WO2003092782A1 - Dispositif de guide de tube a demeure - Google Patents

Dispositif de guide de tube a demeure Download PDF

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Publication number
WO2003092782A1
WO2003092782A1 PCT/JP2003/005509 JP0305509W WO03092782A1 WO 2003092782 A1 WO2003092782 A1 WO 2003092782A1 JP 0305509 W JP0305509 W JP 0305509W WO 03092782 A1 WO03092782 A1 WO 03092782A1
Authority
WO
WIPO (PCT)
Prior art keywords
indwelling tube
tube
guide
indwelling
state
Prior art date
Application number
PCT/JP2003/005509
Other languages
English (en)
Japanese (ja)
Inventor
Hiroaki Goto
Takaaki Komiya
Yoshimitsu Inoue
Original Assignee
Olympus Corporation
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 Olympus Corporation filed Critical Olympus Corporation
Priority to JP2004500963A priority Critical patent/JPWO2003092782A1/ja
Priority to DE10392571T priority patent/DE10392571T5/de
Publication of WO2003092782A1 publication Critical patent/WO2003092782A1/fr
Priority to US10/975,881 priority patent/US7550002B2/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/94—Stents retaining their form, i.e. not being deformable, after placement in the predetermined place
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2002/041—Bile ducts
    • 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
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0082—Catheter tip comprising a tool
    • A61M2025/0096—Catheter tip comprising a tool being laterally outward extensions or tools, e.g. hooks or fibres
    • 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
    • A61M25/02—Holding devices, e.g. on the body
    • A61M2025/0293—Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube

Definitions

  • the present invention relates to an indwelling tube guide device used for inserting and placing an indwelling tube in a body cavity of a patient using an endoscope.
  • the following treatment is performed as a treatment for draining bile and the like accumulated in the bile duct.
  • the insertion section of the endoscope is inserted into a body cavity or the like in advance.
  • the stent as an indwelling tube is guided to the stenotic part of the bile duct through the channel provided in the insertion part.
  • the stent is then placed in the stenosis.
  • the bile collected in the bile duct is drained through the lumen of this stent.
  • the state is relatively flexible using a polymer compound such as polyethylene or silicone rubber as a material. It is a hollow pipe. Flaps facing each other are provided on the outer peripheral portion near both ends of this stent to prevent removal.
  • the procedure for guiding the stent configured as described above into the body cavity endoscopically and placing the stent in the constriction of the bile duct is performed in the following procedure.
  • a long guide wire 3 made of a flexible wire is inserted into a forceps channel 2 provided in an insertion portion 4 of the endoscope 1, and the guide wire is inserted.
  • the guide 3 is guided to the bile duct 5 together with the insertion section 4 of the endoscope 1.
  • the guide wire 3 is operated by hand.
  • the stent 7 is inserted, and then the pusher tube 8 is inserted.
  • the guide wire 3 having passed through the stenosis 6 is used as a guide, and the state 7 is pushed in by the pusher tube 8 so that the step is performed. Insert the implant 7 into the stenosis 6 and place it there.
  • the stenosis 6 cannot be observed with the endoscope 1 because it is located deep within the body cavity. Therefore, the procedure is generally performed under radiography.
  • the stent 7 when the stent 7 is pushed into the stenosis 6 by the pusher tube 8, it may be pushed too far.
  • the force 7 and the pusher tube 8 are not connected to the stem 7. For this reason, as shown by the arrow in FIG. 10B, even if the pusher tube 8 is pulled back, the state 7 cannot be pulled back. For this reason, it is inconvenient that the stent 7 cannot be accurately positioned.
  • U.S. Pat. No. 5,921,952 discloses a drainage force delivery system in which a pusher tube and a stent are connected by a thread. As will be described in detail below, in a drainage catheter delivery system, if the pusher tube is pulled too far when the pusher tube is pulled too far, the stent will be pulled through the thread. You can pull it back.
  • an insertion hole through which a thread passes is provided at the distal end of the pusher tube. Also, by forming a flap on the stent, There is an opening in the center. Then, tie a thread to the guide wire. This yarn is derived from the opening force of the stent. In addition, tie this thread through the insertion hole of the pusher tube. Thus, the stent and the pusher tube are connected.
  • the state can be pulled back through the thread.
  • the guidewire is pulled back after the stent is placed in the stenosis.
  • the thread comes off the stint. In this way, the stent and the pusher tube are separated.
  • a stent is inserted through a guidewire. And The proximal end of this stent is in abutment with the distal end of the pusher tube. For this reason, the bending strength of the connecting portion between the pusher tube and the stent is weak. Therefore, if the pusher tube is pushed forward to place the stent in the stenosis, the stent and the pusher tube may buckle at the joint. This makes it impossible to approach the stent to the target site.
  • the purpose of the present invention is that when the indwelling tube is indwelled, it can be pulled back even if the indwelling tube is pushed in too much, and the bending strength at the connecting portion between the pusher tube and the indwelling tube
  • the present invention provides an indwelling tube guide device that can push an indwelling tube to a target portion even if the traveling path of the indwelling tube is large and curved.
  • the indwelling tube guide device of the present invention has an indwelling tube to be indwelled in a body cavity. This indwelling tube has a lumen. On the proximal side of the indwelling tube, a pusher tube for moving the indwelling tube is arranged. An elongated guide catheter is inserted into the indwelling tube and pusher tube so as to be able to advance and retreat. At least at the distal end of the guide catheter, a guidewire can be accommodated. Further, the indwelling tube guide device of the present invention has a linear member. The proximal portion of the linear member is located more proximally than the indwelling tube. An engagement member is provided at a distal portion of the linear member.
  • the engagement member is moved from the first state in which the guide catheter is engaged with the indwelling tube by moving the guide catheter in the axial direction thereof, and thereby the indwelling tube is moved. It is possible to shift to the second state in which the engagement with Ube is released.
  • the indwelling tube is indwelled, the indwelling tube is inserted by the pusher tube in a state where the guide catheter is inserted into the connecting portion between the indwelling tube and the pusher tube. Push to the site. Further, when the indwelling tube is pushed too much, the engaging member engaged with the indwelling tube pulls the proximal portion of the linear member provided in the distal portion to the proximal side.
  • the guide member is moved in the axial direction so that the engaging member is moved from the first state in which the indwelling tube is engaged with the indwelling tube. Move to the second state in which the engagement with the tube is released. After placing the indwelling tube, the guided wire housed in the guided catheter is left as it is.
  • the indwelling tube of the present invention preferably has an engagement concave portion on the inner wall where the engagement member can be disengaged. Then, in the first state, the engagement member is locked by the peripheral wall of the guide catheter passed through the indwelling tube and the engagement recess.
  • the engaging member is locked by the engaging concave portion provided in the indwelling tube and the peripheral wall of the guide catheter inserted in the indwelling tube.
  • the proximal portion of the linear member of the present invention is preferably fixed to a pusher tube.
  • the proximal portion of the linear member is fixed to the pusher tube.
  • the engaging member of the present invention is locked by the distal end face of the indwelling tube and the peripheral wall of the guide catheter protruding from the distal portion of the indwelling tube in the first state. ing.
  • the engaging member is locked by the distal end face of the indwelling tube and the peripheral wall of the guide catheter protruding from the distal portion of the indwelling tube.
  • the peripheral wall of the guide catheter according to the present invention is provided with an opening through which the engaging member can drop. Then, the engaging member can be shifted to the second state by dropping into the opening.
  • the engaging member is preferably locked by the indwelling tube and the peripheral wall of the guide catheter. Then, by moving the guide catheter in the axial direction, the engaging member is dropped into an opening provided on the peripheral wall of the guide catheter. In this way, the engagement between the engaging member and the indwelling tube is released.
  • the indwelling tube of the present invention preferably has an engagement hole in which the engagement member is detachable. Then, in the first state, the engaging member is locked by the peripheral wall of the guide catheter inserted into the indwelling tube and the engaging hole.
  • the engagement member is locked by an engagement hole provided in the indwelling tube and a peripheral wall of the guide catheter inserted in the indwelling tube.
  • the guide catheter of the present invention is preferably located distal to the pusher tube. Then, near the guide catheter, The position part is connected to the distal part of the towing wire which is inserted into the pusher tube so as to be able to move forward and backward.
  • the guide catheter is preferably disposed on the distal side of the pusher tube. Then, the guide catheter is advanced and retracted by retracting and retracting the traction wire having the distal portion connected to the proximal portion of the guide catheter.
  • the indwelling tube guide device of the present invention has an indwelling tube to be indwelled in a body cavity.
  • This indwelling tube has a lumen.
  • a pusher tube for moving the indwelling tube is arranged on the proximal side of the indwelling tube.
  • An elongated guide member is inserted into the indwelling tube and pusher tube so as to be able to advance and retreat.
  • the indwelling tube guide device of the present invention has a linear member. The proximal part of this linear member is located more proximally than the indwelling tube.
  • An engagement member is provided at a distal portion of the linear member. The engagement member moves from the first state in which the guide member is engaged with the indwelling tube to the second state in which the engagement with the indwelling tube is released by moving the guide member in the axial direction. It can transition to the state.
  • the indwelling tube when the indwelling tube is to be indwelled, the indwelling tube is inserted by the pusher tube in a state where the guide member is passed through the connecting portion between the indwelling tube and the pusher tube. Push to the site. Also, if the indwelling tube is pushed too far, the engaging member engaged with the indwelling tube may pull the proximal portion of the linear member provided at the distal portion to the proximal side. Then pull back the indwelling tube. And the indwelling tube When the guide member is placed in the indwelling tube, by moving the guide member in the axial direction, the engagement member is moved from the first state in which the guide member is engaged with the indwelling tube. Move to the released second state.
  • the engagement member of the present invention is locked by the peripheral wall of the guide member inserted into the indwelling tube and the inner surface of the indwelling tube.
  • the distal portion of the engaging member holds the distal portion of the indwelling tube.
  • the proximal portion of the engagement member holds the proximal portion of the indwelling tube.
  • the distal portion of the indwelling tube is held by the distal portion of the engaging member.
  • the proximal part of the indwelling tube is held by the proximal part of the engaging member.
  • the indwelling tube guide device of the present invention has an indwelling tube to be indwelled in a body cavity. This indwelling tube has a lumen. On the proximal side of the indwelling tube, a pusher tube for moving the indwelling tube is arranged. The guide catheter is rotatably inserted in the indwelling tube and the pusher tube in the axial direction. At least at the distal portion of the guide catheter, a guidewire can be received. Further, the indwelling tube guide device of the present invention has a linear member. The proximal portion of this linear member is located more proximally than the indwelling tube. An engagement member is provided at a distal portion of the linear member. The engagement member is configured to rotate the guide catheter in the direction around the axis, thereby releasing the engagement with the indwelling tube from the first state in which the indwelling tube is engaged. It is possible to move to state 2 is there.
  • the indwelling tube when the indwelling tube is to be indwelled, the indwelling tube is inserted by the pusher tube in a state where the guide catheter is inserted into the connecting portion between the indwelling tube and the pusher tube. Push to the site. Also, if the indwelling tube is pushed too far, the engaging member engaged with the indwelling tube may pull the proximal portion of the linear member provided at the distal end thereof to the proximal side. Then, the indwelling tube is pulled back.
  • the guide member When the indwelling tube is to be indwelled, the guide member is rotated in the direction around the axis, so that the engagement member is brought into the first state in which the indwelling tube is engaged with the indwelling tube. From the second state in which the engagement with the indwelling tube is released. After placing the indwelling tube, the guidewire housed in the guide catheter is left as it is.
  • FIG. 1A is a vertical cross-sectional view of the indwelling tube guide device in a state where a stent is engaged, showing a first embodiment of the present invention.
  • FIG. 1B is a side view of the distal end portion of the indwelling tube guide device of FIG. 1A.
  • FIG. 1C is a longitudinal sectional view of the indwelling tube guide device according to the first embodiment of the present invention, in which the stent is not engaged.
  • FIG. 1D is a longitudinal side view of the distal end portion of the indwelling tube guide device of FIG. 1C.
  • FIG. 2 shows an indwelling tube guide according to a second embodiment of the present invention.
  • FIG. 3 is a vertical cross-sectional view of a tip portion of the storage device.
  • FIG. 3 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device according to a third embodiment of the present invention.
  • FIG. 4A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where a stent is engaged, showing a fourth embodiment of the present invention.
  • FIG. 4B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the stent is not engaged, showing the fourth embodiment of the present invention.
  • FIG. 5A is a longitudinal sectional view of an indwelling tube guide device according to a fifth embodiment of the present invention.
  • FIG. 5B is a side view of the indwelling tube guide device of FIG. 5A.
  • FIG. 6 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device, showing a sixth embodiment of the present invention.
  • FIG. 7 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device according to a seventh embodiment of the present invention.
  • FIG. 8A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where an indwelling tube is engaged, showing an eighth embodiment of the present invention.
  • FIG. 8B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the indwelling tube is not engaged, showing the eighth embodiment of the present invention.
  • FIG. 8C is a perspective view of the engaging member according to the eighth embodiment of the present invention.
  • FIG. 9A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where a stent is engaged, showing a ninth embodiment of the present invention.
  • FIG. 9B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the stent is not engaged, showing the ninth embodiment of the present invention.
  • FIG. 10A is an explanatory diagram of a technique for guiding a stent into a body cavity endoscopically.
  • FIG. 10B is an explanatory view of a procedure for guiding a stent into a body cavity endoscopically and then placing the stent in a stenotic part of a bile duct.
  • FIG. 1A is a longitudinal sectional view of the indwelling tube guide device in a state where a stent is engaged, showing a first embodiment of the present invention.
  • FIG. 1B is a side view of the distal end portion of the indwelling tube guide device of FIG. 1A.
  • FIG. 1C is a longitudinal sectional view of the indwelling tube guide device according to the first embodiment of the present invention in a state where the stent is not engaged.
  • FIG. 1D is a side view of the distal end of the indwelling tube guide device of FIG. 1C.
  • the guide catheter 11 is a long guide member that can be inserted into the forceps channel of the endoscope.
  • the guide catheter 11 is formed of a flexible synthetic resin material, for example, a fluorine-based resin or a nylon-based resin.
  • Guide catheter 1 1 has a full length! : The lumen 1 2 is formed.
  • a guide catheter cock 13 is provided at the proximal end of the guide catheter 11.
  • the distal end of the guide catheter 11 is provided with a stent 14 as an indwelling tube. This stent 14 has a lumen.
  • Guide catheter 11 is passed through the lumen of stent 14.
  • a pusher tube 15 is provided on the guide catheter 11 on the proximal side of the stent 14. The guide catheter 11 is inserted into the lumen of the pusher tube 15.
  • Stent 14 is a relatively flexible hollow pipe.
  • the stent 14 is made of a biocompatible resin such as, for example, polyethylene, fluorine resin, nylon resin, thermoplastic elastomer, or silicone rubber. It is desirable that the stent 14 be coated with a hydrophilic lubricant on the outer peripheral surface. Flaps 16 facing each other are provided on the outer peripheral portions near both ends of the state 14 to prevent removal. Further, an engagement recess 17 is provided on a part of the inner peripheral surface of the stent 14.
  • the pusher tube 15 is formed by molding a flexible synthetic resin material, for example, a fluorine-based resin or a nylon-based resin.
  • a pusher tube cock 18 is provided at the proximal end of the pusher tube 15.
  • a guide wire 19 is inserted through the lumen of the guide catheter 11 in the axial direction.
  • a linear member 20 extends in the axial direction between the outer peripheral surface of the guide catheter 11 and the inner peripheral surface of the pusher tube 15.
  • the guide wire 19 is made of a long metal body, a stranded wire body, a coil body, or the like, and is preferably a nickel-titanium alloy. Made of a metal having superelastic properties. The distal end of this guidewire 19 is tapered. On the other hand, the proximal end of the guidewire 19 is derived from the guide catheter cock 13 force.
  • the linear member 20 is a linear body such as stainless steel, nickel, titanium alloy, nylon, liquid crystal polymer, and silk.
  • an engaging member 21 is provided at the distal end of the linear member 20.
  • the engaging member 21 is engageable with and disengageable from the engaging recess 17 of the stent 14.
  • the engagement member 21 is formed of a ball-shaped enlarged portion formed of metal, ceramic, thermoplastic resin, or the like.
  • the proximal side of the linear member 20 is fixed to the pusher tube cock 18.
  • the engagement member 21 When the guide catheter 11 is inserted through the stent 14, the engagement member 21 is pressed against the engagement recess 17 on the outer peripheral surface of the guide catheter 11, and 17 is engaged. Therefore, when the linear member 20 is retracted to the proximal side, the stent 14 can be moved in the proximal direction. When the guide force catheter 11 is withdrawn from the state 14 force, the engagement member 21 comes out of the engagement recess 1 ⁇ , and the engagement of the engagement member 21 is released. You.
  • the engaging member 21 can be disengaged from the engaging concave portion 17 of the state 14. That is, the shape is not limited to the ball-shaped enlarged portion, and may be a cylindrical shape, a rectangular block shape, or a hook shape.
  • the insertion portion of the endoscope is inserted into the body cavity, and the distal end component is guided to the vicinity of the bile duct.
  • the guider 19 is inserted into the forceps channel of the endoscope.
  • the guider 19 is advanced under the endoscope and X-ray observation.
  • the distal end of the guidewire 19 is guided to the bile duct stenosis.
  • the guide catheter 11 is inserted through the guide wire 19 from the proximal end of the guide wire 19.
  • a guide 14 and a pusher tube 15 are set in the guide catheter 11.
  • the guide wire 19 as a guide, insert the guide force table 11 through the forceps channel.
  • the guide catheter 11 is advanced by the proximal operation at the proximal end. Then, the distal portion of the guide catheter 11 is led out from the distal end component of the endoscope. Further, the distal portion is inserted through the stenosis. Then, by pushing the pusher tube 15, the stent 14 is inserted through the stenosis along the guide catheter 11. At this time, the distal end of the stent 14 is located more proximally than the distal end of the guide catheter 11.
  • the pusher tube 15 is pulled back to the proximal side. Then, the state 1 is connected via the linear member 20. 4 is pulled back.
  • guide catheter 11 is retracted proximally relative to stent 14. Then, the distal portion of the guide catheter 11 comes out of the lumen of the stent 14. As a result, as shown in FIGS. 1C and 1D, the engaging member 21 comes out of the engaging concave portion 17 of the state 14. Therefore, the linear member 20 and the stem 14 are separated. In this way, the statement 14 is placed in the stenosis.
  • the distal end of the guide wire 19 is located at the stenosis. For this reason, this guidewire 19 remains inserted through the stenosis.
  • the following effects are obtained with the above configuration. That is, in the present embodiment, in order to hold the stent 14, the stent 14 is pushed forward by the pusher tube 15. At this time, the guide catheter 11 is inserted through the connection between the stem 14 and the pusher tube 15. Therefore, the bending strength at the connection between the stent 14 and the pusher tube 15 is high. Therefore, even when the traveling path of the stent 14 is largely curved, the stent 14 and the pusher tube 15 do not buckle. Therefore, it is possible to push the stent 14 smoothly.
  • the engaging member 21 When the stent 14 is placed, the engaging member 21 is engaged with the stem 14.
  • the engaging member 21 is connected to a distal portion of the linear member 20.
  • the proximal part of the linear member 20 is fixed to the pusher tube 15. Because of this, stainless steel If the pusher 14 is pushed too far, the pusher tube 15 is moved to the proximal side. State 14 can be pulled back.
  • the guide catheter 11 is retracted proximally with respect to the stent 14. At this time, the guide wire 19 inserted through the guide catheter 11 is kept as it is. For this reason, after the stent 14 is indwelled, the distal portion of the guide wire 19 is left inserted through the stenosis. Therefore, after the stent 14 is placed, the following treatment can be performed using the guide wire 19 as a guide.
  • FIG. 2 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device, showing a second embodiment of the present invention.
  • the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • the proximal end of the linear member 20 is connected to the inner surface of the distal portion of the pusher tube 15.
  • the operation of the present embodiment is the same as the operation of the first embodiment.
  • the length of the linear member 20 can be reduced. For this reason, the cost can be reduced by simplifying the configuration.
  • FIG. 3 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device according to a third embodiment of the present invention.
  • the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • the engaging member 21 provided at the distal end of the linear member 20 is engaged with the distal end of the stent 14.
  • the operation of the present embodiment is the same as the operation of the first embodiment. In this embodiment, it is not necessary to provide the engaging recess 17 in the stem 14. For this reason, the conventional stent 14 can be used as it is. As a result, costs can be reduced.
  • FIG. 4A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where a stent is engaged, showing a fourth embodiment of the present invention.
  • FIG. 4B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the stent is not engaged, showing the fourth embodiment of the present invention.
  • an opening 22 is provided in the vicinity of the distal portion of the guide catheter 11 and in the peripheral wall inserted into the lumen of the stent 14.
  • the opening 22 can face the engagement recess 17 of the state 14.
  • the engagement member 21 can fall into the opening 22.
  • the state 14 is inserted into the stenosis by the pusher tube 15.
  • the stent 14 can be pulled back via the linear member 20.
  • the stent 14 can be reliably positioned and retained at the target portion.
  • the guide catheter 11 is retracted proximally while keeping the guide wire 19 and the pusher tube 15 unchanged. Then, the opening 22 of the guide catheter 11 faces the engaging recess 17. As a result, the engaging member 21 falls into the opening 22. Accordingly, as shown in FIG. 4B, the engagement member 21 escapes from the engagement recess 17 of the state 14. In this way, the linear member 20 and the Tents 14 and are separated. As a result, the stent 14 is placed in the stenosis.
  • the guide catheter 11 is slightly retracted to the proximal side, and the opening 22 faces the engaging member 21. Then, the engaging member 21 is dropped into the opening 22. As a result, the linear member 20 and the stent 14 can be separated. Thus, the operability has been improved.
  • FIG. 5A is a longitudinal sectional view of an indwelling tube guide device according to a fifth embodiment of the present invention.
  • FIG. 5B is a side view of the indwelling tube guide device of FIG. 5A.
  • the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof will be omitted.
  • An engagement hole 23 is formed in a part of the peripheral wall of the state 14.
  • An engagement member 21 provided at the distal end of the linear member 20 is engaged with the engagement hole 23.
  • the proximal end of the linear member 20 is connected to the pusher tube cock 18.
  • a short guide catheter 24 is inserted through the distal end of the stent 14 and the pusher tube 15 so as to be able to advance and retreat.
  • the proximal portion of the guide catheter 24 is connected to the distal portion of the traction wire 25.
  • the traction wire 25 extends to the proximal end of the pusher tube 15.
  • the proximal end of the towing wire 25 is connected to the operating ring 26.
  • a side hole 27 is provided near the proximal portion of the pusher tube 15. The guide wire 19 is led out of the side hole 27.
  • the guide catheter 24 is used to Insert 14 into the stenosis.
  • the pusher tube 15 pulls the pusher tube 15 back to the proximal side. Then, the stent 14 can be pulled back via the linear member 20. In this way, it is possible to reliably position and retain the state 14 at the target portion.
  • the fingers are put on the operation ring 26 while leaving the guide wire 19 and the pusher tube 15 as they are. Then, when the tow guide 25 is retracted to the proximal side, the guide catheter 24 retreats. Then, the distal end of the guide catheter 24 is moved to the proximal end through the engagement hole 23. As a result, the engaging member 21 engaged with the engaging hole 23 escapes from the engaging hole 23. In this way, the linear member 20 and the stent 14 are separated. As a result, the stent 14 is placed in the stenosis.
  • FIG. 6 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device, showing a sixth embodiment of the present invention.
  • the same components as those of the fifth embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • the linear member 20 is provided outside the pusher tube 15 along the axial direction of the pusher tube 15. Then, the distal portion of the linear member 20 is introduced into the lumen of the stent 14 from the distal end of the pusher tube 15. Further, the engaging member 21 is engaged with the engaging hole 23.
  • the operation of the present embodiment is the same as the operation of the fifth embodiment. In the present embodiment, the linear portion Routing of timber 20 is easy. For this reason, assembly workability can be improved.
  • FIG. 7 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device according to a seventh embodiment of the present invention.
  • the same components as those of the fifth embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • a through hole 28 is provided in a side wall at the distal portion of the pusher tube 15 and the pusher tube 15 is laid. Then, the linear member 20 is passed through the through hole 28, and the linear member 20 is connected to the distal portion of the pusher tube 15.
  • the operation of the present embodiment is the same as the operation of the fifth embodiment. In the present embodiment, the length of the linear member 20 is reduced. For this reason, cost can be reduced by simplifying the configuration.
  • FIG. 8A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where an indwelling tube is engaged, showing an eighth embodiment of the present invention.
  • FIG. 8B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the indwelling tube is not engaged, according to the eighth embodiment of the present invention.
  • FIG. 8C is a perspective view of the engaging member according to the eighth embodiment of the present invention.
  • the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • the engagement member 21 formed of the ball-shaped enlarged portion of the first embodiment is replaced with an elongated engagement member 29 shown in FIGS. 8A, 8B and 8C. is there.
  • the rod member 34 is used as the guide member, a guide catheter 11 may be used.
  • the engaging member 29 of the present embodiment is It has a recess 30.
  • the recess 30 is formed by cutting out a part of the outer peripheral surface of the main body 29 a of the engaging member 29.
  • the recess 30 fits with the inner surface of the stent 14 along the axial direction.
  • the proximal portion 33 of the engagement member 29 is connected to the distal portion of the linear member 20.
  • the engaging member 29 is attached to the stem 1 by the peripheral wall of the rod-shaped member 34. 4 is fitted and locked.
  • the distal portion 31 of the recess 30 holds the distal end of the state 14.
  • the proximal portion 32 of the recess 30 holds the proximal end of the stent 14.
  • the proximal portion 32 of the engagement member 29 is pulled proximally by the linear member 20 so that the pusher tube
  • the pusher tube 15 is used to control
  • the bar-shaped member 34 is moved proximally with respect to the stent 14. Further, the rod-shaped member 34 is pulled out from the stairs by 14 cm. Then, the engagement member 29 is disengaged from the state 14. As a result, the engagement member 29 and the state 14 are separated. In this way, stent 14 is detained. After this, the engaging member 29 is housed in the pusher tube 15 by pulling the linear member 20 to the proximal side.
  • the engaging member 29 is engaged by fitting the stem 14 into the recess 30. At this time, the engagement member 29 holds the distal end and the proximal end of the stent 14. As described above, since the engaging member 29 holds the both ends of the stent 14, it is possible to push the stent 14 forward or to pull it in. 4 can be moved accurately and reliably.
  • FIG. 9A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where a stent is engaged, showing a ninth embodiment of the present invention.
  • FIG. 9B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the stent is not engaged, showing the ninth embodiment of the present invention.
  • the same components as those of the fourth embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • the guide catheter 11 is inserted into the stent 14 and the pusher tube 15.
  • the guide catheter 11 is rotatable around the shaft with respect to the stent 14 and the pusher tube 15.
  • an opening 22 is provided in a peripheral wall inserted into the lumen of the stent 14, and is provided.
  • the engaging member 21 can fall into the opening 22.
  • the opening 22 is substantially perpendicular to the central axis of the stem 14 and is in a plane crossing the engagement recess 17. Are located in
  • the guide catheter 11 is rotated in the direction around the axis while the guide wire 19 and the pusher tube 15 are left as they are. Then, the opening 22 of the guide catheter 11 faces the engaging recess 17. The engaging member 21 falls into the opening 22. As shown in FIG. 9B, the engaging member 21 escapes from the engaging recess 17 of the state 14. As a result, the linear member 20 and the stent 14 are separated. In this way, the stent 14 is placed in the stenosis.
  • the guide catheter 11 is rotatable around the axis in the stent 14 and the pusher tube 15. Further, an opening 22 is provided on the peripheral wall of the guide catheter 11.
  • the engaging member 21 can be dropped into the opening 22.
  • the opening 22 is arranged in a plane substantially perpendicular to the central axis of the stent and crossing the engagement recess 17. For this reason, the engagement member 21 falls into the opening 22 simply by slightly rotating the guide catheter 11. In this way, the engagement between the stent 14 and the engagement member 21 can be released. Therefore, the operability has been improved.
  • an indwelling tube guide device which is used in combination with an endoscope and can accurately position and indwell an indwelling tube in a body cavity or the like is obtained.

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

Abstract

L'invention concerne un dispositif de guide de tube à demeure possédant un tube à demeure (14) et un tube poussoir (15). La portion proximale d'un élément linaire (20) est placée plus proche du côté proximal que le tube à demeure (14). La partie distale de cet élément linéaire (20) est munie d'un élément d'enclenchement (21). Le déplacement axial de l'élément guide (11) permet à l'élément d'enclenchement (21) de se déplacer d'un premier état auquel il rentre en contact avec le tube à demeure (14) à un second état auquel il n'est pas en contact avec le tube à demeure (14).
PCT/JP2003/005509 2002-04-30 2003-04-30 Dispositif de guide de tube a demeure WO2003092782A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
JP2004500963A JPWO2003092782A1 (ja) 2002-04-30 2003-04-30 留置チューブガイド装置
DE10392571T DE10392571T5 (de) 2002-04-30 2003-04-30 Stent-Legevorrichtung
US10/975,881 US7550002B2 (en) 2002-04-30 2004-10-28 Stent delivery device

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2002-128941 2002-04-30
JP2002128941 2002-04-30

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US10/975,881 Continuation US7550002B2 (en) 2002-04-30 2004-10-28 Stent delivery device

Publications (1)

Publication Number Publication Date
WO2003092782A1 true WO2003092782A1 (fr) 2003-11-13

Family

ID=29397284

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2003/005509 WO2003092782A1 (fr) 2002-04-30 2003-04-30 Dispositif de guide de tube a demeure

Country Status (3)

Country Link
JP (1) JPWO2003092782A1 (fr)
DE (1) DE10392571T5 (fr)
WO (1) WO2003092782A1 (fr)

Cited By (8)

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Publication number Priority date Publication date Assignee Title
JP2007330796A (ja) * 2006-06-16 2007-12-27 Olympus Medical Systems Corp ステントデリバリーシステム
US7879080B2 (en) 2005-06-03 2011-02-01 Olympus Medical Systems Corp. Stent placement device
JP4913251B1 (ja) * 2011-05-24 2012-04-11 株式会社カテックス ステントデリバリーシステム
WO2015060424A1 (fr) * 2013-10-25 2015-04-30 オリンパスメディカルシステムズ株式会社 Endoprothèse médicale
WO2015133333A1 (fr) * 2014-03-03 2015-09-11 国立大学法人香川大学 Tube de drainage biliaire
JP2016187366A (ja) * 2015-03-30 2016-11-04 日本ゼオン株式会社 チューブステント
JP2020534098A (ja) * 2017-09-20 2020-11-26 シノプシス サージカル インコーポレイテッドＳｉｎｏｐｓｙｓ Ｓｕｒｇｉｃａｌ，Ｉｎｃ． 副鼻腔流体アクセス埋め込み器具、アセンブリ、キット、および方法
WO2022058893A1 (fr) * 2020-01-01 2022-03-24 Endo Gi Medical Ltd. Ensembles de déploiement d'endoprothèse avec mécanismes de verrouillage et procédés d'assemblage

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JPH05184684A (ja) * 1992-08-06 1993-07-27 Olympus Optical Co Ltd 生体管路拡張具
JPH05220227A (ja) * 1991-04-03 1993-08-31 Olympus Optical Co Ltd 留置チューブ
JPH1176419A (ja) * 1997-09-03 1999-03-23 Asahi Optical Co Ltd 内視鏡用留置バスケット
US5895391A (en) * 1996-09-27 1999-04-20 Target Therapeutics, Inc. Ball lock joint and introducer for vaso-occlusive member
US5921952A (en) * 1997-08-14 1999-07-13 Boston Scientific Corporation Drainage catheter delivery system
JP2000152985A (ja) * 1998-11-20 2000-06-06 Olympus Optical Co Ltd 内視鏡用処置具

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Publication number Priority date Publication date Assignee Title
JPH05220227A (ja) * 1991-04-03 1993-08-31 Olympus Optical Co Ltd 留置チューブ
JPH05184684A (ja) * 1992-08-06 1993-07-27 Olympus Optical Co Ltd 生体管路拡張具
US5895391A (en) * 1996-09-27 1999-04-20 Target Therapeutics, Inc. Ball lock joint and introducer for vaso-occlusive member
US5921952A (en) * 1997-08-14 1999-07-13 Boston Scientific Corporation Drainage catheter delivery system
JPH1176419A (ja) * 1997-09-03 1999-03-23 Asahi Optical Co Ltd 内視鏡用留置バスケット
JP2000152985A (ja) * 1998-11-20 2000-06-06 Olympus Optical Co Ltd 内視鏡用処置具

Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7879080B2 (en) 2005-06-03 2011-02-01 Olympus Medical Systems Corp. Stent placement device
US9510962B2 (en) 2006-06-16 2016-12-06 Olympus Corporation Stent delivery system
JP2007330796A (ja) * 2006-06-16 2007-12-27 Olympus Medical Systems Corp ステントデリバリーシステム
JP4913251B1 (ja) * 2011-05-24 2012-04-11 株式会社カテックス ステントデリバリーシステム
US8986364B2 (en) 2011-05-24 2015-03-24 Gadelius Medical K.K. Stent delivery system
WO2015060424A1 (fr) * 2013-10-25 2015-04-30 オリンパスメディカルシステムズ株式会社 Endoprothèse médicale
JP5815164B2 (ja) * 2013-10-25 2015-11-17 オリンパス株式会社 医療用ステント
WO2015133333A1 (fr) * 2014-03-03 2015-09-11 国立大学法人香川大学 Tube de drainage biliaire
JPWO2015133333A1 (ja) * 2014-03-03 2017-04-06 国立大学法人 香川大学 胆道ドレナージチューブ
US10391286B2 (en) 2014-03-03 2019-08-27 National University Corporation Kagawa University Biliary tract drainage tube
JP2016187366A (ja) * 2015-03-30 2016-11-04 日本ゼオン株式会社 チューブステント
JP2020534098A (ja) * 2017-09-20 2020-11-26 シノプシス サージカル インコーポレイテッドＳｉｎｏｐｓｙｓ Ｓｕｒｇｉｃａｌ，Ｉｎｃ． 副鼻腔流体アクセス埋め込み器具、アセンブリ、キット、および方法
JP7408542B2 (ja) 2017-09-20 2024-01-05 シノプシス サージカル インコーポレイテッド 副鼻腔流体アクセス埋め込み器具、アセンブリ、キット、および方法
US12017023B2 (en) 2017-09-20 2024-06-25 Sinopsys Surgical, Inc. Paranasal sinus fluid access implantation tools, assemblies, kits and methods
WO2022058893A1 (fr) * 2020-01-01 2022-03-24 Endo Gi Medical Ltd. Ensembles de déploiement d'endoprothèse avec mécanismes de verrouillage et procédés d'assemblage
GB2614639A (en) * 2020-01-01 2023-07-12 Endo Gi Medical Ltd Stent-deployment assemblies with locking mechanisms and methods of assembly

Also Published As

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JPWO2003092782A1 (ja) 2005-09-08
DE10392571T5 (de) 2005-06-16

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