistance is low, it does not cause discomfort to the patient and there is no risk of damaging living tissue.
  • the medical insertion aid of the present invention has a straight pipe shape when the dilator is inserted into the lumen of the sheath, and can be easily operated. When the dilator is removed after insertion into a blood vessel, the sheath is bent. When the shape is restored, no kink occurs and there is no risk of discomfort or pain to the patient.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

La présente invention concerne un instrument médical facilitant l'insertion et ne présentant qu'une faible résistance lors de l'insertion dans le tissu organique. L'insertion se fait sans que le patient ressente le moindre inconfort ni la moindre douleur, et sans léser le tissu organique. L'invention concerne également un instrument médical facilitant l'insertion, et qui, sans être susceptible de provoquer de vrillage, ne présente qu'une faible résistance lorsqu'on y insère un cathéter. Cet instrument médical facilitant l'insertion est constitué d'un fourreau tubulaire présentant une lumière, d'une tulipe de fourreau montée à l'extrémité proximale du fourreau, d'un dilatateur tubulaire pourvu d'une lumière, et d'une tulipe de dilatateur montée à l'extrémité proximale du dilatateur. Le dilatateur est constitué d'une première zone d'expansion de diamètre, où le diamètre augmente progressivement de l'extrémité distale vers l'extrémité proximale, d'une seconde zone d'expansion de diamètre, où le diamètre augmente plus doucement et progressivement que dans la première partie d'expansion de diamètre, d'une zone de rétrécissement du diamètre où le diamètre diminue progressivement, et d'un tambour de diamètre extérieur sensiblement constant. Lors de l'introduction du dilatateur par la lumière du fourreau, la paroi intérieure de l'extrémité distale du fourreau vient en contact intime avec la paroi extérieure de la zone de rétrécissement du diamètre du dilatateur, et, même lorsque le dilatateur ainsi que le fourreau sont inclinés, l'extrémité distale du fourreau est en contact intime avec la paroi extérieure du dilatateur.
PCT/JP1997/000479 1996-02-21 1997-02-21 Instrument medical facilitant l'insertion WO1997030746A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP8/58485 1996-02-21
JP05848596A JP3855243B2 (ja) 1996-02-21 1996-02-21 医用挿入補助具

Publications (1)

Publication Number Publication Date
WO1997030746A1 true WO1997030746A1 (fr) 1997-08-28

Family

ID=13085740

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP1997/000479 WO1997030746A1 (fr) 1996-02-21 1997-02-21 Instrument medical facilitant l'insertion

Country Status (2)

Country Link
JP (1) JP3855243B2 (fr)
WO (1) WO1997030746A1 (fr)

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999021605A3 (fr) * 1997-10-28 1999-08-19 Medtronic Ave Inc Dispositif d'introduction d'un catheter
EP1321163A1 (fr) * 2001-12-19 2003-06-25 C-I-Medic Co., Ltd. Ensemble cathéter
US7792591B2 (en) 2005-06-09 2010-09-07 Medtronic, Inc. Introducer for therapy delivery elements
EP2481439A1 (fr) * 2002-11-15 2012-08-01 Applied Medical Resources Corporation Gaine d'accès résistante au coudage et son procédé de fabrication
CN104168944A (zh) * 2012-01-13 2014-11-26 泰利福医疗公司 新颖的带凸起扩张器末端
US8909353B2 (en) 2003-08-29 2014-12-09 Medtronic, Inc. Percutaneous lead introducer
US9474884B2 (en) 2012-01-13 2016-10-25 Teleflex Medical Incorporated Bumped dilator tip
US10420919B2 (en) 2015-04-24 2019-09-24 Cook Medical Technologies Llc Introducer with dynamic dilator and methods of using the same
EP3448489A4 (fr) * 2016-04-27 2019-12-25 QXMedical, LLC Dispositifs d'assistance à la progression de cathéters et systèmes et procédés associés
US11712539B2 (en) 2016-04-27 2023-08-01 Qxmedical, Llc Devices for assisting with advancement of catheters and related systems and methods

Families Citing this family (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0755418A (ja) * 1993-08-13 1995-03-03 Ono Sokki Co Ltd 変位計
ATE326996T1 (de) * 2000-11-29 2006-06-15 Helmut Wollschlaeger Verfahren und vorrichtung zur verwendung in nichtinvasiven, chirurgischen behandlungen
JP4675475B2 (ja) * 2000-12-27 2011-04-20 日本シャーウッド株式会社 ダイレーター
US6979343B2 (en) 2001-02-14 2005-12-27 Ev3 Inc. Rolled tip recovery catheter
JP2007037971A (ja) * 2005-07-05 2007-02-15 Ookiddo:Kk カテーテル組立体とシース引裂補助具
JP2008011867A (ja) * 2006-05-25 2008-01-24 Nippon Zeon Co Ltd ダイレーター、ダイレーターの製造方法、およびシースイントロデューサー
JP2009178518A (ja) * 2008-02-01 2009-08-13 Nipro Corp 医療用管状体、血栓捕捉部材回収用シース、血栓回収カテーテル及びバルーンカテーテル
JP2012085816A (ja) 2010-10-19 2012-05-10 Asahi Intecc Co Ltd カテーテル組立体
JP5126910B2 (ja) 2010-10-29 2013-01-23 朝日インテック株式会社 補助ダイレータとこれを用いたカテーテル組立体
JP5964445B2 (ja) * 2011-11-04 2016-08-03 アベヌ メディカル インコーポレイテッドＡｖｅｎｕ Ｍｅｄｉｃａｌ，Ｉｎｃ． 経皮的な血管内アクセスおよびガイドワイヤ配置用のシステムおよび方法
IN2014DN06819A (fr) * 2012-03-27 2015-06-26 Terumo Corp
JP5615317B2 (ja) * 2012-04-19 2014-10-29 保夫 田中 涙道拡張型ブジー
JP2022181321A (ja) * 2021-05-26 2022-12-08 朝日インテック株式会社 ダイレータ及びカテーテル組立体
WO2024090107A1 (fr) * 2022-10-25 2024-05-02 テルモ株式会社 Cathéter

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0644553U (ja) * 1992-11-25 1994-06-14 東郷メディキット株式会社 カテーテルのイントロデューサ
JPH06335531A (ja) * 1993-04-22 1994-12-06 Nippon Zeon Co Ltd イントロデューサ
JPH0751357A (ja) * 1993-08-18 1995-02-28 Sumitomo Bakelite Co Ltd ドレナージチューブ及びその使用方法

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0644553U (ja) * 1992-11-25 1994-06-14 東郷メディキット株式会社 カテーテルのイントロデューサ
JPH06335531A (ja) * 1993-04-22 1994-12-06 Nippon Zeon Co Ltd イントロデューサ
JPH0751357A (ja) * 1993-08-18 1995-02-28 Sumitomo Bakelite Co Ltd ドレナージチューブ及びその使用方法

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999021605A3 (fr) * 1997-10-28 1999-08-19 Medtronic Ave Inc Dispositif d'introduction d'un catheter
EP1321163A1 (fr) * 2001-12-19 2003-06-25 C-I-Medic Co., Ltd. Ensemble cathéter
EP2481439A1 (fr) * 2002-11-15 2012-08-01 Applied Medical Resources Corporation Gaine d'accès résistante au coudage et son procédé de fabrication
US10173040B2 (en) 2003-08-29 2019-01-08 Medtronic, Inc. Percutaneous flat lead introducer
US9687637B2 (en) 2003-08-29 2017-06-27 Medtronic, Inc. Percutaneous flat lead introducer
US8909353B2 (en) 2003-08-29 2014-12-09 Medtronic, Inc. Percutaneous lead introducer
US9084872B2 (en) 2005-06-09 2015-07-21 Medtronic, Inc. Introducer for therapy delivery elements
US7792591B2 (en) 2005-06-09 2010-09-07 Medtronic, Inc. Introducer for therapy delivery elements
US9474884B2 (en) 2012-01-13 2016-10-25 Teleflex Medical Incorporated Bumped dilator tip
CN104168944A (zh) * 2012-01-13 2014-11-26 泰利福医疗公司 新颖的带凸起扩张器末端
US9693800B2 (en) 2012-01-13 2017-07-04 Teleflex Medical Incorporated Bumped dilator tip
US10420919B2 (en) 2015-04-24 2019-09-24 Cook Medical Technologies Llc Introducer with dynamic dilator and methods of using the same
EP3448489A4 (fr) * 2016-04-27 2019-12-25 QXMedical, LLC Dispositifs d'assistance à la progression de cathéters et systèmes et procédés associés
US11712539B2 (en) 2016-04-27 2023-08-01 Qxmedical, Llc Devices for assisting with advancement of catheters and related systems and methods

Also Published As

Publication number Publication date
JPH09225035A (ja) 1997-09-02
JP3855243B2 (ja) 2006-12-06

Similar Documents

Publication Publication Date Title
WO1997030746A1 (fr) Instrument medical facilitant l'insertion
EP0829270B1 (fr) Cathéter d'angiographie préformé
KR100818903B1 (ko) 브레이드 및 코일을 구비한 의료 기기
EP0820259B1 (fr) Dispositif d'introduction d'un extenseur a membrane a enroulement
US5336205A (en) Flow directed catheter
JP5300734B2 (ja) カテーテル
JPH10216237A (ja) スタイレット及びスタイレットを具備する装置
US4624657A (en) Medical devices having inflatable portions
US10952710B2 (en) Balloon closure device
CN109414567B (zh) 用于血管通路的导引鞘
JP2009022432A (ja) ガイディングカテーテル
JP2004180764A (ja) 能動細管
WO2018092387A1 (fr) Ensemble cathéter
JPH07265432A (ja) 加工硬化型非形状記憶合金製カテーテル
JPH01121064A (ja) カテーテル
JP2002143318A (ja) イントロデューシングカテーテルと診断治療用カテーテルとの組立体
JPH09225036A (ja) 医用挿入補助具
JP2838291B2 (ja) 生体器官拡張器及びカテーテル
JP3958086B2 (ja) 拡張バルーンカテーテル
JP4174277B2 (ja) 拡張バルーンカテーテル
KR102601618B1 (ko) 무외장 카테터 삽입용 신속 교환 확장기
JP3446353B2 (ja) ドレナージ用具
JP2726696B2 (ja) 生体器官拡張器及びカテーテル
JP2565219Y2 (ja) カテーテル用ガイドワイヤ
JP3237597B2 (ja) カテーテル

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): US

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FI FR GB GR IE IT LU MC NL PT SE

121 Ep: the epo has been informed by wipo that ep was designated in this application
DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
122 Ep: pct application non-entry in european phase