WO2007034639A1 - Stent delivery catheter - Google Patents

Stent delivery catheter Download PDF

Info

Publication number
WO2007034639A1
WO2007034639A1 PCT/JP2006/316103 JP2006316103W WO2007034639A1 WO 2007034639 A1 WO2007034639 A1 WO 2007034639A1 JP 2006316103 W JP2006316103 W JP 2006316103W WO 2007034639 A1 WO2007034639 A1 WO 2007034639A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
distal
stent
balloon
distal end
Prior art date
Application number
PCT/JP2006/316103
Other languages
French (fr)
Japanese (ja)
Inventor
Yorito Suzuki
Masumi Yonemitsu
Katsuhiko Shimizu
Original Assignee
Terumo Kabushiki Kaisha
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 Terumo Kabushiki Kaisha filed Critical Terumo Kabushiki Kaisha
Publication of WO2007034639A1 publication Critical patent/WO2007034639A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/958Inflatable balloons for placing stents or stent-grafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Definitions

  • the present invention relates to a stent delivery catheter used for improving a stenosis formed in a living organ such as a blood vessel, a bile duct, a trachea, an esophagus, a urethra, and other organs.
  • a stent delivery catheter used for improving a stenosis formed in a living organ such as a blood vessel, a bile duct, a trachea, an esophagus, a urethra, and other organs.
  • a stent delivery catheter used for improving a stenosis formed in a living organ such as a blood vessel, a bile duct, a trachea, an esophagus, a urethra, and other organs.
  • a living organ dilatation method has been performed in which a stent is placed in a narrowed portion of a body lumen or body cavity such as a blood vessel, bile duct, esophagus, trachea, urethra, and other organs to secure the lumen or body cavity space. It has been broken.
  • Stents used for this include balloon expandable stents and self-expandable stents depending on the function and placement method.
  • the nora expandable stent is inserted into the target site and then the balloon is expanded.
  • the stent is expanded (plastically deformed) by the expansion force of the balloon, and is fixed in close contact with the inner surface of the target site.
  • a conventional balloon expandable stent delivery catheter includes, for example, an inner tube, an outer tube provided at a position retracted to a proximal end side by a predetermined length from the inner tube, as disclosed in Japanese Patent Publication No. 10-234860, X-ray fluoroscopy of the balloon with the distal end fixed to the inner tube and the proximal end fixed to the outer tube in a contracted or folded state, the stent placed on the outer surface of the balloon, and the stent position X-ray contrast markers, such as radiopaque materials, are provided near both ends of the stent for visual recognition below.
  • such a conventional stent delivery catheter has a marker-existing portion and a marker on the proximal side portion of the contrast marker made of a radiopaque material that is a hard material. Only the inner tube and the balloon also have a force. Peripheral When the catheter is configured so as to have a very small diameter so that it can be inserted into the target living organ part, the difference in rigidity between the two is large, so that the catheter (inner tube) is easily kinked in that part. When such a kink occurs, the pushing force applied at the hand of the catheter disappears at this kink, and the pushing force is not transmitted to the distal end of the catheter, making it difficult to carry the catheter to the peripheral target living organ site.
  • the contrast marker is formed of a very hard radiopaque material such as platinum, when the catheter is pushed forward to a more peripheral living body organ site, a living body such as a bent blood vessel is formed. When passing through the duct, a hard marker may come into contact with the end of the stent through the balloon wall, damaging the stent and balloon wall.
  • FIG. 8 of Japanese Patent Laying-Open No. 2003-102844 shows a stent delivery catheter in which the distal end of the outer tube 2 extends into the balloon 1 and is close to the proximal end of the marker 4. According to this, the area of the portion formed only by the inner tube and the balloon is reduced, and the kink prevention effect at that portion can be expected.
  • the stent 11 is attached to the entire cylindrical portion 1A of the balloon 1.
  • the marker 4 is located within the proximal end portion of the stent 11, and both are overlapped in the axial direction.
  • the proximal end portion of the stent 11 is considerably hard, and further, the distal end of the outer tube is positioned close to the proximal end portion of the stent, and the proximal end portion force of the stent is applied to the distal end portion of the outer tube.
  • the proximal end of the stent 11 that is crimped as shown in FIG. 13 of Japanese Patent Laid-Open No. 2003-102844 (US Publication 2004267280) is close to the proximal end of the marker via a balloon.
  • the proximal end of the stent, the proximal end of the force, and the balloon are close to closing the distal end opening of the outer tube, and there is a high possibility that the inflow of the balloon expansion fluid will be inhibited.
  • An object of the present invention is to solve the above-mentioned problems of the prior art, generate kinks between the distal end of the outer tube and the proximal end of the stent, and partially harden the catheter by overlapping the marker and the stent. And a stent delivery catheter that can be reliably expanded with a stent that is excellent in pushability to a target living organ site in the periphery and that has no inflow failure of the expansion liquid into the cell.
  • An outer tube an inner tube having a tip portion that is inserted through the outer tube and protrudes from the tip of the outer tube for a predetermined length, and a cylindrical portion that has a substantially uniform outer diameter when expanded.
  • a distal-side catheter joint, a distal-side outer diameter changing portion located between a distal end of the tubular portion and a proximal end of the distal-side catheter joint, a proximal-side catheter joint, and the proximal end A proximal-side outer diameter changing portion located between the distal end of the side catheter joint and the proximal end of the tubular portion, the distal catheter joint is fixed to the distal end of the inner tube,
  • a contrast marker provided on the outer surface of the inner tube and having contrasting material force A s
  • the outer tube includes a distal end portion that extends to a distal end side from the proximal catheter coupling portion of the balloon, and is positioned within the proximal outer diameter changing portion.
  • the proximal end of the stent is located at the proximal end of the tubular portion of the nolane, and the distal end of the marker is at a position corresponding to the stent proximal end in the axial direction of the catheter or slightly from the position.
  • the base end of the marker is one-fifth of the total length of the marker from the tip of the outer tube, and is lmm from the tip of the outer tube from the position of the base end side.
  • Stent delivery catheter located within range.
  • FIG. 1 is a front view of one embodiment of a stent delivery catheter of the present invention.
  • FIG. 2 is an enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. is there.
  • FIG. 3 is an enlarged cross-sectional view of the stent delivery catheter shown in FIG. 1 in the vicinity of the proximal end portion of the stent.
  • FIG. 4 is a partially omitted enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. 1 when the balloon is expanded.
  • FIG. 5 is an enlarged cross-sectional view of the distal end portion of a stent delivery catheter according to another embodiment of the present invention.
  • FIG. 6 is an enlarged cross-sectional view of the stent delivery catheter shown in FIG. 5 in the vicinity of the proximal end portion of the stent.
  • FIG. 7 is a partially omitted enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. 5 at the time of balloon expansion.
  • FIG. 8 is a partially omitted enlarged cross-sectional view of a distal end portion of a stent delivery catheter according to another embodiment of the present invention when the balloon is expanded.
  • FIG. 9 is an enlarged view of the vicinity of the joint between the distal shaft and the base shaft in the catheter shown in FIG. 1.
  • FIG. 10 is an enlarged cross-sectional view of the vicinity of the joint between the distal shaft and the base shaft in the catheter shown in FIG.
  • FIG. 11 is a cross-sectional view taken along line BB in FIG.
  • FIG. 12 is a cross-sectional view taken along line CC of FIG.
  • FIG. 13 is a perspective view of the distal end portion of the base side shaft used in the catheter of FIG. 1.
  • FIG. 14 is a cross-sectional view taken along line AA in FIG.
  • FIG. 15 is an enlarged cross-sectional view of the proximal end portion of the catheter shown in FIG. 1.
  • FIG. 16 is a front view of an example of a stent used in the stent delivery catheter of the present invention.
  • FIG. 17 is an external view of another embodiment of the stent delivery catheter of the present invention.
  • FIG. 1 is a front view of an embodiment of the stent delivery catheter of the present invention.
  • FIG. 2 is an enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG.
  • FIG. 3 is an enlarged cross-sectional view of the stent delivery catheter shown in FIG. 1 in the vicinity of the proximal end portion of the stent.
  • FIG. 4 is a partially omitted enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. 1 when the balloon is expanded.
  • FIG. 1 is a front view of an embodiment of the stent delivery catheter of the present invention.
  • FIG. 2 is an enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG.
  • FIG. 3 is an enlarged cross-sectional view of the stent delivery catheter shown in FIG. 1 in the vicinity of the proximal end portion of the stent.
  • FIG. 4 is a partially omitted enlarged cross
  • FIG. 5 is an enlarged cross-sectional view of the distal end portion of a stent deli catheter of another embodiment of the present invention.
  • FIG. 6 is an enlarged cross-sectional view of the vicinity of the proximal end of the stent of the stent delivery catheter shown in FIG.
  • FIG. 7 is an enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG.
  • FIG. 8 is a partially omitted enlarged sectional view of the distal end portion of the stent delivery catheter according to another embodiment of the present invention when the balloon is expanded.
  • 14 is a cross-sectional view taken along line AA in FIG.
  • FIG. 15 is an enlarged cross-sectional view of the proximal end portion of the catheter shown in FIG.
  • the stent delivery catheter 1 of the present invention includes an outer tube 8, an inner tube 5 having a distal end projecting from the distal end of the outer tube 8 through a predetermined length, and a substantially uniform outer tube when expanded.
  • a cylindrical portion 6a having a diameter, a distal-side catheter joint 6d, and a distal-end outer diameter changing portion located between the distal end of the tubular portion 6a and the distal-side force tatel joint 6d 6b, a proximal catheter joint 6e, and a proximal outer diameter changing portion 6c positioned between the distal end of the proximal catheter joint 6e and the proximal end of the tubular portion 6a.
  • the distal catheter joint 6d is fixed to the distal end of the inner tube 5, the proximal catheter joint 6e is fixed to the outer tube 8, and the balloon 6 is attached to the outer surface of the balloon 6.
  • Contrast material provided on the outer surface of the stent 9 to be expanded and the inner tube 5 at a position in the balloon 6 and on the proximal end side of the balloon
  • a stent delivery catheter having a distal portion and a contrast marker 18 consisting of.
  • the outer tube 8 extends to the distal end side from the proximal catheter joining portion 6e of the balloon 6 and includes a distal end portion located in the proximal outer diameter changing portion 6c.
  • the proximal end of the stent 9 is The distal end of the marker 18 is located at a position corresponding to the proximal end of the stent 9 in the axial direction of the catheter 1 or slightly closer to the proximal end than the position. Yes.
  • the proximal end of the marker 18 extends from the proximal end position by one fifth of the total length of the marker 18 from the distal end of the outer tube 8 to the lmm distal end position from the distal end of the outer tube 8. Located within range.
  • the stent delivery catheter 1 of the present invention is referred to as a so-called rabbit exchange type, and will be described using a catheter provided with a guide wire introduction port 52 in the middle part of the catheter.
  • the catheter of the present invention is not limited to the rabbit exchange type having the guide wire introduction port 52 in the intermediate portion.
  • the stent delivery catheter 1 includes a distal side shaft 3 including a balloon 6, a proximal side shaft 2, and a stent 9 mounted on the balloon 6.
  • the distal side shaft 3 and the base side shaft 2 are joined by a fixing portion 42 as shown in FIGS.
  • the outer tube 8 and the inner tube disposed in the outer tube 8 and fixed to the outer tube 8 at the proximal end and having the guide wire introduction port 52 at the proximal end. 5 and a connecting pipe part that is arranged in parallel with the base end part of the inner pipe 5 and is fixed to the base end part of the inner pipe 5 and whose tip part is liquid-tightly fixed to the base end part of the outer pipe 8 4 and a proximal shaft 2 having a distal end portion inserted and fixed in the connecting pipe portion 4 of the distal shaft 3, and the outer tube 8 or the connecting tube portion 4.
  • a distal-end shaft lumen 31 formed between the inner surface and the outer surface of the inner tube 5 communicates with a proximal-side shaft lumen 20 formed in the proximal-side shaft 2.
  • the base side shaft 2 includes a main body 21, a distal end 22 that is thinner than the main body 21 and enters the lumen 45 of the connecting pipe 4, and between the main body 21 and the distal end 22.
  • a lumen 45 of the connecting tube portion 4 is provided on the proximal end side of the connecting tube portion 4 and is directed toward the distal end to reduce the lumen cross section.
  • the base-side shaft inclined portion 23 and the lumen changing portion 46 are in contact with each other, and the pushing force applied to the main body portion 21 of the base-side shaft 2 passes through the contact portion between the two. It is transmitted to the tip side shaft 3.
  • the distal shaft 3 includes an outer tube 8, an inner tube 5, and a connecting tube portion 4.
  • the shaft 3 on the distal end side is parallel to the outer tube 8, the inner tube 5 disposed in the outer tube 8 and fixed to the outer tube 8 at the base end, and the base end of the inner tube 5.
  • the proximal end of the inner tube 5 and the distal end of the outer tube 8 is liquid-tight.
  • a fixed connecting pipe 4 is provided. Note that the outer tube 8 and the connecting tube portion 4 fixed to the base end portion of the outer tube 8 are not limited to such a configuration in which two members are fixed, but can be a single member.
  • the outer tube 8 is a tube body penetrating from the distal end to the proximal end, and the inner tube 5 can be inserted therein.
  • the outer tube 8 has an outer diameter of 0.6 to 1.5 mm, preferably 0.8 to 1. lmm, and an inner diameter force of 0.5 to 1.4 mm, preferably 0.7 to 1.0 mm. .
  • the inner tube 5 is a tube body having a guide wire lumen 51 penetrating to the proximal end as well as being inserted into the outer tube 8, as shown in Figs. As shown in FIG. 2, the tip of the inner tube 5 protrudes from the tip of the outer tube 8 by a predetermined length.
  • the inner pipe 5 has an outer diameter force of 0.35 to: L Omm, preferably 0.45 to 0.8 mm, and an inner diameter force of O. 2 to 0.9 mm, preferably 0.35 to 0.7 mm. .
  • the protruding length of the inner tube 5 at the tip of the outer tube 8 is a force 5 to about LOOmm, preferably 10 to 60 mm, which varies depending on the length of the balloon used.
  • the balloon 6 expands the stent 9 to be mounted by expanding.
  • the stent 9 is fitted onto the balloon 6 by being fitted onto the cylindrical portion 6a of the balloon 6 and compressed. Nolane 6 is folded by the compressed stent 9 and is in contact with the outer surface of the inner tube.
  • the expansion fluid flows into the balloon 6, the balloon 6 expands and the stent mounted on the balloon expands.
  • the balloon 6 used in this embodiment is provided on the distal end side of the tubular portion 6a (in other words, a stent mounting portion) that becomes a tubular shape having a substantially uniform outer diameter when expanded.
  • Tip side taper part (constitutes tip side outer diameter changing part) 6b
  • base end side taper part provided on the base end side of cylindrical part 6a (forms base end side outer diameter changing part) 6c
  • the outer diameter force of the tubular portion 6a (specifically, the cylindrical portion) when expanded is preferably 1.5 to 5.
  • Omm force and particularly preferably 2.5 to 4.
  • Omm force ⁇ I like it!
  • the length of the cylindrical portion 6a is preferably 5 to 50 mm, particularly preferably 10 to 40 mm.
  • the length of the tip side turret 6b is up to ⁇ , 2. 0 to 6. Omm force is preferable, especially 3.0 to 5.0 mm force ⁇ is preferable!
  • the length of the proximal end side tapered portion 6c is preferably 2.0 to 6.
  • the outer diameter of the distal catheter joint 6d is preferably from 0.5 to 1.5 mm, particularly preferably from 0.7 to 1. Omm.
  • the length of the distal catheter joint 6d is preferably 1 to 5 mm, and particularly preferably 1.0 to 1.3 mm.
  • the outer diameter of the proximal catheter joint 6e is preferably 0.8 to 1.6 mm, and particularly preferably 1.0 to 1.5 mm.
  • the length of the proximal end catheter joint 6e is preferably 1 to 5 mm, particularly preferably 2 to 4 mm.
  • a material having a certain degree of flexibility is preferably used as the material for forming the nolane 6, for example, heat such as polyolefin, polychlorinated bur, polyamide, polyamide elastomer, polyester elastomer, polyurethane, polyester, polyarylene sulfide, etc.
  • Plastic resin, silicone rubber, latex rubber, etc. can be used.
  • the balloon 6 which is preferably a stretchable material is preferably biaxially stretched having high strength and expansion force.
  • the balloon may be either a single layer or a multilayer structure.
  • the distal catheter joint 6d of the balloon 6 is fixed to the distal end of the inner tube 5. It should be noted that the distal end side catheter joint 6d of the balloon 6 is fixed so as to be located on the proximal end side with respect to the distal end of the inner tube 5 at a predetermined distance.
  • the distance between the distal end catheter joint 6d of the balloon 6 and the distal end of the inner tube 5 is preferably 1.0 to 4. Omm.
  • the proximal end side catheter joint 6 e of the balloon 6 is fixed to the distal end portion of the outer tube 8.
  • the outer tube 8 is provided with a distal end portion 8b that extends to the distal end side from the proximal end side catheter joint 6e of the balloon 6 and is positioned in the proximal end tapered portion 6c of the balloon 6.
  • the proximal end side catheter joint 6e of the balloon 6 is fixed so that the distal end thereof is closer to the proximal end side by a predetermined distance than the distal end 8a of the outer tube 8.
  • the length of the distal end portion 8b (in other words, the distal end of the proximal end catheter joint portion 6e of the balloon 6 and the outer tube 8 is fixed to the proximal end catheter joint portion 6e of the balloon 6 of the outer tube 8.
  • Omm force S is preferable, and 3.0 to 5.
  • Omm force S is particularly preferable.
  • the distal end 8a of the outer tube 8 is located in the proximal end side tapered portion 6c of the balloon 6 and does not reach the cylindrical portion 6a.
  • the proximal-side outer diameter changing portion (proximal-side tapered portion) 6c of the balloon 6 extends from the distal end 8a of the outer tube 8 to the distal end side.
  • the distal end 8a of the outer tube 8 is inside the proximal end side tapered portion 6c of the balloon 6.
  • all or most of the markers 18 are located within the base end side outer diameter changing portion (base end side tapered portion) 6c of the balloon 6.
  • the marker 18 is disposed between the distal end 8a of the outer tube 8 and the proximal end of the balloon tubular portion 6a. Even if the balloon tubular portion 6a, which is the stent expansion region, is arranged so as to be at the base end, the stent and the marker do not overlap.
  • the balloon tubular portion protruding from the stent can be made extremely small.
  • the balloon tubular portion that protrudes from the stent does not have the stent on the outside, so it expands excessively (expands) during expansion, and the normal lumen of the body or the inner wall of the body cavity near the stenosis There is a fear of expanding and damaging the inner wall.
  • the stent and the marker do not overlap each other.
  • the outer diameter (profile) in the stent and marker placement portion during insertion into the living body can be made small.
  • the outer tube and the marker do not overlap.
  • the stent 9 used in the stent delivery catheter 1 of the present invention is formed in a substantially tubular body, has a diameter for insertion into a living body, and has a wide force radially outward from the inside of the tubular body. Can be expanded when the balloon 6 is expanded, in other words when the balloon 6 is expanded It is a so-called balloon expandable stent.
  • the proximal end of the stent 9 is located at the proximal end portion of the cylindrical portion 6a of the balloon 6.
  • the proximal end of the stent 9 is mounted so as not to protrude from the proximal end of the tubular portion 6a of the nolane 6, and the distance between the proximal end of the stent 9 and the proximal end of the tubular portion 6a of the balloon 6 is 1. It is preferable that it is 5 mm or less. Further, the distal end of the stent 9 is located at the distal end portion of the cylindrical portion 6 a of the balloon 6. The distal end of the stent 9 is mounted so as not to protrude from the distal end of the tubular portion 6a of the balloon 6. The distance between the distal end of the stent 9 and the distal end of the tubular portion 6a of the balloon 6 is 1.5 mm or less. It is preferable that it exists.
  • the stent 9 may be any balloon expandable stent.
  • the stent 9 shown in FIG. 16 has a first wavy annular body 92a formed in a ring shape by a wavy element having a large number of bent portions 85a, and a peak portion close to a valley portion of the first wavy annular body 92a.
  • a second corrugated annular body 92b that is arranged in the axial direction of the stent 9 so as to be in contact with each other and is annularly formed by a corrugated element having a linear bent portion 85a, and a valley portion of the first corrugated annular body 92a 2 is composed of an annular unit 84 comprising a plurality of connecting portions 86 connecting the peaks of the corrugated annular body 92b, and the annular units 84 are arranged in the axial direction of the stent 9 and are adjacent to each other.
  • a connecting portion 87 for connecting the units at the connecting portion forming portion is provided.
  • a plurality of connecting portions 87 are provided between the adjacent annular units 84 so as to have a plurality of opposing positions or substantially equiangular positions with respect to the central axis of the stent.
  • the stent 9 in this example is arranged so as to be substantially linear in the axial direction of the plurality of annular units 84 force stent 9, and the corrugated elements (corrugated annular bodies) of adjacent annular units. 92b and 92a) are provided with a connecting portion 87 for connecting the connecting portion 86 to the forming portion thereof.
  • the stent 9 is a tubular body formed by connecting a large number of annular units 84 by connecting portions 87.
  • the shape of the stent 9 is not limited to this, and a known one such as a mesh shape can be used.
  • Examples of preferable materials for forming the stent 9 include stainless steel, tantalum or tantalum alloy, platinum or platinum alloy, gold or gold alloy, and cobalt base alloy. It is done. In addition, precious metal plating (gold, platinum) may be performed after the stent shape is produced. The most corrosion resistant stainless steel SUS316L with is suitable.
  • annealing after creating the final shape of the stent.
  • the flexibility and plasticity of the entire stent is improved, and the indwellability in the bent blood vessel is improved.
  • the force that tries to restore the shape before expansion after expanding the stent is reduced.
  • Physical stimulation given to the bent inner wall of the blood vessel is reduced, and the factor of restenosis can be reduced.
  • Annealing is preferably performed by heating to 900-1200 ° C in an inert gas atmosphere (for example, argon gas) and then cooling slowly so that no oxide film is formed on the stent surface! /.
  • the diameter when the stent 9 is mounted is preferably about 0.8 to 1.5 mm, and more preferably 0.9 to 1.3 mm.
  • the length of the stent is preferably about 5 to 50 mm, and particularly preferably 8 to 40 mm.
  • the length of the stent is preferably about 1 to 0.95 times the length of the balloon tubular portion.
  • a proximal contrast marker 18 is fixed to the inner tube 5.
  • the proximal end side marker 18 is fixed to the outer surface of the inner tube 5 so as to be positioned in the proximal end side tapered portion 6 c of the nolane 6.
  • the proximal end 18a of the marker 18 has a position force on the proximal end side that is one fifth of the total length of the marker 18 from the distal end of the outer tube 8. It is located within the range up to the position lmm ahead.
  • the proximal end 18a of the marker 18 is located at the same position as the distal end of the outer tube 8 or slightly on the distal end side, and both overlap with each other in the axial direction. I don't have a part.
  • the distance L1 between the proximal end 18a of the marker 18 and the distal end 8a of the outer tube 8 is 1 mm or less.
  • L1 is 0.8 mm or less.
  • the two have overlapping portions in the axial direction as described above, but it may be as shown in FIG. 5 and FIG.
  • the proximal end 18a of the marker 18 is located on the proximal end side from the distal end of the outer tube 8, and both have overlapping portions in the axial direction.
  • the distance L2 (the length overlapping in the axial direction) between the proximal end 18a of the marker 18 and the distal end 8a of the outer tube 8 is 1Z5 or less of the total length of the marker 18.
  • L2 is 1/8 or less of the total length of the marker 18.
  • L2 is preferably 1.2 mm or less.
  • the portion where the marker and the outer tube overlap is sufficiently short. Neither does it impede the responsiveness of balloon dilation, “inflow of deflation fluid into the balloon” or outflow.
  • the distal end 18b of the marker 18 is located at a position corresponding to the proximal end of the stent 9 in the axial direction of the catheter 1 or slightly proximal from the position.
  • the marker 18 and the stent 9 do not have an overlapping portion with respect to the axial direction.
  • the axial distance X between the distal end 18b of the marker 18 and the proximal end 9 of the stent 9 is preferably 1 mm or less. Particularly preferably, X is 0.5 mm or less.
  • the catheter when the catheter is positioned at the same position as the proximal end of the stent or the proximal end of the stent, when the catheter passes through a biological conduit such as a more peripheral tortuous blood vessel.
  • the marker does not come into contact with the stent through the balloon wall, and there is no fear that the end of the stent or the balloon will be damaged by the marker. Therefore, it is possible to provide a stent delivery catheter that can reliably carry a stent to a peripheral target living organ site without damaging the stent or balloon.
  • the distal contrast marker 17 is fixed to the inner tube 5.
  • the distal side marker 17 is fixed to the outer surface of the inner tube 5 so as to be located in the distal side tapered portion 6b of the balloon 6.
  • the proximal end of the marker 17 is located at a position corresponding to the distal end of the stent 9 in the axial direction of the catheter 1 or slightly on the distal side from the position.
  • the marker 17 and the stent 9 do not have an overlapping portion with respect to the axial direction.
  • the axial distance between the proximal end of the marker 17 and the distal end of the stent 9 is preferably 1 mm or less. Particularly preferably, it is 0.5 mm or less.
  • Radiographic markers include gold, platinum, tungsten or Among these alloys, those formed of at least one metal or two or more alloy members from the group consisting of silver-palladium alloy force are preferable.
  • ultrasonic contrast marker stainless steel or the like can be used in addition to the metal described above.
  • the stent delivery catheter of the present invention includes a guide wire member constituted by the lumen of the inner tube 5.
  • the stent delivery catheter of the illustrated embodiment has a guide wire lumen 51 constituted by the lumen of the inner tube 5 and a guide wire guide that communicates with the guide wire lumen 51 and opens at an intermediate portion of the stent delivery catheter.
  • An entrance 52 is provided.
  • the catheter 1 of this embodiment includes a distal side shaft 3 that forms a distal end side portion, and a proximal side shaft 2 in which the distal end side portion is inserted and fixed in the distal end side shaft.
  • the shaft 3 is formed at the proximal end portion of the distal end side shaft 3 and includes a guide wire introduction port 52 communicating with the inside of the inner tube 2, and the lumen 31 formed in the outer tube 8 is formed in the proximal side shaft 2. In communication with the formed proximal shaft lumen 20.
  • the inner pipe 5 has a base end portion exposed from the outer pipe 8.
  • the inner tube 5 is liquid-tightly fixed to the proximal end of the outer tube 8 at a portion slightly distal to the proximal end.
  • a guide wire introduction port 52 is provided at the proximal end portion of the inner pipe 5, in this embodiment, the proximal end.
  • the guide wire introduction port 52 is formed obliquely so as to incline toward the base end side. This facilitates guide wire insertion.
  • the connecting pipe part 4 has a tip formed obliquely.
  • the distal end portion 41 of the connecting pipe portion 4 does not penetrate into the outer tube 8, is positioned outside the outer tube 8, and is a part of the inner surface of the distal end portion 41 of the connecting tube portion 4. Is in contact with a part of the outer surface of the base end portion of the outer tube 8.
  • the outer tube 8 and the connecting tube 4 are fused in a liquid-tight manner at the contact surface described above. Furthermore, a part of the outer surface on the distal end side of the connecting pipe part 4 is in contact with a part of the outer surface of the proximal end part of the inner pipe 5.
  • the inner tube 5 and the connecting tube 4 are fused in a liquid-tight manner at the contact portion 43.
  • the contact portion 43 is melt-deformed into a shape corresponding to the curved shape of the proximal end portion of the inner tube 5, and forms an inclined surface continuous with the guide wire introduction port 52 of the inner tube 5. It is made.
  • the connecting tube portion lumen 45 formed between the inner surface of the connecting tube portion 4 and the outer surface of the inner tube 5 and the base portion formed in the base side shaft 2 are used.
  • the proximal end portion of the connecting pipe portion 4 and the distal end portion of the proximal side shaft 2 are fused.
  • a material having a certain degree of flexibility is preferable as a material for forming the inner tube 5, the connecting tube portion 4, and the outer tube 8.
  • polyamide, polyester, polyamide elastomer, polyester elastomer, polyolefin (for example, polyethylene) Polypropylene, ethylene propylene copolymer, ethylene vinyl acetate copolymer, and cross-linked or partially cross-linked products thereof, polyvinyl chloride, polyurethane and the like are suitable.
  • the inner tube 5 may be formed of a single resin material. However, in order to improve the sliding property of the guide wire, the inner layer is made of a low friction material such as polyethylene, fluorine.
  • the outer layer has a material force compatible with the material of the distal end side shaft (the outer tube 8 and the connecting tube portion 4).
  • the inner layer forming material may not be compatible with the material of the base side shaft and the tip side shaft.
  • the base side shaft 2 is a tube body penetrating from the distal end to the proximal end, and includes a node 7 fixed to the proximal end.
  • the distal end portion of the base side shaft 2 is joined to the proximal end portion of the distal end side shaft 3.
  • the base side shaft 2 is fixed to the distal end portion of the hub 7 at the base end.
  • a kink prevention tube 71 is attached to the outer surface of the boundary between the hub 7 and the base shaft 2 so as to cover both.
  • the base end portion of the hub 7 serves as a connection portion 72 of a balloon inflating fluid injection device (for example, a syringe).
  • the length force S800mm ⁇ 1500mm, more preferably 1000 ⁇ 13 OOmm, the outer diameter is 0.5 ⁇ 1.5mm, preferably 0.6 ⁇ 1.3mm, Is 0.3 to 1.4 mm, preferably 0.5 to 1.2 mm.
  • the base-side shaft 2 enters the body portion 21 and the lumen 45 of the connecting tube portion 4 which is narrower than the body portion 21.
  • the base side shaft inclined portion 23 formed to connect the front end portion 22 and the main body portion 21 and the front end portion 22 to each other. I have.
  • the length of the tip 22 is 3mn! About 15 mm is preferable.
  • the length of the inclined portion 23 in the axial direction is preferably about 2 mm to 10 mm.
  • this base side shaft 2 as shown in FIGS. 10, 11, and 13, only a part of the main body portion 21 of the base side shaft 2 is axially moved. It is formed in the shape of a bowl extending to the top.
  • the size of the arc formed by the cross section when cut in the direction perpendicular to the axial direction of the tip 22 is preferably about 1Z16 to LZ2 of the size of the circle formed by the cross section of the main body 21.
  • the distal end portion 22 is not limited to such a bowl-like shape curved in the direction of the central axis of the shaft 2, but is a bowl-like shape curved in the direction opposite to the direction of the central axis of the shaft 2. It may be a flat plate,
  • the base side shaft inclined portion 23 is formed so as to be inclined with respect to the central axis of the base side shaft from the distal end of the main body portion 21 to the proximal end of the distal end portion 22. ing.
  • the base-side shaft inclined portion 23 has a form in which the base-side shaft is cut obliquely by a predetermined length, and the cut-out inclined portion forms the base-side shaft lumen 20 and the distal end side.
  • a communication portion communicating with the shaft lumen 31 is formed.
  • the distal end portion of the base side shaft 2 has a shape in which the base side shaft is cut out in a predetermined length and a predetermined width axis direction, and the base side shaft inclined portion 23 is formed by cutting the base side shaft. It has a shape that is obliquely cut out by a predetermined length, and the cut-out inclined portion forms a communication portion that communicates the base-side shaft lumen and the distal-end shaft lumen.
  • the inclined portion 23 may be opened only at the distal end portion and not at the proximal end portion.
  • a material for forming the base side shaft 2 it is preferable to use a material having relatively high rigidity, for example, a metal such as Ni—Ti, brass, SUS, or aluminum.
  • a resin such as polyimide, butyl chloride, and polycarbonate.
  • the lumen 45 of the connecting tube portion 4 forms the proximal end portion of the distal shaft lumen 31, and the lumen changing portion 46 is for connection. It is provided in the pipe 4. Then, the distal end portion 22 of the base side shaft 2 has entered the connecting tube lumen 45. .
  • the connecting pipe portion 4 has a form as shown in FIGS.
  • the connecting pipe part 4 includes a fixing part (tip part) 41 to the outer pipe 8 at the tip part, and a part of the side wall on the proximal side from the fixing part 41 is a side wall of the base part of the inner pipe 5.
  • a welded part (contact part) 43 that is liquid-tightly welded to a part of the tube, a lumen changing part 46 located on the proximal side of the welded part 43, and a lumen changing part 46, and a predetermined length.
  • a cylindrical portion 44 that extends, and a fixing portion 42 to the base side shaft 2 formed at the base end are provided.
  • the lumen 45 in the connecting pipe portion 4 is in a state of being parallel to the inner tube 5 at the distal end portion, and closer to the proximal end than the proximal end of the inner tube 5.
  • the lumen 45 is present alone.
  • the lumen 45 in a portion where the inner tube 5 does not exist is provided with a lumen changing portion 46 that is directed toward the distal end and becomes smaller in lumen cross section.
  • the lumen 45 in the connecting tube portion 4 has a smaller inner diameter on the distal end side than the proximal end side of the lumen changing portion (lumen inclined portion) 46.
  • the lumen changing portion 46 is not limited to such a shape.
  • a wall portion formed in a direction perpendicular to the long axis of the connecting pipe portion is more than the wall portion.
  • a shape in which the distal end side is narrower than the base end side than the wall portion may be used. That is, the lumen changing portion 46 may be either a lumen stepped portion or a lumen inclined portion.
  • the outer surface of the connecting tube portion 4 corresponding to the lumen changing portion 46 is also inclined according to the inclined surface of the lumen changing portion 46.
  • the lumen changing portion 46 at the proximal end side from the portion where both the distal-side shaft lumen (connecting tube lumen) and the inner-tube lumen exist on the distal side from the guide wire introduction port, Since the inner diameter of the distal shaft shaft lumen in the portion where the two lumens coexist can be made small, the outer diameter of the portion where the two lumens coexist can be suppressed.
  • the base side shaft inclined portion 23 of the base side shaft 2 and the lumen changing portion 46 of the connecting pipe portion 4 are in contact with each other.
  • the pushing force applied to the main body portion 21 of the base side shaft 2 is transmitted to the distal end side shaft 3 through the contact portion between the two.
  • the base side shaft 2 is disposed at the base end portion of the connecting pipe portion 4 so that the tip end portion 22 is on the fused portion 43 and the inner tube 5 side.
  • the distal end portion 22 of the base side shaft 2 may be in contact with the fused portion 43 (and the inner tube 5), or may be slightly separated. Preferably, it is in contact.
  • the distal end of the distal end portion 22 of the base side shaft 2 is preferably positioned closer to the distal end side of the catheter 1 than the guide wire introduction port 52 is.
  • the guide wire introduction port 52 is reinforced, and the catheter can be prevented from being broken in the vicinity of the opening 52.
  • the distal end of the distal end portion 22 of the base side shaft 2 reaches the inside of the outer tube 8 as shown in FIGS. 9 and 10.
  • the direction of the guide wire introduction port 52 of the inner tube 2 and the direction of the base-side shaft inclined portion 23 are opposite to the central axis of the outer tube.
  • the opening 52 exists on the back side of the arc of the cross section of the base side shaft inclined portion 23 (outside of the curved portion of the inclined portion 23, on the outer surface side of the inclined portion 23).
  • the catheter When the guide wire is inserted into the guide wire lumen, the catheter is easily bent in the direction in which the guide wire is outside the curve. When such bending occurs, the pushing force applied at hand tends to escape. However, in the portion where the base shaft tilt portion is formed, the catheter is unlikely to bend in the direction in which the side with the base shaft tilt portion is located inside the curve. Bending can be suppressed and prevented.
  • the distal end portion 22 of the base side shaft 2 is formed in a bowl shape in which only a part of the main body portion 21 of the base side shaft 2 extends in the axial direction.
  • the distal end portion 22 is disposed so as to be on the fused portion 43 side and the inner tube 5 side. For this reason, the bowl-shaped distal end portion 22 is in a state of being turned to the back with respect to the fused portion 43 and the inner tube 5, thereby suppressing or preventing the bending of the catheter when the guide wire is inserted.
  • a slit 25 or a large number of openings may be formed in the distal end portion of the main body portion of the base side shaft 2.
  • a distal end is provided slightly on the proximal end side with respect to the base shaft inclined portion 46 and extends to the proximal end side for a predetermined length.
  • a slit or an opening may also be formed in the base shaft inclined portion.
  • the length of the slit or aperture formation area is lOOmn! About 300mm is suitable.
  • the slit 25 is preferably a spiral slit as shown in the figure, but may be a slit extending in parallel with the central axis of the shaft 2. Further, when the spiral slit is used, the flexibility may be changed by appropriately changing the slit pitch in the longitudinal direction of the base side shaft. In addition, it is preferable that the pitch of the spiral slit is short on the tip end side of the slit and is long on the base end side of the slit. By doing so, it becomes flexible toward the tip, so that the curve with a sudden change in physical properties becomes natural. Further, it is preferable that the intermediate portion between the front end portion and the base end portion has an intermediate pitch between them or the pitch gradually changes. In particular, it is preferable that the spiral slit has a pitch that gradually decreases toward the tip! / Or that the width gradually increases toward the tip.
  • the hole diameter is 0.1 nm! About 0.4mm is more preferable, 0.2mn! ⁇ 0.3mm.
  • the hole diameter is preferably about 1Z10 to 1Z3, which is the outer diameter of the base side shaft.
  • the distance between the openings is preferably about 0.1 to 0.5 mm.
  • the shape of the opening does not need to be a perfect circle, but may be an ellipse, for example, an ellipse elongated in the circumferential direction or the axial direction of the base side shaft, or a polygon (for example, a quadrangle, a pentagon).
  • the number of apertures in the aperture formation region is larger at the tip than at the base end.
  • the number of apertures gradually increases as the force is directed toward the distal end side from the proximal end side.
  • a slit or a large number of apertures are formed in the distal end side portion of the main body portion 21 of the base side shaft 2, and the base end portion of the distal end side shaft 3 is slit or multi-opened. It encloses the main body 21 of the base side shaft 2 in which a number of apertures are formed, and is fixed to the base side shaft on the base end side with respect to the slits or the portions where the plurality of apertures are formed.
  • the connecting pipe portion 4 includes a cylindrical portion 44 that encloses the slit or hole forming region of the base side shaft 2.
  • the fixing portion 42 of the connecting pipe portion 4 is fixed to the base side shaft 2 in a liquid-tight manner on the base side from the slit or opening formation region. Furthermore, a gap 47 is formed between the base side shaft 2 and the cylindrical portion 44 of the connecting pipe portion 4 as shown in FIGS. That is, the cylindrical part 44 of the connecting pipe part 4 is The part side shaft 2 is not in close contact. For this reason, it is possible to make a good curve with little deformation inhibition of the slit or the opening forming region of the base side shaft 2 by the cylindrical portion.
  • the connecting pipe portion 4 preferably has a total length of about 100 mm to 400 mm.
  • the length from the distal end of the connecting tube portion 4 to the proximal end of the lumen changing portion is preferably about 3 to 15 mm, more preferably 5 to 7 mm.
  • the length of the cylindrical portion 44 of the connecting pipe portion 4 is preferably about 50 mm to 300 mm.
  • the connecting pipe part covers the slit part of the base side shaft, so that the connecting pipe part is rather long at the distal end side of the connecting pipe part. ) Is to be positioned.
  • the present invention is not limited to this, and the lumen changing portion may be located on the proximal end side of the connecting pipe portion.
  • a rigidity imparting member 11 may be inserted into the base side shaft 2.
  • the rigidity imparting body 11 is fixed to the hub 7 of the base side shaft 2 at the base end, and the tip protrudes from the tip of the base side shaft 2 and extends into the tip side shaft 3.
  • the distal end of the rigidity imparting body 11 reaches the distal end shaft lumen 31 (in other words, the balloon expansion lumen) formed by the inner tube 5 and the outer tube 8 of the distal shaft 3. is doing.
  • the rigidity imparting body 11 extends from the proximal end of the base side shaft 2 to the distal end side. Further, the rigidity imparting body 11 is fixed to the base side shaft 2 or the hub 7 only at the base end so as not to obstruct the bending of the catheter 1, and other parts, specifically, the base side shaft 2 is fixed. It is not fixed to any of the inside, the inner tube 5 and the distal end side shaft 3 except for the base end portion. The rigidity imparting body 11 prevents the base-side shaft 2 from being meandered in the blood vessel by extreme bending of the base-side shaft 2 at the bent portion without significantly reducing the flexibility of the base-side shaft 2.
  • the rigidity imparting body 11 is preferably formed of a linear body.
  • the linear body is preferably a metal wire, preferably a wire diameter of 0.05 to L: 5 mm, preferably 0.1 to 1. Omm, such as an elastic metal such as stainless steel, a superelastic alloy, etc. High-strength stainless steel and superelastic alloy wire are preferable.
  • the superelastic alloy is generally a shape memory alloy, and is superelastic at least at a living body temperature (around 37 ° C).
  • a Ti-Ni compound of 49-53 atomic% Ni. Gold, 38. 5-41. 5 wt% Zn Cu—Zn alloy, 1 10 wt% 01—211—alloy (X Be, Si, Sn, Al, Ga), 36—38 atomic% Ni Ni — Superelastic alloys such as Al alloys are preferably used.
  • the above Ti-Ni alloy is desirable.
  • the mechanical characteristics can be appropriately changed by selecting the cold working rate and / or the final heat treatment conditions.
  • the mechanical properties can be changed as appropriate by selecting the cold work rate and Z or final heat treatment conditions using the Ti-Ni-X alloy described above.
  • the balloon may have a shape like the stent delivery catheter 40 shown in FIG.
  • the difference between the balloon 6 described above and the catheter 16 of this embodiment is only the distal-end-side outer diameter changing portion 16b and the proximal-end-side outer diameter changing portion 16c.
  • the proximal-side outer diameter changing portion 16c is continuous with the proximal-side joining portion 16e, and has an outer diameter that increases toward the distal direction, and an inclination angle with respect to the longitudinal axis of the balloon 16 is 3 to 10 °.
  • the proximal low slope part is located on the distal side of the proximal low slope part, and the outer diameter increases at a rate of change larger than the change rate of the outer diameter in the proximal low slope part toward the distal direction.
  • a base-side high slope portion is provided.
  • the distal end side outer diameter changing portion 16b is continuous with the distal end side joint portion 16d, the outer diameter increases toward the proximal direction, and the inclination angle with respect to the longitudinal axis of the balloon 16 is 3 to 10 °. It is located at the base end side of the tip side low slope part and the tip side low slope part, and the outer diameter is directed toward the base end and increases at a change rate larger than the change rate of the outer diameter in the tip side low slope part. And a tip side high inclined portion.
  • the catheter of the present invention is not limited to the rabbit status change type having the guide wire introduction port 52 in the intermediate portion.
  • a stent delivery catheter 100 of the type shown in FIG. 17 may be used.
  • the catheter 100 of this embodiment has the structure shown in FIGS. 2 to 4 or FIGS. 5 to 7 similar to the catheter 1 or catheter 30 of the embodiment described above.
  • the inner tube 5 is It penetrates the entire length of the tube. Therefore, the overall force of the catheter is a double tube structure consisting of an inner tube and an outer tube force.
  • the hub 110 that fixes the proximal end of the inner tube 5 and the proximal end of the outer tube 8 includes a guide wire inlet 109 that communicates with the inner tube 5 and an expansion fluid inlet 111 that communicates with the inner tube 5. .
  • the stent delivery catheter of the present invention since there is no overlapping marker portion in the axial direction in the balloon and on the outer surface of the inner tube, there is no overlap between the marker and the stent. In addition, there is no formation of a hard part due to this, and since the distance between the marker and the outer tube is within a predetermined range, kinking between the marker and the outer tube is prevented, and pushability to the peripheral target living organ part is improved. Excellent. In addition, it is possible to reliably expand a stent that does not impede the flow of expansion liquid into the balloon.

Abstract

Stent delivery catheter (1) having a distal-end-side section comprising outer tube (8); inner tube (5) passing through the interior of the outer tube (8); balloon (6) having tubular part (6a), distal-end-side catheter junction part (6d), distal-end-side outside diameter change part (6b), base-end-side catheter junction part (6e) and base-end-side outside diameter change part (6c), the balloon (6) at its distal end side fixed to the inner tube (5) and at its base end side fixed to the outer tube (8); stent (9) fitted to the balloon (6); and imaging marker (18) fitted to the inner tube (5). The outer tube (8) has a distal-end portion positioned in the base-end-side outside diameter change part (6c) of the balloon (6). The distal end of the marker (18) lies in a position corresponding to the base end of the stent (9) or slightly to the base end side. The base end of the marker lies in the region ranging from a position to the base end side by 1/5 of the whole length of the marker from the distal end of the outer tube to a position to the distal end side by 1 mm from the distal end of the outer tube.

Description

明 細 書  Specification
ステントデリバリーカテーテル  Stent delivery catheter
技術分野  Technical field
[0001] 本発明は、血管、胆管、気管、食道、尿道、その他の臓器などの生体器官内に形 成された狭窄部の改善に使用されるステントデリバリーカテーテルに関する。特に、 血管内治療における狭窄病変、主に心血管等の狭窄部位における PTCA施行後に 行う生体器官拡張用ステントを安全かつ、スムーズな操作性のもとに、目的生体器官 部位まで運ぶことの可能なステントデリバリーカテーテルに関するものである。  The present invention relates to a stent delivery catheter used for improving a stenosis formed in a living organ such as a blood vessel, a bile duct, a trachea, an esophagus, a urethra, and other organs. In particular, it is possible to transport a stent for expanding a living organ after PTCA at a stenotic lesion in endovascular treatment, mainly cardiovascular, to the target living organ site with safe and smooth operability. The present invention relates to a stent delivery catheter.
背景技術  Background art
[0002] 従来より、血管、胆管、食道、気管、尿道、その他の臓器などの生体管腔または体 腔の狭窄部にステントを留置して管腔または体腔空間を確保する生体器官拡張法が 行われている。  [0002] Conventionally, a living organ dilatation method has been performed in which a stent is placed in a narrowed portion of a body lumen or body cavity such as a blood vessel, bile duct, esophagus, trachea, urethra, and other organs to secure the lumen or body cavity space. It has been broken.
これに使用されるステントとしては、機能および留置方法によって、バルーンエキス パンダブルステントとセルフエキスパンダブルステントとがある。  Stents used for this include balloon expandable stents and self-expandable stents depending on the function and placement method.
[0003] ノ レーンエキスパンダブルステントは、ステント自身に拡張機能はなぐステントを目 的部位に留置するには、例えば、バルーンに装着されたステントを目的部位まで挿 入した後、バルーンを拡張させ、バルーンの拡張力によりステントを拡張 (塑性変形) させ目的部位の内面に密着させて固定する。  In order to place a stent having no expansion function in the stent itself at the target site, for example, the nora expandable stent is inserted into the target site and then the balloon is expanded. The stent is expanded (plastically deformed) by the expansion force of the balloon, and is fixed in close contact with the inner surface of the target site.
従来のバルーンエキスパンダブル型ステントデリバリーカテーテルは、例えば、特 開平 10— 234860号公報にあるように、内管と、内管より所定長基端側に後退した 位置に設けられた外管と、先端部が内管に固着され基端部が外管に固着され、収縮 または折り畳まれた状態で設けられたバルーンと、バルーンの外面に載置されたステ ントと、ステントの位置を X線透視下で視認するためにステントの両端部付近にそれ ぞれ設けられた放射線不透過性材料カゝらなる X線造影用マーカーを備えている。  A conventional balloon expandable stent delivery catheter includes, for example, an inner tube, an outer tube provided at a position retracted to a proximal end side by a predetermined length from the inner tube, as disclosed in Japanese Patent Publication No. 10-234860, X-ray fluoroscopy of the balloon with the distal end fixed to the inner tube and the proximal end fixed to the outer tube in a contracted or folded state, the stent placed on the outer surface of the balloon, and the stent position X-ray contrast markers, such as radiopaque materials, are provided near both ends of the stent for visual recognition below.
[0004] しかし、このような従来のステントデリバリーカテーテルは、硬 、材料である放射線 不透過性材料カゝらなる造影マーカーよりも基端側部分に、マーカーが存在する部分 とマーカーが存在せず内管およびバルーンのみ力もなる部分とが形成される。末梢 の目的生体器官部位まで挿入可能にカテーテルを極めて細径に構成した場合、上 述の両者間の剛性の差が大き 、ため、その部分にぉ 、てカテーテル(内管)がキンク し易い。このようなキンクが発生すると、カテーテルの手元で与えた押し込み力がこの キンクで消失し、カテーテル先端まで押し込み力が伝達されず、カテーテルを末梢の 目的生体器官部位まで運ぶことが困難となる。 [0004] However, such a conventional stent delivery catheter has a marker-existing portion and a marker on the proximal side portion of the contrast marker made of a radiopaque material that is a hard material. Only the inner tube and the balloon also have a force. Peripheral When the catheter is configured so as to have a very small diameter so that it can be inserted into the target living organ part, the difference in rigidity between the two is large, so that the catheter (inner tube) is easily kinked in that part. When such a kink occurs, the pushing force applied at the hand of the catheter disappears at this kink, and the pushing force is not transmitted to the distal end of the catheter, making it difficult to carry the catheter to the peripheral target living organ site.
[0005] また、造影マーカーは白金等のきわめて硬 ヽ放射線不透過性材料から形成されて いるため、より末梢の生体目的器官部位までカテーテルを押し進めようとすると、曲が りくねつた血管等の生体管路を通過する際に硬いマーカーがバルーン壁を介してス テント端部と接触し、ステントおよびバルーン壁を傷つける虞れもある。  [0005] In addition, since the contrast marker is formed of a very hard radiopaque material such as platinum, when the catheter is pushed forward to a more peripheral living body organ site, a living body such as a bent blood vessel is formed. When passing through the duct, a hard marker may come into contact with the end of the stent through the balloon wall, damaging the stent and balloon wall.
特開 2003— 102844号公報(米国公開公報 2004267280)の図 8には、アウター チューブ 2の先端をバルーン 1内に延ばし、マーカー 4の基端に近接させたステント デリバリーカテーテルが図示されている。このものによれば、インナーチューブとバル ーンのみで形成される部分の領域が少なくなり、その部分におけるキンク防止効果が 期待できる。  FIG. 8 of Japanese Patent Laying-Open No. 2003-102844 (US Publication 2004267280) shows a stent delivery catheter in which the distal end of the outer tube 2 extends into the balloon 1 and is close to the proximal end of the marker 4. According to this, the area of the portion formed only by the inner tube and the balloon is reduced, and the kink prevention effect at that portion can be expected.
発明の開示  Disclosure of the invention
発明が解決しょうとする課題  Problems to be solved by the invention
[0006] し力し、特開 2003— 102844号公報(米国公開公報 2004267280)の図 7に示す ステントデリバリーカテーテルでは、特開 2003— 102844号公報 (米国公開公報 20 04267280)の図 13に示すように、バルーン 1の円筒状部分 1A全体にステント 11が 被着される。このため、マーカー 4は、ステント 11の基端部内に位置するものとなり、 両者は軸方向において重なった状態となる。このためステント 11の基端部がかなり硬 いものとなり、さらに、ステントの基端部と近接した位置にアウターチューブの先端が 位置することになり、ステントの基端部力 アウターチューブの先端部にかけて、湾曲 しにくい部分が形成され、操作性の低下が危惧される。さらに、特開 2003— 10284 4号公報(米国公開公報 2004267280)の図 13のように圧着されたステント 11の基 端は、マーカーの基端とバルーンを介して近接する。これにより、ステントの基端、マ 一力一の基端、バルーンにより、アウターチューブの先端開口が閉塞されるに近い状 態となり、バルーン拡張の流体の流入を阻害する可能性が高い。 [0007] 本発明の目的は、上記従来技術の問題点を解消し、外管の先端とステントの基端 との間におけるキンクの発生、およびマーカーとステントの重なりによるカテーテルの 部分的硬質ィ匕を防止し、末梢の目的生体器官部位への押し込み性に優れるとともに 、ノ レーンへの拡張用液体の流入障害もなぐステントを確実に拡張させることが可 能なステントデリバリーカテーテルを提供する。 [0006] In the stent delivery catheter shown in FIG. 7 of Japanese Patent Laid-Open No. 2003-102844 (US Publication 2004267280), as shown in FIG. In addition, the stent 11 is attached to the entire cylindrical portion 1A of the balloon 1. For this reason, the marker 4 is located within the proximal end portion of the stent 11, and both are overlapped in the axial direction. For this reason, the proximal end portion of the stent 11 is considerably hard, and further, the distal end of the outer tube is positioned close to the proximal end portion of the stent, and the proximal end portion force of the stent is applied to the distal end portion of the outer tube. As a result, parts that are difficult to bend are formed, and the operability may be degraded. Furthermore, the proximal end of the stent 11 that is crimped as shown in FIG. 13 of Japanese Patent Laid-Open No. 2003-102844 (US Publication 2004267280) is close to the proximal end of the marker via a balloon. As a result, the proximal end of the stent, the proximal end of the force, and the balloon are close to closing the distal end opening of the outer tube, and there is a high possibility that the inflow of the balloon expansion fluid will be inhibited. [0007] An object of the present invention is to solve the above-mentioned problems of the prior art, generate kinks between the distal end of the outer tube and the proximal end of the stent, and partially harden the catheter by overlapping the marker and the stent. And a stent delivery catheter that can be reliably expanded with a stent that is excellent in pushability to a target living organ site in the periphery and that has no inflow failure of the expansion liquid into the cell.
課題を解決するための手段  Means for solving the problem
[0008] 上記目的を達成するものは、以下のものである。 [0008] What achieves the above object is as follows.
(1) 外管と、該外管内を挿通し、所定長前記外管の先端より突出する先端部を有 する内管と、拡張時にほぼ均一な外径を有する筒状となる筒状部と、先端側カテー テル接合部と、前記筒状部の先端と前記先端側カテーテル接合部の基端との間に 位置する先端側外径変化部と、基端側カテーテル接合部と、前記基端側カテーテル 接合部の先端と前記筒状部の基端との間に位置する基端側外径変化部とを有し、 前記先端側カテーテル接合部が前記内管の先端部に固定され、前記基端側カテー テル接合部が前記外管に固定されたバルーンと、該バルーンの外面に装着され、該 バルーンの拡張により拡張されるステントと、前記バルーン内かつ該バルーンの基端 側となる位置の前記内管の外面に設けられた造影性材料力もなる造影用マーカーと を備える先端側部分を有するステントデリバリーカテーテルであって、  (1) An outer tube, an inner tube having a tip portion that is inserted through the outer tube and protrudes from the tip of the outer tube for a predetermined length, and a cylindrical portion that has a substantially uniform outer diameter when expanded. A distal-side catheter joint, a distal-side outer diameter changing portion located between a distal end of the tubular portion and a proximal end of the distal-side catheter joint, a proximal-side catheter joint, and the proximal end A proximal-side outer diameter changing portion located between the distal end of the side catheter joint and the proximal end of the tubular portion, the distal catheter joint is fixed to the distal end of the inner tube, A balloon in which a proximal catheter joint is fixed to the outer tube, a stent attached to the outer surface of the balloon and expanded by expansion of the balloon, and a position in the balloon and on the proximal side of the balloon A contrast marker provided on the outer surface of the inner tube and having contrasting material force A stent delivery catheter having a distal portion comprising:
前記外管は、前記バルーンの前記基端側カテーテル接合部よりも先端側に延び、 前記基端側外径変化部内に位置する先端部を備えており、  The outer tube includes a distal end portion that extends to a distal end side from the proximal catheter coupling portion of the balloon, and is positioned within the proximal outer diameter changing portion.
該ステントの基端は、前記ノ レーンの筒状部の基端部に位置しており、 前記マーカーの先端は、前記カテーテルの軸方向における前記ステントの基端に 対応する位置若しくは該位置より若干基端側に位置し、前記マーカーの基端は、前 記外管の先端より前記マーカーの全長の五分の一の長さ分基端側の位置から前記 外管の先端より lmm先端側の位置までの範囲内に位置するステントデリバリーカテ ーテノレ。  The proximal end of the stent is located at the proximal end of the tubular portion of the nolane, and the distal end of the marker is at a position corresponding to the stent proximal end in the axial direction of the catheter or slightly from the position. Located at the base end side, the base end of the marker is one-fifth of the total length of the marker from the tip of the outer tube, and is lmm from the tip of the outer tube from the position of the base end side. Stent delivery catheter located within range.
図面の簡単な説明  Brief Description of Drawings
[0009] [図 1]図 1は、本発明のステントデリバリーカテーテルの一実施例の正面図である。  FIG. 1 is a front view of one embodiment of a stent delivery catheter of the present invention.
[図 2]図 2は、図 1に示したステントデリバリーカテーテルの先端部分の拡大断面図で ある。 FIG. 2 is an enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. is there.
[図 3]図 3は、図 1に示したステントデリバリーカテーテルのステント基端部付近の拡大 断面図である。  FIG. 3 is an enlarged cross-sectional view of the stent delivery catheter shown in FIG. 1 in the vicinity of the proximal end portion of the stent.
[図 4]図 4は、図 1に示したステントデリバリーカテーテルのバルーン拡張時における 先端部分の部分省略拡大断面図である。  FIG. 4 is a partially omitted enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. 1 when the balloon is expanded.
[図 5]図 5は、本発明の他の実施例のステントデリバリーカテーテルの先端部分の拡 大断面図である。  FIG. 5 is an enlarged cross-sectional view of the distal end portion of a stent delivery catheter according to another embodiment of the present invention.
[図 6]図 6は、図 5に示したステントデリバリーカテーテルのステント基端部付近の拡大 断面図である。  FIG. 6 is an enlarged cross-sectional view of the stent delivery catheter shown in FIG. 5 in the vicinity of the proximal end portion of the stent.
[図 7]図 7は、図 5に示したステントデリバリーカテーテルのバルーン拡張時における 先端部分の部分省略拡大断面図である。  FIG. 7 is a partially omitted enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. 5 at the time of balloon expansion.
[図 8]図 8は、本発明の他の実施例のステントデリバリーカテーテルのバルーン拡張 時における先端部分の部分省略拡大断面図である。  FIG. 8 is a partially omitted enlarged cross-sectional view of a distal end portion of a stent delivery catheter according to another embodiment of the present invention when the balloon is expanded.
[図 9]図 9は、図 1に示したカテーテルにおける先端側シャフトと基部側シャフトとの接 合部付近の拡大図である。  FIG. 9 is an enlarged view of the vicinity of the joint between the distal shaft and the base shaft in the catheter shown in FIG. 1.
[図 10]図 10は、図 1に示したカテーテルにおける先端側シャフトと基部側シャフトとの 接合部付近の拡大断面図である。  FIG. 10 is an enlarged cross-sectional view of the vicinity of the joint between the distal shaft and the base shaft in the catheter shown in FIG.
[図 11]図 11は、図 9の B— B線断面図である。  FIG. 11 is a cross-sectional view taken along line BB in FIG.
[図 12]図 12は、図 9の C C線断面図である。  FIG. 12 is a cross-sectional view taken along line CC of FIG.
[図 13]図 13は、図 1のカテーテルに用いられている基部側シャフトの先端部の斜視 図である。  FIG. 13 is a perspective view of the distal end portion of the base side shaft used in the catheter of FIG. 1.
[図 14]図 14は、図 1の A— A線断面図である。  FIG. 14 is a cross-sectional view taken along line AA in FIG.
[図 15]図 15は、図 1に示したカテーテルの基端部の拡大断面図である。  FIG. 15 is an enlarged cross-sectional view of the proximal end portion of the catheter shown in FIG. 1.
[図 16]図 16は、本発明のステントデリバリーカテーテルに使用されるステントの一例 の正面図である。  FIG. 16 is a front view of an example of a stent used in the stent delivery catheter of the present invention.
[図 17]図 17は、本発明のステントデリバリーカテーテルの他の実施例の外観図であ る。  FIG. 17 is an external view of another embodiment of the stent delivery catheter of the present invention.
発明を実施するための最良の形態 [0010] 本発明のステントデリバリーカテーテルを図面に示した実施例を用いて説明する。 図 1は、本発明のステントデリバリーカテーテルの一実施例の正面図である。図 2は 、図 1に示したステントデリバリーカテーテルの先端部分の拡大断面図である。図 3は 、図 1に示したステントデリバリーカテーテルのステント基端部付近の拡大断面図であ る。図 4は、図 1に示したステントデリバリーカテーテルのバルーン拡張時における先 端部分の部分省略拡大断面図である。図 5は、本発明の他の実施例のステントデリ ノ リーカテーテルの先端部分の拡大断面図である。図 6は、図 5に示したステントデリ ノ リーカテーテルのステント基端部付近の拡大断面図である。図 7は、図 5に示したス テントデリバリーカテーテルのバルーン拡張時における先端部分の部分省略拡大断 面図である。図 8は、本発明の他の実施例のステントデリバリーカテーテルのバル一 ン拡張時における先端部分の部分省略拡大断面図である。図 14は、図 1の A—A線 断面図である。図 15は、図 1に示したカテーテルの基端部の拡大断面図である。 BEST MODE FOR CARRYING OUT THE INVENTION [0010] The stent delivery catheter of the present invention will be described with reference to the embodiments shown in the drawings. FIG. 1 is a front view of an embodiment of the stent delivery catheter of the present invention. FIG. 2 is an enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. FIG. 3 is an enlarged cross-sectional view of the stent delivery catheter shown in FIG. 1 in the vicinity of the proximal end portion of the stent. FIG. 4 is a partially omitted enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. 1 when the balloon is expanded. FIG. 5 is an enlarged cross-sectional view of the distal end portion of a stent deli catheter of another embodiment of the present invention. FIG. 6 is an enlarged cross-sectional view of the vicinity of the proximal end of the stent of the stent delivery catheter shown in FIG. FIG. 7 is an enlarged cross-sectional view of the distal end portion of the stent delivery catheter shown in FIG. FIG. 8 is a partially omitted enlarged sectional view of the distal end portion of the stent delivery catheter according to another embodiment of the present invention when the balloon is expanded. 14 is a cross-sectional view taken along line AA in FIG. FIG. 15 is an enlarged cross-sectional view of the proximal end portion of the catheter shown in FIG.
[0011] 本発明のステントデリバリーカテーテル 1は、外管 8と、外管 8内を揷通し、所定長外 管 8の先端より突出する先端部を有する内管 5と、拡張時にほぼ均一な外径を有する 筒状となる筒状部 6aと、先端側カテーテル接合部 6dと、筒状部 6aの先端と先端側力 テーテル接合部 6dの基端との間に位置する先端側外径変化部 6bと、基端側カテー テル接合部 6eと、基端側カテーテル接合部 6eの先端と筒状部 6aの基端との間に位 置する基端側外径変化部 6cとを有し、先端側カテーテル接合部 6dが内管 5の先端 部に固定され、基端側カテーテル接合部 6eが外管 8に固定されたノ レーン 6と、バ ルーン 6の外面に装着され、バルーンの拡張により拡張されるステント 9と、バルーン 6内かつバルーンの基端側となる位置の内管 5の外面に設けられた造影性材料から なる造影用マーカー 18とを備える先端側部分を有するステントデリバリーカテーテル である。そして、外管 8は、バルーン 6の基端側カテーテル接合部 6eよりも先端側に 延び、基端側外径変化部 6c内に位置する先端部を備えており、ステント 9の基端は、 バルーン 6の筒状部 6aの基端部に位置しており、マーカー 18の先端は、カテーテル 1の軸方向におけるステント 9の基端に対応する位置若しくは該位置より若干基端側 に位置している。そして、マーカー 18の基端は、外管 8の先端よりマーカー 18の全長 の五分の一の長さ分基端側の位置から外管 8の先端より lmm先端側の位置までの 範囲内に位置している。 [0011] The stent delivery catheter 1 of the present invention includes an outer tube 8, an inner tube 5 having a distal end projecting from the distal end of the outer tube 8 through a predetermined length, and a substantially uniform outer tube when expanded. A cylindrical portion 6a having a diameter, a distal-side catheter joint 6d, and a distal-end outer diameter changing portion located between the distal end of the tubular portion 6a and the distal-side force tatel joint 6d 6b, a proximal catheter joint 6e, and a proximal outer diameter changing portion 6c positioned between the distal end of the proximal catheter joint 6e and the proximal end of the tubular portion 6a. The distal catheter joint 6d is fixed to the distal end of the inner tube 5, the proximal catheter joint 6e is fixed to the outer tube 8, and the balloon 6 is attached to the outer surface of the balloon 6. Contrast material provided on the outer surface of the stent 9 to be expanded and the inner tube 5 at a position in the balloon 6 and on the proximal end side of the balloon A stent delivery catheter having a distal portion and a contrast marker 18 consisting of. The outer tube 8 extends to the distal end side from the proximal catheter joining portion 6e of the balloon 6 and includes a distal end portion located in the proximal outer diameter changing portion 6c. The proximal end of the stent 9 is The distal end of the marker 18 is located at a position corresponding to the proximal end of the stent 9 in the axial direction of the catheter 1 or slightly closer to the proximal end than the position. Yes. The proximal end of the marker 18 extends from the proximal end position by one fifth of the total length of the marker 18 from the distal end of the outer tube 8 to the lmm distal end position from the distal end of the outer tube 8. Located within range.
[0012] そこで、本発明のステントデリバリーカテーテル 1をいわゆるラビットエクスチェンジタ イブと呼ばれ、カテーテルの中間部にガイドワイヤー導入口 52を備えるものを用いて 説明する。なお、本発明のカテーテルは、中間部にガイドワイヤー導入口 52を備える ラビットエクスチェンジタイプに限定されるものではない。  [0012] Therefore, the stent delivery catheter 1 of the present invention is referred to as a so-called rabbit exchange type, and will be described using a catheter provided with a guide wire introduction port 52 in the middle part of the catheter. The catheter of the present invention is not limited to the rabbit exchange type having the guide wire introduction port 52 in the intermediate portion.
このステントデリバリーカテーテル 1は、バルーン 6を備える先端側シャフト 3と、基部 側シャフト 2と、バルーン 6上に装着されたステント 9とを備える。そして、先端側シャフ ト 3と基部側シャフト 2は、図 1、図 9および図 10に示すように、固定部 42により接合さ れている。  The stent delivery catheter 1 includes a distal side shaft 3 including a balloon 6, a proximal side shaft 2, and a stent 9 mounted on the balloon 6. The distal side shaft 3 and the base side shaft 2 are joined by a fixing portion 42 as shown in FIGS.
特に、この実施例のカテーテル 1では、外管 8と、外管 8内に配置されるとともに基 端部において外管 8と固定され、かつ、基端部にガイドワイヤ導入口 52を有する内管 5と、内管 5の基端部と並列的に配置されかつ内管 5の基端部に固定されるとともに 外管 8の基端部に先端部が液密に固定された接続用管部 4とを備える先端側シャフ ト 3と、先端側シャフト 3の接続用管部 4内に先端側部分が挿入され固定された基部 側シャフト 2とを備え、外管 8または接続用管部 4の内面と内管 5の外面との間により 形成される先端側シャフト内腔 31と基部側シャフト 2内に形成された基部側シャフト 内腔 20とが連通したものとなっている。  In particular, in the catheter 1 of this embodiment, the outer tube 8 and the inner tube disposed in the outer tube 8 and fixed to the outer tube 8 at the proximal end and having the guide wire introduction port 52 at the proximal end. 5 and a connecting pipe part that is arranged in parallel with the base end part of the inner pipe 5 and is fixed to the base end part of the inner pipe 5 and whose tip part is liquid-tightly fixed to the base end part of the outer pipe 8 4 and a proximal shaft 2 having a distal end portion inserted and fixed in the connecting pipe portion 4 of the distal shaft 3, and the outer tube 8 or the connecting tube portion 4. A distal-end shaft lumen 31 formed between the inner surface and the outer surface of the inner tube 5 communicates with a proximal-side shaft lumen 20 formed in the proximal-side shaft 2.
[0013] さらに、基部側シャフト 2は、本体部 21と、本体部 21よりも細くかつ接続用管部 4の 内腔 45内に侵入する先端部 22と、本体部 21と先端部 22間に位置する基部側シャ フト傾斜部 23を備え、接続用管部 4の内腔 45は、接続用管部 4の基端側に設けられ 、先端側に向力つて内腔断面が小さくなる内腔変化部 46を有し、基部側シャフト傾 斜部 23と内腔変化部 46とは当接しており、基部側シャフト 2の本体部 21に付与され る押し込み力が両者の当接部分を介して先端側シャフト 3に伝達されるものとなって いる。 Furthermore, the base side shaft 2 includes a main body 21, a distal end 22 that is thinner than the main body 21 and enters the lumen 45 of the connecting pipe 4, and between the main body 21 and the distal end 22. And a lumen 45 of the connecting tube portion 4 is provided on the proximal end side of the connecting tube portion 4 and is directed toward the distal end to reduce the lumen cross section. The base-side shaft inclined portion 23 and the lumen changing portion 46 are in contact with each other, and the pushing force applied to the main body portion 21 of the base-side shaft 2 passes through the contact portion between the two. It is transmitted to the tip side shaft 3.
[0014] 先端側シャフト 3は、図 1、図 9、図 10、図 14に示すように、外管 8と、内管 5と、接続 用管部 4とを備えている。具体的には、先端側シャフト 3は、外管 8と、外管 8内に配置 されかつ基端部において外管 8と固定された内管 5と、内管 5の基端部と並列的に配 置されかつ内管 5の基端部に固定されるとともに外管 8の基端部に先端部が液密に 固定された接続用管部 4を備える。なお、外管 8と外管 8の基端部に固定された接続 用管部 4は、このような 2つの部材を固定した構成に限定されるものではなぐ一つの 部材カもなるものであってもよ!/、。 As shown in FIGS. 1, 9, 10, and 14, the distal shaft 3 includes an outer tube 8, an inner tube 5, and a connecting tube portion 4. Specifically, the shaft 3 on the distal end side is parallel to the outer tube 8, the inner tube 5 disposed in the outer tube 8 and fixed to the outer tube 8 at the base end, and the base end of the inner tube 5. Is fixed to the proximal end of the inner tube 5 and the distal end of the outer tube 8 is liquid-tight. A fixed connecting pipe 4 is provided. Note that the outer tube 8 and the connecting tube portion 4 fixed to the base end portion of the outer tube 8 are not limited to such a configuration in which two members are fixed, but can be a single member. Anyway!
外管 8は、先端から基端まで貫通したチューブ体であり、内部に、内管 5を挿入可 能なものである。外管 8としては、外径が 0. 6〜1. 5mm、好ましくは 0. 8〜1. lmm であり、内径力 0. 5〜1. 4mm、好ましくは 0. 7〜1. 0mmである。  The outer tube 8 is a tube body penetrating from the distal end to the proximal end, and the inner tube 5 can be inserted therein. The outer tube 8 has an outer diameter of 0.6 to 1.5 mm, preferably 0.8 to 1. lmm, and an inner diameter force of 0.5 to 1.4 mm, preferably 0.7 to 1.0 mm. .
[0015] 内管 5は、図に示すように、先端力も基端まで貫通したガイドワイヤ用内腔 51を有 するチューブ体であり、外管 8内に挿入されるととともに、図 1および図 2に示すように 、内管 5の先端部は、外管 8の先端より所定長突出している。 [0015] As shown in the figure, the inner tube 5 is a tube body having a guide wire lumen 51 penetrating to the proximal end as well as being inserted into the outer tube 8, as shown in Figs. As shown in FIG. 2, the tip of the inner tube 5 protrudes from the tip of the outer tube 8 by a predetermined length.
内管 5としては、外径力 0. 35〜: L Omm、好ましくは 0. 45〜0. 8mmであり、内径 力 O. 2〜0. 9mm、好ましくは 0. 35〜0. 7mmである。また、内管 5の外管 8の先端 力もの突出長は、使用するバルーンの長さによって相違する力 5〜: LOOmm程度で あり、好ましくは 10〜60mmである。  The inner pipe 5 has an outer diameter force of 0.35 to: L Omm, preferably 0.45 to 0.8 mm, and an inner diameter force of O. 2 to 0.9 mm, preferably 0.35 to 0.7 mm. . Further, the protruding length of the inner tube 5 at the tip of the outer tube 8 is a force 5 to about LOOmm, preferably 10 to 60 mm, which varies depending on the length of the balloon used.
そして、バルーン 6は、拡張することにより装着されるステント 9を拡張させるものであ る。ステント 9は、バルーン 6の筒状部 6a上に被嵌され圧縮されることによりバルーン 6 上に装着される。ノ レーン 6は、圧縮されたステント 9により、折り畳まれた状態となり、 内管の外面に接触した状態となる。そして、バルーン 6内に拡張用流体が流入される と、バルーン 6が拡張するとともに、バルーン上に装着されているステントも拡張する。  The balloon 6 expands the stent 9 to be mounted by expanding. The stent 9 is fitted onto the balloon 6 by being fitted onto the cylindrical portion 6a of the balloon 6 and compressed. Nolane 6 is folded by the compressed stent 9 and is in contact with the outer surface of the inner tube. When the expansion fluid flows into the balloon 6, the balloon 6 expands and the stent mounted on the balloon expands.
[0016] この実施例に用いられているバルーン 6は、拡張時にほぼ均一な外径を有する筒 状となる筒状部 6a (言い換えれば、ステント装着部)、筒状部 6aの先端側に設けられ た先端側テーパー部 (先端側外径変化部を構成する) 6b、筒状部 6aの基端側に設 けられた基端側テーパー部 (基端側外径変化部を構成する) 6c、先端側テーパー部 [0016] The balloon 6 used in this embodiment is provided on the distal end side of the tubular portion 6a (in other words, a stent mounting portion) that becomes a tubular shape having a substantially uniform outer diameter when expanded. Tip side taper part (constitutes tip side outer diameter changing part) 6b, base end side taper part provided on the base end side of cylindrical part 6a (forms base end side outer diameter changing part) 6c , Tip side taper
6aと連続する先端側カテーテル接合部 6d、基端側テーパー部 6cと連続する基端側 カテーテル接合部 6eを有して 、る。 バルーン 6の大きさとしては、拡張されたときの筒状部 6a (具体的には、円筒部分) の外径力 1. 5〜5. Omm力好ましく、特に 2. 5〜4. Omm力 ^好まし!/ヽ。また、筒状 部 6aの長さは、 5〜50mmが好ましぐ特に 10〜40mmが好ましい。また、先端側テ ーノ ー咅 6bの長さ ίま、 2. 0〜6. Omm力好ましく、特に 3. 0〜5. 0mm力 ^好まし!/、。 また、基端側テーパー部 6cの長さは、 2. 0〜6. Ommが好ましぐ特に 3. 0〜5. Om mが好ましい。先端側カテーテル接合部 6dの外径は、 0. 5〜1. 5mmが好ましぐ特 に 0. 7〜1. Ommが好ましい。先端側カテーテル接合部 6dの長さは、 l〜5mmが好 ましぐ特に、 1. 0〜1. 3mmが好ましい。また、基端側カテーテル接合部 6eの外径 は、 0. 8〜1. 6mmが好ましぐ特に 1. 0〜1. 5mmが好ましい。また、基端側カテー テル接合部 6eの長さは、 l〜5mmが好ましぐ特に、 2〜4mmが好ましい。 It has a distal catheter joint 6d continuous with 6a and a proximal catheter joint 6e continuous with the proximal taper 6c. As the size of the balloon 6, the outer diameter force of the tubular portion 6a (specifically, the cylindrical portion) when expanded is preferably 1.5 to 5. Omm force, and particularly preferably 2.5 to 4. Omm force ^ I like it! Further, the length of the cylindrical portion 6a is preferably 5 to 50 mm, particularly preferably 10 to 40 mm. Also, the length of the tip side turret 6b is up to ί, 2. 0 to 6. Omm force is preferable, especially 3.0 to 5.0 mm force ^ is preferable! The length of the proximal end side tapered portion 6c is preferably 2.0 to 6. Omm, and particularly preferably 3.0 to 5. Omm. The outer diameter of the distal catheter joint 6d is preferably from 0.5 to 1.5 mm, particularly preferably from 0.7 to 1. Omm. The length of the distal catheter joint 6d is preferably 1 to 5 mm, and particularly preferably 1.0 to 1.3 mm. The outer diameter of the proximal catheter joint 6e is preferably 0.8 to 1.6 mm, and particularly preferably 1.0 to 1.5 mm. The length of the proximal end catheter joint 6e is preferably 1 to 5 mm, particularly preferably 2 to 4 mm.
ノ レーン 6の形成材料としては、ある程度の可撓性を有するものが好ましぐ例えば 、ポリオレフイン、ポリ塩化ビュル、ポリアミド、ポリアミドエラストマ一、ポリエステルエラ ストマー、ポリウレタン、ポリエステル、ポリアリレーンサルファイド等の熱可塑性榭脂、 シリコーンゴム、ラテックスゴム等が使用できる。特に、延伸可能な材料であることが好 ましぐバルーン 6は、高い強度および拡張力を有する 2軸延伸されたものが好ましい 。また、バルーンは、単層のものでも多層構造のものいずれでもよい。  A material having a certain degree of flexibility is preferably used as the material for forming the nolane 6, for example, heat such as polyolefin, polychlorinated bur, polyamide, polyamide elastomer, polyester elastomer, polyurethane, polyester, polyarylene sulfide, etc. Plastic resin, silicone rubber, latex rubber, etc. can be used. In particular, the balloon 6 which is preferably a stretchable material is preferably biaxially stretched having high strength and expansion force. The balloon may be either a single layer or a multilayer structure.
そして、バルーン 6の先端側カテーテル接合部 6dが内管 5の先端部に固定されて いる。なお、バルーン 6の先端側カテーテル接合部 6dは、所定距離内管 5の先端より 基端側に位置するように固定されている。内管 5の先端とのバルーン 6の先端側カテ 一テル接合部 6d間の距離としては 1. 0〜4. Ommが好適である。  The distal catheter joint 6d of the balloon 6 is fixed to the distal end of the inner tube 5. It should be noted that the distal end side catheter joint 6d of the balloon 6 is fixed so as to be located on the proximal end side with respect to the distal end of the inner tube 5 at a predetermined distance. The distance between the distal end catheter joint 6d of the balloon 6 and the distal end of the inner tube 5 is preferably 1.0 to 4. Omm.
また、バルーン 6の基端側カテーテル接合部 6eは、外管 8の先端側部分に固定さ れている。そして、外管 8は、バルーン 6の基端側カテーテル接合部 6eよりも先端側 に延びバルーン 6の基端側テーパー部 6c内に位置する先端部 8bを備えるものとな つている。言い換えれば、バルーン 6の基端側カテーテル接合部 6eは、その先端が 外管 8の先端 8aより所定距離基端側となるように固定されている。外管 8のバルーン 6 の基端側カテーテル接合部 6eと固定されて 、な 、先端部 8bの長さ(言 、換えれば、 バルーン 6の基端側カテーテル接合部 6eの先端と外管 8の先端 8a間の距離)として ίま、 2. 0〜6. Omm力 S好適であり、特に、 3. 0〜5. Omm力 S好適である。  Further, the proximal end side catheter joint 6 e of the balloon 6 is fixed to the distal end portion of the outer tube 8. The outer tube 8 is provided with a distal end portion 8b that extends to the distal end side from the proximal end side catheter joint 6e of the balloon 6 and is positioned in the proximal end tapered portion 6c of the balloon 6. In other words, the proximal end side catheter joint 6e of the balloon 6 is fixed so that the distal end thereof is closer to the proximal end side by a predetermined distance than the distal end 8a of the outer tube 8. The length of the distal end portion 8b (in other words, the distal end of the proximal end catheter joint portion 6e of the balloon 6 and the outer tube 8 is fixed to the proximal end catheter joint portion 6e of the balloon 6 of the outer tube 8. As the distance between the tips 8a), 2.0 to 6. Omm force S is preferable, and 3.0 to 5. Omm force S is particularly preferable.
なお、図 4に示すように、外管 8の先端 8aは、バルーン 6の基端側テーパー部 6c内 に位置し、筒状部 6aには到達しない。具体的には、図 4に示すように、バルーン 6の 基端側外径変化部 (基端側テーパー部) 6cは、外管 8の先端 8aよりも先端側に延び ている。言い換えれば、外管 8の先端 8aは、バルーン 6の基端側テーパー部 6c内に 位置し、筒状部 6aの基端より所定距離カテーテルの基端側に位置している。そして、 後述する、マーカー 18の全部または大部分(図 4に示す実施例では、全部)は、バル ーン 6の基端側外径変化部 (基端側テーパー部) 6c内に位置して 、る。 As shown in FIG. 4, the distal end 8a of the outer tube 8 is located in the proximal end side tapered portion 6c of the balloon 6 and does not reach the cylindrical portion 6a. Specifically, as shown in FIG. 4, the proximal-side outer diameter changing portion (proximal-side tapered portion) 6c of the balloon 6 extends from the distal end 8a of the outer tube 8 to the distal end side. In other words, the distal end 8a of the outer tube 8 is inside the proximal end side tapered portion 6c of the balloon 6. Located at a predetermined distance from the proximal end of the tubular portion 6a to the proximal end side of the catheter. Then, all or most of the markers 18 (all in the embodiment shown in FIG. 4), which will be described later, are located within the base end side outer diameter changing portion (base end side tapered portion) 6c of the balloon 6. RU
この実施例のカテーテルでは、このように外管 8の先端 8aとバルーン筒状部 6aの基 端との間にマーカー 18のほぼ全部若しくは大部分が配設されるため、ステント 9の基 端を、ステント拡張領域であるバルーン筒状部 6aの基端ぎりぎりとなるように配置して も、ステントとマーカーが重なり合うことがない。  In the catheter of this embodiment, almost all or most of the marker 18 is disposed between the distal end 8a of the outer tube 8 and the proximal end of the balloon tubular portion 6a. Even if the balloon tubular portion 6a, which is the stent expansion region, is arranged so as to be at the base end, the stent and the marker do not overlap.
ステントの基端をバルーンの筒状部の基端にぎりぎりに近 、ところに配設することに より、ステントからはみだすバルーン筒状部を極めて小さいものとすることができる。こ のステントからはみだしている部分のバルーン筒状部は、ステントが外側に位置しな いため、拡張時に過度に拡張 (過拡張)し、狭窄部近傍の正常な生体管腔または体 腔の内壁を拡張して該内壁に損傷を与えることが危惧される。  By disposing the proximal end of the stent close to the proximal end of the tubular portion of the balloon, the balloon tubular portion protruding from the stent can be made extremely small. The balloon tubular portion that protrudes from the stent does not have the stent on the outside, so it expands excessively (expands) during expansion, and the normal lumen of the body or the inner wall of the body cavity near the stenosis There is a fear of expanding and damaging the inner wall.
また、この実施例のカテーテルでは、ステント 9の基端を、ステント拡張領域である バルーン筒状部 6aの基端ぎりぎりとなるように配置しても、ステントとマーカーが重な り合うことがない。このため、生体内挿入時におけるステントおよびマーカー配置部に おける外径 (プロファイル)を小さいものとすることができる。また、外管とマーカーが 重なり合うこともない。  In the catheter of this embodiment, even if the proximal end of the stent 9 is arranged so as to be just below the proximal end of the balloon tubular portion 6a that is the stent expansion region, the stent and the marker do not overlap each other. . For this reason, the outer diameter (profile) in the stent and marker placement portion during insertion into the living body can be made small. Also, the outer tube and the marker do not overlap.
特開 2003— 102844号公報(米国公開公報 2004267280)のものでは、ステン卜 力もはみだすバルーン筒状部の部分が形成されな 、ようにするためには、ステントの 端部が、マーカーと重なるように配置しなければならない。このため、生体内挿入時 におけるステントおよびマーカー配置部における外径 (プロファイル)は大きなものと なる。ステントの端部にて、カテーテルの外径 (プロファイル)が大きくなると、ガイディ ングカテーテルの先端、病変(特に石灰化した狭窄部)、他のデバイスに引つかかる ことが危惧される。このような引つかかりは、カテーテルの生体内への挿入操作性の 低下、生体内目的部位への挿入障害を招くことになる。  In Japanese Patent Laid-Open No. 2003-102844 (US Publication No. 2004267280), in order to prevent the formation of a balloon tubular portion that also protrudes the stainless steel force, the end of the stent is overlapped with the marker. Must be placed. For this reason, the outer diameter (profile) of the stent and marker placement portion during insertion into the living body is large. If the outer diameter (profile) of the catheter becomes larger at the end of the stent, it is feared that it will be caught on the tip of the guiding catheter, lesion (especially calcified stenosis), and other devices. Such pulling leads to a decrease in operability of insertion of the catheter into the living body and an obstacle to insertion into the target site in the living body.
本発明のステントデリバリーカテーテル 1に使用されるステント 9は、略管状体に形 成され、生体内への挿入のための直径を有し、管状体の内部より半径方向外方に広 力 ¾力が付加されたとき、言い換えればバルーン 6が拡張したときに拡張可能 (伸張 可能)なものである、いわゆるバルーンエキスパンダブルステントである。そして、ステ ント 9の基端は、バルーン 6の筒状部 6aの基端部に位置している。ステント 9の基端は 、ノ レーン 6の筒状部 6aの基端より突出しないように装着されており、ステント 9の基 端とバルーン 6の筒状部 6aの基端との間の距離は、 1. 5mm以下であることが好まし い。また、ステント 9の先端は、バルーン 6の筒状部 6aの先端部に位置している。ステ ント 9の先端は、バルーン 6の筒状部 6aの先端より突出しないように装着されており、 ステント 9の先端とバルーン 6の筒状部 6aの先端間の距離は、 1. 5mm以下であるこ とが好ましい。 The stent 9 used in the stent delivery catheter 1 of the present invention is formed in a substantially tubular body, has a diameter for insertion into a living body, and has a wide force radially outward from the inside of the tubular body. Can be expanded when the balloon 6 is expanded, in other words when the balloon 6 is expanded It is a so-called balloon expandable stent. The proximal end of the stent 9 is located at the proximal end portion of the cylindrical portion 6a of the balloon 6. The proximal end of the stent 9 is mounted so as not to protrude from the proximal end of the tubular portion 6a of the nolane 6, and the distance between the proximal end of the stent 9 and the proximal end of the tubular portion 6a of the balloon 6 is 1. It is preferable that it is 5 mm or less. Further, the distal end of the stent 9 is located at the distal end portion of the cylindrical portion 6 a of the balloon 6. The distal end of the stent 9 is mounted so as not to protrude from the distal end of the tubular portion 6a of the balloon 6. The distance between the distal end of the stent 9 and the distal end of the tubular portion 6a of the balloon 6 is 1.5 mm or less. It is preferable that it exists.
[0019] ステント 9としては、バルーンエキスパンダブルステントであればどのようなものでもよ い。例えば、図 16に示すステント 9は、多数の屈曲部 85aを有する波状要素により環 状に形成された第 1の波状環状体 92aと、第 1の波状環状体 92aの谷部に山部が近 接するようにステント 9の軸方向に配置されるとともに線状屈曲部 85aを有する波状要 素により環状に形成された第 2の波状環状体 92bと、第 1の波状環状体 92aの谷部と 第 2の波状環状体 92bの山部とを接続する複数の接続部 86とからなる環状ユニット 8 4からなり、さらに、環状ユニット 84は、ステント 9の軸方向に複数配列されるとともに、 隣り合う環状ユニットを接続部形成部位にて連結する連結部 87を備えるものとなって いる。さらに、連結部 87は、隣り合う環状ユニット 84間に複数かつ向かい合う位置も しくはステントの中心軸に対してほぼ等角度配置となるように設けられて 、るものであ る。この例のステント 9は、図 16に示すように、複数の環状ユニット 84力 ステント 9の 軸方向にほぼ直線状となるように配列されるとともに、隣り合う環状ユニットの波状要 素(波状環状体 92bと 92a)を接続部 86の形成部位にぉ ヽて連結する連結部 87を 備えている。ステント 9は、見方を変えれば、多数の環状ユニット 84が、連結部 87に より連結したことにより構成された管状体である。しかし、ステント 9の形状はこのような ものに限定されるものではなぐ網目状などの公知のものが使用できる。  [0019] The stent 9 may be any balloon expandable stent. For example, the stent 9 shown in FIG. 16 has a first wavy annular body 92a formed in a ring shape by a wavy element having a large number of bent portions 85a, and a peak portion close to a valley portion of the first wavy annular body 92a. A second corrugated annular body 92b that is arranged in the axial direction of the stent 9 so as to be in contact with each other and is annularly formed by a corrugated element having a linear bent portion 85a, and a valley portion of the first corrugated annular body 92a 2 is composed of an annular unit 84 comprising a plurality of connecting portions 86 connecting the peaks of the corrugated annular body 92b, and the annular units 84 are arranged in the axial direction of the stent 9 and are adjacent to each other. A connecting portion 87 for connecting the units at the connecting portion forming portion is provided. Further, a plurality of connecting portions 87 are provided between the adjacent annular units 84 so as to have a plurality of opposing positions or substantially equiangular positions with respect to the central axis of the stent. As shown in FIG. 16, the stent 9 in this example is arranged so as to be substantially linear in the axial direction of the plurality of annular units 84 force stent 9, and the corrugated elements (corrugated annular bodies) of adjacent annular units. 92b and 92a) are provided with a connecting portion 87 for connecting the connecting portion 86 to the forming portion thereof. In other words, the stent 9 is a tubular body formed by connecting a large number of annular units 84 by connecting portions 87. However, the shape of the stent 9 is not limited to this, and a known one such as a mesh shape can be used.
[0020] ステント 9の形成材料としては、ある程度の生体適合性を有するものが好ましぐ例 えば、ステンレス鋼、タンタルもしくはタンタル合金、プラチナもしくはプラチナ合金、 金もしくは金合金、コバルトベース合金等が考えられる。またステント形状を作製した 後に貴金属メツキ (金、プラチナ)をしてもよい。ステンレス鋼としては、最も耐腐食性 のある SUS316Lが好適である。 [0020] Examples of preferable materials for forming the stent 9 include stainless steel, tantalum or tantalum alloy, platinum or platinum alloy, gold or gold alloy, and cobalt base alloy. It is done. In addition, precious metal plating (gold, platinum) may be performed after the stent shape is produced. The most corrosion resistant stainless steel SUS316L with is suitable.
さらに、ステントの最終形状を作成したのち、焼なましすることが好ましい。焼きなま しを行うことにより、ステント全体の柔軟性および可塑性が向上し、屈曲した血管内で の留置性が良好となる。焼きなましを行わない場合に比べて、ステントを拡張した後 の拡張前形状に復元しょうとする力、特に、屈曲した血管部位で拡張したときに発現 する直線状に復帰しょうとする力が減少し、屈曲した血管内壁に与える物理的な刺 激が減少し、再狭窄の要因を減少させることができる。焼きなましは、ステント表面に 酸化皮膜が形成されないように、不活性ガス雰囲気下 (例えば、アルゴンガス)にて、 900〜 1200°Cに加熱したのち、ゆっくりと冷却することにより行うことが好まし!/、。 ステント 9の装着時の直径は、 0. 8〜1. 5mm程度が好適であり、特に、 0. 9〜1. 3mmがより好ましい。また、ステントの長さは、 5〜50mm程度が好適であり、特に、 8 〜40mmが好ましい。また、ステントの長さは、バルーンの筒状部の長さの 1倍から 0 . 95倍程度であることが好ましい。  Furthermore, it is preferable to anneal after creating the final shape of the stent. By annealing, the flexibility and plasticity of the entire stent is improved, and the indwellability in the bent blood vessel is improved. Compared to the case without annealing, the force that tries to restore the shape before expansion after expanding the stent, especially the force that tries to return to the linear shape when expanding at the bent blood vessel site, is reduced. Physical stimulation given to the bent inner wall of the blood vessel is reduced, and the factor of restenosis can be reduced. Annealing is preferably performed by heating to 900-1200 ° C in an inert gas atmosphere (for example, argon gas) and then cooling slowly so that no oxide film is formed on the stent surface! /. The diameter when the stent 9 is mounted is preferably about 0.8 to 1.5 mm, and more preferably 0.9 to 1.3 mm. The length of the stent is preferably about 5 to 50 mm, and particularly preferably 8 to 40 mm. The length of the stent is preferably about 1 to 0.95 times the length of the balloon tubular portion.
そして、内管 5には、基端側造影マーカー 18が固定されている。特に、本発明の力 テーテル 1では、基端側マーカー 18は、ノ レーン 6の基端側テーパー部 6c内に位 置するように、内管 5の外面に固定されている。  A proximal contrast marker 18 is fixed to the inner tube 5. In particular, in the force tape 1 of the present invention, the proximal end side marker 18 is fixed to the outer surface of the inner tube 5 so as to be positioned in the proximal end side tapered portion 6 c of the nolane 6.
さらに、マーカー 18の基端 18aは、図 3および図 4に示すように、外管 8の先端より マーカー 18の全長の五分の一の長さ分基端側の位置力も外管 8の先端より lmm先 端側の位置までの範囲内に位置している。図 2ないし図 4に示す実施例の力テーテ ル 1では、マーカー 18の基端 18aは、外管 8の先端と同じ位置もしくは若干先端側に 位置しており、両者は軸方向に対して重なり合う部分を持っていない。この実施例に おけるマーカー 18の基端 18aと外管 8の先端 8a間の距離 L1は、 1mm以下となって いる。好ましくは、 L1は、 0. 8mm以下である。特に、このように両者は軸方向に対し て重なり合う部分を持って 、な 、ことが好まし 、が、図 5な!、し図 7に示すようなもので あってもよい。図 5ないし図 7に示す実施例のカテーテル 30では、マーカー 18の基 端 18aは、外管 8の先端より基端側に位置しており、両者は軸方向に対して重なり合 う部分を持っている。この実施例におけるマーカー 18の基端 18aと外管 8の先端 8a 間の距離 L2 (軸方向に重なり合う長さ)は、マーカー 18の全長の 1Z5以下となって いる。好ましくは、 L2は、マーカー 18の全長の 1/8以下となっていることが好ましい 。また、具体的には、 L2は、 1. 2mm以下であることが好ましい。 Further, as shown in FIGS. 3 and 4, the proximal end 18a of the marker 18 has a position force on the proximal end side that is one fifth of the total length of the marker 18 from the distal end of the outer tube 8. It is located within the range up to the position lmm ahead. In the force tail 1 of the embodiment shown in FIGS. 2 to 4, the proximal end 18a of the marker 18 is located at the same position as the distal end of the outer tube 8 or slightly on the distal end side, and both overlap with each other in the axial direction. I don't have a part. In this embodiment, the distance L1 between the proximal end 18a of the marker 18 and the distal end 8a of the outer tube 8 is 1 mm or less. Preferably, L1 is 0.8 mm or less. In particular, it is preferable that the two have overlapping portions in the axial direction as described above, but it may be as shown in FIG. 5 and FIG. In the catheter 30 of the embodiment shown in FIGS. 5 to 7, the proximal end 18a of the marker 18 is located on the proximal end side from the distal end of the outer tube 8, and both have overlapping portions in the axial direction. ing. In this embodiment, the distance L2 (the length overlapping in the axial direction) between the proximal end 18a of the marker 18 and the distal end 8a of the outer tube 8 is 1Z5 or less of the total length of the marker 18. Yes. Preferably, L2 is 1/8 or less of the total length of the marker 18. Specifically, L2 is preferably 1.2 mm or less.
[0022] 外管の先端がマーカーの基端力 マーカー全長の五分の一を下回る距離で先端 側に位置するものであれば、マーカーと外管が重なる部分は十分に短ぐバルーン のインフレーションルーメンを狭めることも、バルーン拡張'収縮用流体のバルーン内 への流入'流出の応答性を阻害することもない。 [0022] If the distal end of the outer tube is positioned on the distal end side at a distance less than one-fifth of the total length of the marker, the portion where the marker and the outer tube overlap is sufficiently short. Neither does it impede the responsiveness of balloon dilation, “inflow of deflation fluid into the balloon” or outflow.
さらに、マーカー 18の先端 18bは、図 3および図 4に示すように、カテーテル 1の軸 方向におけるステント 9の基端に対応する位置若しくはその位置より若干基端側に位 置している。マーカー 18とステント 9とは、軸方向に対して重なり合う部分を持ってい ない。この実施例におけるマーカー 18の先端 18bとステント 9の基端 9間の軸方向距 離 Xは、 1mm以下であることが好ましい。特に、好ましくは、 Xは、 0. 5mm以下であ る。  Further, as shown in FIGS. 3 and 4, the distal end 18b of the marker 18 is located at a position corresponding to the proximal end of the stent 9 in the axial direction of the catheter 1 or slightly proximal from the position. The marker 18 and the stent 9 do not have an overlapping portion with respect to the axial direction. In this embodiment, the axial distance X between the distal end 18b of the marker 18 and the proximal end 9 of the stent 9 is preferably 1 mm or less. Particularly preferably, X is 0.5 mm or less.
上記のように、マーカーの先端力ステントの基端と同じ位置若しくはステント基端より も基端側に位置していれば、カテーテルがより末梢の曲がりくねった血管等の生体管 路を通過する際に、硬 、マーカーがバルーン壁を介してステントと接触することがなく 、ステント端部やバルーンがマーカーにより傷つけられる虞れがない。したがって、ス テントやバルーンが損傷することなくより末梢の目的生体器官部位まで確実にステン トを運ぶことのできるステントデリバリーカテーテルを提供できる。  As described above, when the catheter is positioned at the same position as the proximal end of the stent or the proximal end of the stent, when the catheter passes through a biological conduit such as a more peripheral tortuous blood vessel. The marker does not come into contact with the stent through the balloon wall, and there is no fear that the end of the stent or the balloon will be damaged by the marker. Therefore, it is possible to provide a stent delivery catheter that can reliably carry a stent to a peripheral target living organ site without damaging the stent or balloon.
[0023] さらに、これらの実施例のカテーテル 1では、内管 5には、先端側造影マーカー 17 が固定されている。特に、この実施例のカテーテル 1では、先端側マーカー 17は、バ ルーン 6の先端側テーパー部 6b内に位置するように、内管 5の外面に固定されてい る。マーカー 17の基端は、図 3および図 4に示すように、カテーテル 1の軸方向にお けるステント 9の先端に対応する位置若しくはその位置より若干先端側に位置してい る。マーカー 17とステント 9とは、軸方向に対して重なり合う部分を持っていない。この 実施例におけるマーカー 17の基端とステント 9の先端間の軸方向距離は、 1mm以 下であることが好ましい。特に、好ましくは、 0. 5mm以下である。 Furthermore, in the catheter 1 of these embodiments, the distal contrast marker 17 is fixed to the inner tube 5. In particular, in the catheter 1 of this embodiment, the distal side marker 17 is fixed to the outer surface of the inner tube 5 so as to be located in the distal side tapered portion 6b of the balloon 6. As shown in FIGS. 3 and 4, the proximal end of the marker 17 is located at a position corresponding to the distal end of the stent 9 in the axial direction of the catheter 1 or slightly on the distal side from the position. The marker 17 and the stent 9 do not have an overlapping portion with respect to the axial direction. In this embodiment, the axial distance between the proximal end of the marker 17 and the distal end of the stent 9 is preferably 1 mm or less. Particularly preferably, it is 0.5 mm or less.
造影用マーカーとしては、放射線造影用マーカーもしくは超音波造影用マーカー が用いられる。放射線造影用マーカーとしては、金、白金、タングステンあるいはそれ らの合金、銀一パラジウム合金力もなる群のうち少なくともいずれか一つの金属もしく は 2つ以上の合金カゝら形成されたものが好適である。超音波造影用マーカーとして は、上述した金属の他、ステンレス鋼なども使用できる。 As the contrast marker, a radiographic marker or an ultrasound contrast marker is used. Radiographic markers include gold, platinum, tungsten or Among these alloys, those formed of at least one metal or two or more alloy members from the group consisting of silver-palladium alloy force are preferable. As the ultrasonic contrast marker, stainless steel or the like can be used in addition to the metal described above.
[0024] 本発明のステントデリバリーカテーテルは、内管 5の内腔により構成されるガイドワイ ヤール一メンを備えている。特に、図示する実施例のステントデリバリーカテーテルは 、内管 5の内腔により構成されるガイドワイヤールーメン 51と、ガイドワイヤールーメン 51と連通しかつ、ステントデリバリーカテーテルの中間部にて開口するガイドワイヤ導 入口 52を備えている。より具体的には、この実施例のカテーテル 1は、先端側部分を 形成する先端側シャフト 3と、先端側シャフト内に先端側部分が挿入され固定された 基部側シャフト 2とを備え、先端側シャフト 3は、先端側シャフト 3の基端部に形成され 、内管 2内と連通するガイドワイヤ導入口 52を備え、外管 8内に形成された内腔 31は 、基部側シャフト 2内に形成された基部側シャフト内腔 20と連通している。  [0024] The stent delivery catheter of the present invention includes a guide wire member constituted by the lumen of the inner tube 5. In particular, the stent delivery catheter of the illustrated embodiment has a guide wire lumen 51 constituted by the lumen of the inner tube 5 and a guide wire guide that communicates with the guide wire lumen 51 and opens at an intermediate portion of the stent delivery catheter. An entrance 52 is provided. More specifically, the catheter 1 of this embodiment includes a distal side shaft 3 that forms a distal end side portion, and a proximal side shaft 2 in which the distal end side portion is inserted and fixed in the distal end side shaft. The shaft 3 is formed at the proximal end portion of the distal end side shaft 3 and includes a guide wire introduction port 52 communicating with the inside of the inner tube 2, and the lumen 31 formed in the outer tube 8 is formed in the proximal side shaft 2. In communication with the formed proximal shaft lumen 20.
[0025] そこで、この実施例のカテーテル 1の中間部分および基端側部分の構造について 説明する。  [0025] Therefore, the structure of the intermediate portion and the proximal end portion of the catheter 1 of this embodiment will be described.
内管 5は、図 9および図 10に示すように、その基端部が外管 8より露出している。そ して、内管 5は、基端より若干先端側部分において、外管 8の基端に液密に固定され ている。また、内管 5の基端部、この実施例では、基端にガイドワイヤ導入口 52を備 えている。そして、ガイドワイヤ導入口 52は、図 9、図 10および図 12に示すように、基 端側に向カゝつて傾斜するように斜めに形成されている。これにより、ガイドワイヤの挿 入を容易にしている。  As shown in FIGS. 9 and 10, the inner pipe 5 has a base end portion exposed from the outer pipe 8. The inner tube 5 is liquid-tightly fixed to the proximal end of the outer tube 8 at a portion slightly distal to the proximal end. In addition, a guide wire introduction port 52 is provided at the proximal end portion of the inner pipe 5, in this embodiment, the proximal end. As shown in FIGS. 9, 10, and 12, the guide wire introduction port 52 is formed obliquely so as to incline toward the base end side. This facilitates guide wire insertion.
接続用管部 4は、図 9および図 10に示すように、先端部が斜めに形成されている。 そして、接続用管部 4の先端部 41は、外管 8内に侵入しておらず、外管 8の外側に位 置し、かつ、接続用管部 4の先端部 41の内面の一部が、外管 8の基端部の外面の一 部と接触している。そして、外管 8と接続用管部 4は、上述した接触面において液密 に融着されている。さら〖こ、接続用管部 4の先端側の外面の一部は、内管 5の基端部 の外面の一部と接触している。そして、内管 5と接続用管部 4は、接触部 43において 液密に融着されている。また、接触部 43は、内管 5の基端部の湾曲形状に対応する 形状に溶融変形されており、内管 5のガイドワイヤ導入口 52と連続する傾斜面を形 成している。 As shown in FIG. 9 and FIG. 10, the connecting pipe part 4 has a tip formed obliquely. The distal end portion 41 of the connecting pipe portion 4 does not penetrate into the outer tube 8, is positioned outside the outer tube 8, and is a part of the inner surface of the distal end portion 41 of the connecting tube portion 4. Is in contact with a part of the outer surface of the base end portion of the outer tube 8. The outer tube 8 and the connecting tube 4 are fused in a liquid-tight manner at the contact surface described above. Furthermore, a part of the outer surface on the distal end side of the connecting pipe part 4 is in contact with a part of the outer surface of the proximal end part of the inner pipe 5. The inner tube 5 and the connecting tube 4 are fused in a liquid-tight manner at the contact portion 43. The contact portion 43 is melt-deformed into a shape corresponding to the curved shape of the proximal end portion of the inner tube 5, and forms an inclined surface continuous with the guide wire introduction port 52 of the inner tube 5. It is made.
[0026] そして、この実施例のカテーテル 1では、接続用管部 4の内面と内管 5の外面との間 に形成された接続用管部内腔 45と基部側シャフト 2内に形成された基部側シャフト 内腔 20とが連通した状態にて、接続用管部 4の基端部と基部側シャフト 2の先端部 が融着されている。  [0026] In the catheter 1 of this embodiment, the connecting tube portion lumen 45 formed between the inner surface of the connecting tube portion 4 and the outer surface of the inner tube 5 and the base portion formed in the base side shaft 2 are used. In a state where the side shaft lumen 20 is in communication, the proximal end portion of the connecting pipe portion 4 and the distal end portion of the proximal side shaft 2 are fused.
内管 5、接続用管部 4、外管 8の形成材料としては、ある程度の可撓性を有するもの が好ましぐ例えば、ポリアミド、ポリエステル、ポリアミドエラストマ一、ポリエステルェ ラストマー、ポリオレフイン(例えば、ポリエチレン、ポリプロピレン、エチレン プロピレ ン共重合体、エチレン 酢酸ビニル共重合体、およびこれらの架橋もしくは部分架橋 物)、ポリ塩化ビニル、ポリウレタン等の熱可塑性榭脂が好適である。また、内管 5とし ては、単一の榭脂材料により形成してもよいが、ガイドワイヤの摺動性を良好なものと するために、内層は低摩擦性材料、例えば、ポリエチレン、フッ素榭脂により形成し、 外層が、先端側シャフト (外管 8および接続用管部 4)の材質と相溶性を有する材質 力もなるものとすることが好ましい。なお、この場合、内層形成材料は、基部側シャフト および先端側シャフトの材質と相溶性を持たな 、ものであってもよ 、。  A material having a certain degree of flexibility is preferable as a material for forming the inner tube 5, the connecting tube portion 4, and the outer tube 8. For example, polyamide, polyester, polyamide elastomer, polyester elastomer, polyolefin (for example, polyethylene) Polypropylene, ethylene propylene copolymer, ethylene vinyl acetate copolymer, and cross-linked or partially cross-linked products thereof, polyvinyl chloride, polyurethane and the like are suitable. The inner tube 5 may be formed of a single resin material. However, in order to improve the sliding property of the guide wire, the inner layer is made of a low friction material such as polyethylene, fluorine. It is preferable that the outer layer has a material force compatible with the material of the distal end side shaft (the outer tube 8 and the connecting tube portion 4). In this case, the inner layer forming material may not be compatible with the material of the base side shaft and the tip side shaft.
[0027] 基部側シャフト 2は、図 9ないし図 12および図 15に示すように、先端から基端まで 貫通したチューブ体であり、基端に固定されたノ、ブ 7を備えている。基部側シャフト 2 の先端部は、先端側シャフト 3の基端部と接合されている。 [0027] As shown in Figs. 9 to 12 and 15, the base side shaft 2 is a tube body penetrating from the distal end to the proximal end, and includes a node 7 fixed to the proximal end. The distal end portion of the base side shaft 2 is joined to the proximal end portion of the distal end side shaft 3.
基部側シャフト 2は、基端において、ハブ 7の先端部に固定されている。ハブ 7と基 部側シャフト 2の境界部の外面には、両者を被覆するように、キンク防止用のチュー ブ 71が取り付けられている。また、ハブ 7の基端部は、バルーン拡張用流体注入器 具 (例えば、シリンジ)の接続部 72となって 、る。  The base side shaft 2 is fixed to the distal end portion of the hub 7 at the base end. A kink prevention tube 71 is attached to the outer surface of the boundary between the hub 7 and the base shaft 2 so as to cover both. Further, the base end portion of the hub 7 serves as a connection portion 72 of a balloon inflating fluid injection device (for example, a syringe).
基咅 則シャフト 2としては、長さ力 S800mm〜1500mm、より好ましくは、 1000〜13 OOmmであり、外径が 0. 5〜1. 5mm、好ましくは 0. 6〜1. 3mmであり、内径が 0. 3〜1. 4mm、好ましくは 0. 5〜1. 2mmである。  As the basic rule shaft 2, the length force S800mm ~ 1500mm, more preferably 1000 ~ 13 OOmm, the outer diameter is 0.5 ~ 1.5mm, preferably 0.6 ~ 1.3mm, Is 0.3 to 1.4 mm, preferably 0.5 to 1.2 mm.
[0028] そして、この実施例のカテーテル 1では、図 13に示すように、基部側シャフト 2は、 本体部 21と、本体部 21よりも細くかつ接続用管部 4の内腔 45内に侵入する先端部 2 2と、本体部 21と先端部 22とを連結するように形成された基部側シャフト傾斜部 23を 備えている。先端部 22の長さとしては、 3mn!〜 15mm程度が好ましい。また、傾斜 部 23の軸方向への長さとしては、 2mm〜 10mm程度が好ましい。 In the catheter 1 of this embodiment, as shown in FIG. 13, the base-side shaft 2 enters the body portion 21 and the lumen 45 of the connecting tube portion 4 which is narrower than the body portion 21. The base side shaft inclined portion 23 formed to connect the front end portion 22 and the main body portion 21 and the front end portion 22 to each other. I have. The length of the tip 22 is 3mn! About 15 mm is preferable. The length of the inclined portion 23 in the axial direction is preferably about 2 mm to 10 mm.
具体的には、この基部側シャフト 2では、基部側シャフト 2の先端部 22は、図 10、図 11および図 13に示すように、基部側シャフト 2の本体部 21の一部のみが軸方向に 延出した樋状に形成されて 、る。先端部 22の軸方向に直交する方向に切断したとき の断面が形成する円弧の大きさとしては、本体部 21の断面が形成する円の大きさの 1Z16〜: LZ2程度であることが好ましい。  Specifically, in this base side shaft 2, as shown in FIGS. 10, 11, and 13, only a part of the main body portion 21 of the base side shaft 2 is axially moved. It is formed in the shape of a bowl extending to the top. The size of the arc formed by the cross section when cut in the direction perpendicular to the axial direction of the tip 22 is preferably about 1Z16 to LZ2 of the size of the circle formed by the cross section of the main body 21.
なお、先端部 22としては、このようなシャフト 2の中心軸方向に湾曲した樋状のもの に限定されるものではなく、シャフト 2の中心軸方向と逆方向に湾曲する樋状のもの、 また、平板状のものであってもよい、  The distal end portion 22 is not limited to such a bowl-like shape curved in the direction of the central axis of the shaft 2, but is a bowl-like shape curved in the direction opposite to the direction of the central axis of the shaft 2. It may be a flat plate,
[0029] また、この基部側シャフト 2では、基部側シャフト傾斜部 23は、本体部 21の先端か ら先端部 22の基端まで基部側シャフトの中心軸に対して斜めとなるように形成されて いる。そして、この基部シャフト 2では、基部側シャフト傾斜部 23は、基部側シャフトを 所定長斜めに切り欠いた形態となっており、切り欠かれた傾斜部が、基部側シャフト 内腔 20と先端側シャフト内腔 31とを連通する連通部を形成している。また、表現を変 えれば、基部側シャフト 2の先端部は、基部側シャフトを所定長かつ所定幅軸方向に 切り欠いた形態となっており、基部側シャフト傾斜部 23は、基部側シャフトを所定長 斜めに切り欠いた形態となっており、切り欠かれた傾斜部が、前記基部側シャフト内 腔と前記先端側シャフト内腔とを連通する連通部を形成している。このように、傾斜部 全体を開口とすることにより、基部シャフト内腔内に注入される流体の流通を良好なも のとする。なお、傾斜部 23は、先端側部分のみ開口し、基端側部分は開口しないも のとしてもよい。 Further, in the base side shaft 2, the base side shaft inclined portion 23 is formed so as to be inclined with respect to the central axis of the base side shaft from the distal end of the main body portion 21 to the proximal end of the distal end portion 22. ing. In this base shaft 2, the base-side shaft inclined portion 23 has a form in which the base-side shaft is cut obliquely by a predetermined length, and the cut-out inclined portion forms the base-side shaft lumen 20 and the distal end side. A communication portion communicating with the shaft lumen 31 is formed. In other words, the distal end portion of the base side shaft 2 has a shape in which the base side shaft is cut out in a predetermined length and a predetermined width axis direction, and the base side shaft inclined portion 23 is formed by cutting the base side shaft. It has a shape that is obliquely cut out by a predetermined length, and the cut-out inclined portion forms a communication portion that communicates the base-side shaft lumen and the distal-end shaft lumen. Thus, by making the entire inclined portion an opening, the flow of the fluid injected into the base shaft lumen is improved. The inclined portion 23 may be opened only at the distal end portion and not at the proximal end portion.
基部側シャフト 2の形成材料としては、比較的剛性の高い材質、例えば Ni— Ti、真 鍮、 SUS、アルミ等の金属を用いることが好ましい。なお、比較的剛性の高い材質で あれば、ポリイミド、塩化ビュル、ポリカーボネート等の榭脂を用いることもできる。  As a material for forming the base side shaft 2, it is preferable to use a material having relatively high rigidity, for example, a metal such as Ni—Ti, brass, SUS, or aluminum. In addition, as long as the material is relatively high in rigidity, it is possible to use a resin such as polyimide, butyl chloride, and polycarbonate.
[0030] そして、この実施例のカテーテル 1では、接続用管部 4の内腔 45は、先端側シャフ ト内腔 31の基端部を形成しており、内腔変化部 46は、接続用管部 4内に設けられて いる。そして、基部側シャフト 2の先端部 22は、接続用管部内腔 45内に侵入している 。具体的には、接続用管部 4は、図 9ないし図 11に示すような形態となっている。接 続用管部 4は、先端部に外管 8との固定部 (先端部) 41を備え、この固定部 41より基 端側の側壁の一部は、内管 5の基端部の側壁の一部と液密に融着された融着部 (接 触部) 43と、融着部 43より基端側に位置する内腔変化部 46、内腔変化部 46と連続 するとともに所定長延びる筒状部 44、基端に形成された基部側シャフト 2との固定部 42を備えている。 [0030] In the catheter 1 of this embodiment, the lumen 45 of the connecting tube portion 4 forms the proximal end portion of the distal shaft lumen 31, and the lumen changing portion 46 is for connection. It is provided in the pipe 4. Then, the distal end portion 22 of the base side shaft 2 has entered the connecting tube lumen 45. . Specifically, the connecting pipe portion 4 has a form as shown in FIGS. The connecting pipe part 4 includes a fixing part (tip part) 41 to the outer pipe 8 at the tip part, and a part of the side wall on the proximal side from the fixing part 41 is a side wall of the base part of the inner pipe 5. A welded part (contact part) 43 that is liquid-tightly welded to a part of the tube, a lumen changing part 46 located on the proximal side of the welded part 43, and a lumen changing part 46, and a predetermined length. A cylindrical portion 44 that extends, and a fixing portion 42 to the base side shaft 2 formed at the base end are provided.
[0031] そして、この実施例では、接続用管部 4内の内腔 45は、先端側部分では、内管 5と 並列的状態となっており、内管 5の基端より基端側では、内腔 45が単独にて存在す るものとなっている。そして、この内管 5が存在しない部分における内腔 45には、図 1 0に示すように、先端側に向力つて内腔断面が小さくなる内腔変化部 46が設けられ ている。この実施例では、接続用管部 4内における内腔 45は、内腔変化部(内腔傾 斜部) 46の基端側に比べて先端側は内径が小さいものとなっている。しかし、本発明 では、内腔変化部 46はこのような形状に限定されるものではなぐ例えば接続用管 部の長軸に対して垂直な方向に形成された壁部により、該壁部よりも先端側が該壁 部よりも基端側よりも狭くなつた形状でもよい。つまり、内腔変化部 46としては、内腔 段差部、内腔傾斜部のいずれでもよい。なお、この実施例では、内腔変化部 46に対 応する接続用管部 4の外面も内腔変化部 46の傾斜面に合わせて傾斜している。この ように、ガイドワイヤ導入口より先端側における先端側シャフト内腔 (接続用管部内腔 )と内管内腔の両者が存在する部分よりも基端側に内腔変化部 46を位置させること により、 2つの内腔が併存する部分における先端側シャフト内腔の内径を小さいもの とできるため、 2つの内腔が併存する部分の外径を抑えることができる。  [0031] In this embodiment, the lumen 45 in the connecting pipe portion 4 is in a state of being parallel to the inner tube 5 at the distal end portion, and closer to the proximal end than the proximal end of the inner tube 5. The lumen 45 is present alone. Further, as shown in FIG. 10, the lumen 45 in a portion where the inner tube 5 does not exist is provided with a lumen changing portion 46 that is directed toward the distal end and becomes smaller in lumen cross section. In this embodiment, the lumen 45 in the connecting tube portion 4 has a smaller inner diameter on the distal end side than the proximal end side of the lumen changing portion (lumen inclined portion) 46. However, in the present invention, the lumen changing portion 46 is not limited to such a shape. For example, a wall portion formed in a direction perpendicular to the long axis of the connecting pipe portion is more than the wall portion. A shape in which the distal end side is narrower than the base end side than the wall portion may be used. That is, the lumen changing portion 46 may be either a lumen stepped portion or a lumen inclined portion. In this embodiment, the outer surface of the connecting tube portion 4 corresponding to the lumen changing portion 46 is also inclined according to the inclined surface of the lumen changing portion 46. In this way, by positioning the lumen changing portion 46 at the proximal end side from the portion where both the distal-side shaft lumen (connecting tube lumen) and the inner-tube lumen exist on the distal side from the guide wire introduction port, Since the inner diameter of the distal shaft shaft lumen in the portion where the two lumens coexist can be made small, the outer diameter of the portion where the two lumens coexist can be suppressed.
[0032] さらに、基部側シャフト 2の基部側シャフト傾斜部 23と接続用管部 4の内腔変化部 4 6とは当接している。これにより、基部側シャフト 2の本体部 21に付与される押し込み 力が両者の当接部分を介して先端側シャフト 3に伝達されるものとなっている。また、 この実施例では、図 10に示すように、基部側シャフト 2は、その先端部 22が融着部 4 3および内管 5側となるように、接続用管部 4の基端部に配置されている。なお、基部 側シャフト 2の先端部 22は、融着部 43 (および内管 5)に接触するものであってもよく 、また、若干離間するものであってもよい。好ましくは、接触していることである。さらに 、基部側シャフト 2の先端部 22の先端は、図 9および図 10に示すように、ガイドワイヤ 導入口 52をよりもカテーテル 1の先端側に位置していることが好ましい。これにより、 ガイドワイヤ導入口 52が補強され、この開口 52近傍におけるカテーテルの折れ (キン ク)を防止できる。また、基部側シャフト 2の先端部 22の先端は、図 9および図 10に示 すように、外管 8内に到達して 、な 、ことが好まし 、。 Further, the base side shaft inclined portion 23 of the base side shaft 2 and the lumen changing portion 46 of the connecting pipe portion 4 are in contact with each other. As a result, the pushing force applied to the main body portion 21 of the base side shaft 2 is transmitted to the distal end side shaft 3 through the contact portion between the two. Further, in this embodiment, as shown in FIG. 10, the base side shaft 2 is disposed at the base end portion of the connecting pipe portion 4 so that the tip end portion 22 is on the fused portion 43 and the inner tube 5 side. Has been placed. The distal end portion 22 of the base side shaft 2 may be in contact with the fused portion 43 (and the inner tube 5), or may be slightly separated. Preferably, it is in contact. further As shown in FIGS. 9 and 10, the distal end of the distal end portion 22 of the base side shaft 2 is preferably positioned closer to the distal end side of the catheter 1 than the guide wire introduction port 52 is. As a result, the guide wire introduction port 52 is reinforced, and the catheter can be prevented from being broken in the vicinity of the opening 52. Further, it is preferable that the distal end of the distal end portion 22 of the base side shaft 2 reaches the inside of the outer tube 8 as shown in FIGS. 9 and 10.
[0033] また、この実施例では、内管 2のガイドワイヤ導入口 52の向きと、基部側シャフト傾 斜部 23の向きは、外管の中心軸に対して相反する方向となるように形成されて!、る。 言い換えると、この実施例では、基部側シャフト傾斜部 23の横断面の円弧の背面側 (傾斜部 23の湾曲の外側、傾斜部 23の外面側)に開口 52が存在している。このよう にすることにより、ガイドワイヤ用内腔 51にガイドワイヤを挿通した際におけるカテー テルの曲がりを抑制でき、ガイドワイヤ導入口付近におけるカテーテルのキンクや折 れ曲がりを好適に防止できる。ガイドワイヤをガイドワイヤ用内腔に挿通すると、カテ 一テルはガイドワイヤを湾曲の外側とする方向に曲がり易くなる。このような曲がりが 生ずると、手元で与えた押し込み力の逃げが生じやすい。しかし、基部側シャフト傾 斜部が形成された部分において、カテーテルは、基部側シャフト傾斜部のある側を湾 曲の内側とする方向には曲がり難くなるため、ガイドワイヤ挿通時における力テーテ ルの曲がりを抑制な 、し防止することができる。  [0033] In this embodiment, the direction of the guide wire introduction port 52 of the inner tube 2 and the direction of the base-side shaft inclined portion 23 are opposite to the central axis of the outer tube. Being! In other words, in this embodiment, the opening 52 exists on the back side of the arc of the cross section of the base side shaft inclined portion 23 (outside of the curved portion of the inclined portion 23, on the outer surface side of the inclined portion 23). By doing so, it is possible to suppress the bending of the catheter when the guide wire is inserted into the guide wire lumen 51, and it is possible to suitably prevent the catheter from being kinked or bent in the vicinity of the guide wire introduction port. When the guide wire is inserted into the guide wire lumen, the catheter is easily bent in the direction in which the guide wire is outside the curve. When such bending occurs, the pushing force applied at hand tends to escape. However, in the portion where the base shaft tilt portion is formed, the catheter is unlikely to bend in the direction in which the side with the base shaft tilt portion is located inside the curve. Bending can be suppressed and prevented.
さらに、この実施例では、図 10に示すように、基部側シャフト 2の先端部 22は、基部 側シャフト 2の本体部 21の一部のみが軸方向に延出した樋状に形成されているととも に、その先端部 22は、融着部 43および内管 5側となるように配置されている。このた め、樋状の先端部 22は、融着部 43および内管 5に対して背を向けた状態となってお り、より、ガイドワイヤ挿通時におけるカテーテルの曲がりを抑制ないし防止する。  Further, in this embodiment, as shown in FIG. 10, the distal end portion 22 of the base side shaft 2 is formed in a bowl shape in which only a part of the main body portion 21 of the base side shaft 2 extends in the axial direction. At the same time, the distal end portion 22 is disposed so as to be on the fused portion 43 side and the inner tube 5 side. For this reason, the bowl-shaped distal end portion 22 is in a state of being turned to the back with respect to the fused portion 43 and the inner tube 5, thereby suppressing or preventing the bending of the catheter when the guide wire is inserted.
[0034] また、基部側シャフト 2の本体部の先端側部分には、図 10および図 13に示すように 、スリット 25または多数の開孔が形成されていてもよい。スリットまたは開孔の形成領 域としては、基部シャフト傾斜部 46より若干基端側に先端を備え、所定長基端側に 延びていることが好ましい。なお、基部シャフト傾斜部にもスリットまたは開孔を形成し てもよい。スリットまたは開孔の形成領域の長さとしては、 lOOmn!〜 300mm程度が 好適である。このようなスリットもしくは開孔を設けることにより、シャフト 2の本体部の先 端側部分における物性の急激な変化がなくなり、カテーテルのキンクを防止し、変形 (湾曲)も容易なものとなる。 Further, as shown in FIGS. 10 and 13, a slit 25 or a large number of openings may be formed in the distal end portion of the main body portion of the base side shaft 2. As a formation region of the slit or the opening, it is preferable that a distal end is provided slightly on the proximal end side with respect to the base shaft inclined portion 46 and extends to the proximal end side for a predetermined length. A slit or an opening may also be formed in the base shaft inclined portion. The length of the slit or aperture formation area is lOOmn! About 300mm is suitable. By providing such slits or openings, the tip of the main body of the shaft 2 The abrupt change in physical properties at the end side portion is eliminated, catheter kinking is prevented, and deformation (curvature) is facilitated.
また、スリット 25としては、図示するような螺旋状スリットであることが好ましいが、シャ フト 2の中心軸に平行に延びるスリットであってもよい。また、螺旋状スリットとする場合 、スリットのピッチを基部側シャフトの長手方向に適宜変化させて柔軟性を変化させて もよい。また、螺旋状スリットは、そのピッチが、スリットの先端部側では短ぐスリットの 基端部側では、長くなつていることが好ましい。このようにすることにより、先端部に向 力つて柔軟になるので、急激な物性の変化がなぐ湾曲が自然なものとなる。また、先 端部と基端部の中間部では、両者の中間のピッチを有しているか徐々にピッチが変 化していることが好ましい。特に、螺旋状スリットは、先端に向力つてピッチが徐々に 短くなつて!/、るもしくは先端に向力つて徐々に幅が広くなつて 、ることが好ま 、。  The slit 25 is preferably a spiral slit as shown in the figure, but may be a slit extending in parallel with the central axis of the shaft 2. Further, when the spiral slit is used, the flexibility may be changed by appropriately changing the slit pitch in the longitudinal direction of the base side shaft. In addition, it is preferable that the pitch of the spiral slit is short on the tip end side of the slit and is long on the base end side of the slit. By doing so, it becomes flexible toward the tip, so that the curve with a sudden change in physical properties becomes natural. Further, it is preferable that the intermediate portion between the front end portion and the base end portion has an intermediate pitch between them or the pitch gradually changes. In particular, it is preferable that the spiral slit has a pitch that gradually decreases toward the tip! / Or that the width gradually increases toward the tip.
[0035] また、スリットではなく開孔を設ける場合には、孔径としては、 0. lmn!〜 0. 4mm程 度が好ましぐより好ましくは、 0. 2mn!〜 0. 3mmである。また、孔径は、基部側シャ フトの外径の 1Z10〜1Z3程度が好ましい。開孔間の距離としては、 0. 1〜0. 5m m程度が好ましい。また、開孔の形状は、真円である必要はなく楕円、例えば、基部 側シャフトの周方向または軸方向に細長い長円さらに多角形 (例えば、四角形、五角 形)などでもよい。また、開孔は、開孔形成領域における先端部の方が基端部側より 数が多いことが好ましい。さらに、基端部側より先端側に向力つて、開孔の数が徐々 に多くなることが好ましい。  [0035] When an opening is provided instead of a slit, the hole diameter is 0.1 nm! About 0.4mm is more preferable, 0.2mn! ~ 0.3mm. The hole diameter is preferably about 1Z10 to 1Z3, which is the outer diameter of the base side shaft. The distance between the openings is preferably about 0.1 to 0.5 mm. Further, the shape of the opening does not need to be a perfect circle, but may be an ellipse, for example, an ellipse elongated in the circumferential direction or the axial direction of the base side shaft, or a polygon (for example, a quadrangle, a pentagon). In addition, it is preferable that the number of apertures in the aperture formation region is larger at the tip than at the base end. Furthermore, it is preferable that the number of apertures gradually increases as the force is directed toward the distal end side from the proximal end side.
[0036] そして、この実施例では、基部側シャフト 2の本体部 21の先端側部分には、スリット または多数の開孔が形成されており、先端側シャフト 3の基端部は、スリットまたは多 数の開孔が形成された基部側シャフト 2の本体部 21を被包し、かつ、スリットまたは多 数の開孔の形成部分よりも基端側において基部側シャフトに固着されている。具体 的には、接続用管部 4は、上記の基部側シャフト 2のスリットもしくは開孔形成領域を 被包する筒状部 44を備えている。そして、上記のスリットもしくは開孔形成領域より基 端側において、接続用管部 4の固定部 42が基部側シャフト 2に液密に固定されてい る。さらに、基部側シャフト 2と接続用管部 4の筒状部 44との間には、図 10および図 1 2に示すように、空隙 47が形成されている。つまり、接続用管部 4の筒状部 44は、基 部側シャフト 2に密着していない。このため、筒状部による基部側シャフト 2のスリットも しくは開孔形成領域の変形阻害が少なぐ良好な湾曲が可能となっている。 In this embodiment, a slit or a large number of apertures are formed in the distal end side portion of the main body portion 21 of the base side shaft 2, and the base end portion of the distal end side shaft 3 is slit or multi-opened. It encloses the main body 21 of the base side shaft 2 in which a number of apertures are formed, and is fixed to the base side shaft on the base end side with respect to the slits or the portions where the plurality of apertures are formed. Specifically, the connecting pipe portion 4 includes a cylindrical portion 44 that encloses the slit or hole forming region of the base side shaft 2. Further, the fixing portion 42 of the connecting pipe portion 4 is fixed to the base side shaft 2 in a liquid-tight manner on the base side from the slit or opening formation region. Furthermore, a gap 47 is formed between the base side shaft 2 and the cylindrical portion 44 of the connecting pipe portion 4 as shown in FIGS. That is, the cylindrical part 44 of the connecting pipe part 4 is The part side shaft 2 is not in close contact. For this reason, it is possible to make a good curve with little deformation inhibition of the slit or the opening forming region of the base side shaft 2 by the cylindrical portion.
[0037] 接続用管部 4としては、全長が、 100mm〜400mm程度であることが好ましい。ま た、接続用管部 4の先端から内腔変化部の基端までの長さは、 3〜15mm程度、より 好ましくは 5〜7mmであることが好ましい。また、接続用管部 4の筒状部 44の長さは 、 50mm〜300mm程度であることが好ましい。  [0037] The connecting pipe portion 4 preferably has a total length of about 100 mm to 400 mm. In addition, the length from the distal end of the connecting tube portion 4 to the proximal end of the lumen changing portion is preferably about 3 to 15 mm, more preferably 5 to 7 mm. The length of the cylindrical portion 44 of the connecting pipe portion 4 is preferably about 50 mm to 300 mm.
なお、この実施例では、接続用管部は、基部側シャフトのスリット部を被覆する関係 上、接続用管部は結構長ぐ接続用管部の先端側に内腔変化部(内腔傾斜部)が位 置するものとなっている。しかし、このようなものに限定されるものではなぐ接続用管 部の基端側に内腔変化部が位置するものであってもよい。  In this embodiment, the connecting pipe part covers the slit part of the base side shaft, so that the connecting pipe part is rather long at the distal end side of the connecting pipe part. ) Is to be positioned. However, the present invention is not limited to this, and the lumen changing portion may be located on the proximal end side of the connecting pipe portion.
[0038] さらに、基部側シャフト 2内には、図 9ないし図 12および図 15に示すように、剛性付 与体 11が挿入されていてもよい。剛性付与体 11は、基端部にて基部側シャフト 2の ハブ 7に固定され、先端は、基部側シャフト 2の先端より突出し、先端側シャフト 3内に 延びている。この実施例では、剛性付与体 11の先端部は、先端側シャフト 3の内管 5 と外管 8の間により形成される先端側シャフト内腔 31 (言い換えれば、バルーン拡張 用ルーメン)内に到達している。  [0038] Further, as shown in Figs. 9 to 12 and 15, a rigidity imparting member 11 may be inserted into the base side shaft 2. The rigidity imparting body 11 is fixed to the hub 7 of the base side shaft 2 at the base end, and the tip protrudes from the tip of the base side shaft 2 and extends into the tip side shaft 3. In this embodiment, the distal end of the rigidity imparting body 11 reaches the distal end shaft lumen 31 (in other words, the balloon expansion lumen) formed by the inner tube 5 and the outer tube 8 of the distal shaft 3. is doing.
剛性付与体 11は、基部側シャフト 2の基端より、その内部を先端側に延びている。 また、剛性付与体 11は、カテーテル 1の湾曲の障害とならないように、基端部のみ基 部側シャフト 2もしくはハブ 7に固定されており、その他の部分、具体的には、基部側 シャフト 2の基端部を除く内部、内管 5および先端側シャフト 3のいずれにも固定され ていない。剛性付与体 11は、基部側シャフト 2の可撓性をあまり低下させることなぐ 屈曲部位での基部側シャフト 2の極度の折れ曲がり、基部側シャフト 2の血管内での 蛇行を防止する。剛性付与体 11は、線状体により形成されていることが好ましい。線 状体としては、金属線であることが好ましぐ線径 0. 05〜: L 5mm、好ましくは 0. 1〜 1. Ommのステンレス鋼等の弾性金属、超弾性合金などであり、特に好ましくは、ば ね用高張力ステンレス鋼、超弾性合金線である。  The rigidity imparting body 11 extends from the proximal end of the base side shaft 2 to the distal end side. Further, the rigidity imparting body 11 is fixed to the base side shaft 2 or the hub 7 only at the base end so as not to obstruct the bending of the catheter 1, and other parts, specifically, the base side shaft 2 is fixed. It is not fixed to any of the inside, the inner tube 5 and the distal end side shaft 3 except for the base end portion. The rigidity imparting body 11 prevents the base-side shaft 2 from being meandered in the blood vessel by extreme bending of the base-side shaft 2 at the bent portion without significantly reducing the flexibility of the base-side shaft 2. The rigidity imparting body 11 is preferably formed of a linear body. The linear body is preferably a metal wire, preferably a wire diameter of 0.05 to L: 5 mm, preferably 0.1 to 1. Omm, such as an elastic metal such as stainless steel, a superelastic alloy, etc. High-strength stainless steel and superelastic alloy wire are preferable.
[0039] ここで 、う超弾性合金とは一般に形状記憶合金と!/、われ、少なくとも生体温度(37 °C付近)で超弾性を示すものである。特に好ましくは、 49— 53原子%Niの Ti— Ni合 金、 38. 5-41. 5重量%Znの Cu—Zn合金、 1 10重量% の01—211— 合金( X=Be、 Si、 Sn、 Al、 Ga)、 36— 38原子%A1の Ni— Al合金等の超弾性合金が好 適に使用される。特に、上記の Ti—Ni合金が望ましい。また、 Ti— Ni合金の一部を 0. 01〜: L0. 0原子0 /oXで置換した Ti— Ni— X合金(X=Co, Fe, Mn, Cr, V, Al, Nb, W, Bなど)とする力、または Ti— Ni合金の一部を 0. 01〜30. 0原子0 /0Χで置 換した Ti— Ni— X合金 (X=Cu, Pb, Zr)とすること、また、冷間加工率または/およ び最終熱処理の条件を選択することにより、機械的特性を適宜変えることができる。 また、上記の Ti— Ni—X合金を用いて冷間加工率および Zまたは最終熱処理の条 件を選択することにより、機械的特性を適宜変えることができる。 [0039] Here, the superelastic alloy is generally a shape memory alloy, and is superelastic at least at a living body temperature (around 37 ° C). Particularly preferred is a Ti-Ni compound of 49-53 atomic% Ni. Gold, 38. 5-41. 5 wt% Zn Cu—Zn alloy, 1 10 wt% 01—211—alloy (X = Be, Si, Sn, Al, Ga), 36—38 atomic% Ni Ni — Superelastic alloys such as Al alloys are preferably used. In particular, the above Ti-Ni alloy is desirable. Further, Ti- part of Ni alloy 0. 01~:. L0 0 atoms 0 / was replaced by oX Ti- Ni- X alloy (X = Co, Fe, Mn , Cr, V, Al, Nb, W, B, etc.) to force or Ti- Ni part of alloys 0.01 to 30.0 atom 0/0 and substitution with chi Ti- Ni- X alloy (X = Cu, Pb, Zr ) to be, In addition, the mechanical characteristics can be appropriately changed by selecting the cold working rate and / or the final heat treatment conditions. In addition, the mechanical properties can be changed as appropriate by selecting the cold work rate and Z or final heat treatment conditions using the Ti-Ni-X alloy described above.
[0040] なお、上述したすべての実施例において、バルーンの形状としては、図 8に示すス テントデリバリーカテーテル 40のようなものであってもよ!/、。上述したバルーン 6とこの 実施例のカテーテルのノ レーン 16の相違は、先端側外径変化部 16bおよび基端側 外径変化部 16cのみである。  [0040] In all the embodiments described above, the balloon may have a shape like the stent delivery catheter 40 shown in FIG. The difference between the balloon 6 described above and the catheter 16 of this embodiment is only the distal-end-side outer diameter changing portion 16b and the proximal-end-side outer diameter changing portion 16c.
基端側外径変化部 16cは、基端側接合部 16eと連続し、先端方向に向カゝつて外径 が大きくなるとともに、バルーン 16の長手方向軸線に対する傾斜角度が 3〜10° で ある基端側低傾斜部と、基端側低傾斜部よりも先端側に位置し、外径が先端方向に 向かって基端側低傾斜部における外径の変化率よりも大きい変化率で増大する基 端側高傾斜部とを備えて 、る。  The proximal-side outer diameter changing portion 16c is continuous with the proximal-side joining portion 16e, and has an outer diameter that increases toward the distal direction, and an inclination angle with respect to the longitudinal axis of the balloon 16 is 3 to 10 °. The proximal low slope part is located on the distal side of the proximal low slope part, and the outer diameter increases at a rate of change larger than the change rate of the outer diameter in the proximal low slope part toward the distal direction. And a base-side high slope portion.
同様に、先端側外径変化部 16bは、先端側接合部 16dと連続し、基端方向に向か つて外径が大きくなるとともに、バルーン 16の長手方向軸線に対する傾斜角度が 3〜 10° である先端側低傾斜部と、先端側低傾斜部よりも基端側に位置し、外径が基端 方向に向力つて先端側低傾斜部における外径の変化率よりも大きい変化率で増大 する先端側高傾斜部とを備えて 、る。  Similarly, the distal end side outer diameter changing portion 16b is continuous with the distal end side joint portion 16d, the outer diameter increases toward the proximal direction, and the inclination angle with respect to the longitudinal axis of the balloon 16 is 3 to 10 °. It is located at the base end side of the tip side low slope part and the tip side low slope part, and the outer diameter is directed toward the base end and increases at a change rate larger than the change rate of the outer diameter in the tip side low slope part. And a tip side high inclined portion.
[0041] また、本発明のカテーテルは、中間部にガイドワイヤー導入口 52を備えるラビットェ タスチェンジタイプに限定されるものではない。例えば、図 17に示すようなタイプのス テントデリバリーカテーテル 100であってもよい。この実施例のカテーテル 100は、上 述した実施例のカテーテル 1またはカテーテル 30と同様の図 2ないし図 4もしくは図 5 ないし図 7に示した構造を備えている。なお、このカテーテル 100では、内管 5は、外 管の全長を貫通している。よって、カテーテルの全体力 内管と外管力 なる二重管 構造となっている。内管 5の基端および外管 8の基端を固定するハブ 110には、内管 5内と連通するガイドワイヤ導入口 109と、外管内と連通する拡張用流体導入口 111 を備えている。 [0041] The catheter of the present invention is not limited to the rabbit status change type having the guide wire introduction port 52 in the intermediate portion. For example, a stent delivery catheter 100 of the type shown in FIG. 17 may be used. The catheter 100 of this embodiment has the structure shown in FIGS. 2 to 4 or FIGS. 5 to 7 similar to the catheter 1 or catheter 30 of the embodiment described above. In this catheter 100, the inner tube 5 is It penetrates the entire length of the tube. Therefore, the overall force of the catheter is a double tube structure consisting of an inner tube and an outer tube force. The hub 110 that fixes the proximal end of the inner tube 5 and the proximal end of the outer tube 8 includes a guide wire inlet 109 that communicates with the inner tube 5 and an expansion fluid inlet 111 that communicates with the inner tube 5. .
産業上の利用可能性 Industrial applicability
本発明のステントデリバリーカテーテルによれば、バルーン内かつ内管の外面に設 けられる造影用マーカー力^テントと軸方向にぉ 、て重なる部分が形成されな 、の で、マーカーとステントの重なりに起因する硬質部位の形成がなぐまた、マーカーと 外管間の距離が所定範囲内となっているため、マーカーと外管間でのキンクを防止 し、末梢の目的生体器官部位への押し込み性に優れる。また、バルーンへの拡張用 液体の流入障害もなぐステントを確実に拡張させることが可能である。  According to the stent delivery catheter of the present invention, since there is no overlapping marker portion in the axial direction in the balloon and on the outer surface of the inner tube, there is no overlap between the marker and the stent. In addition, there is no formation of a hard part due to this, and since the distance between the marker and the outer tube is within a predetermined range, kinking between the marker and the outer tube is prevented, and pushability to the peripheral target living organ part is improved. Excellent. In addition, it is possible to reliably expand a stent that does not impede the flow of expansion liquid into the balloon.

Claims

請求の範囲 The scope of the claims
[1] 外管と、該外管内を挿通し、所定長前記外管の先端より突出する先端部を有する内 管と、拡張時にほぼ均一な外径を有する筒状となる筒状部と、先端側カテーテル接 合部と、前記筒状部の先端と前記先端側カテーテル接合部の基端との間に位置す る先端側外径変化部と、基端側カテーテル接合部と、前記基端側カテーテル接合部 の先端と前記筒状部の基端との間に位置する基端側外径変化部とを有し、前記先 端側カテーテル接合部が前記内管の先端部に固定され、前記基端側カテーテル接 合部が前記外管に固定されたバルーンと、該バルーンの外面に装着され、該バルー ンの拡張により拡張されるステントと、前記バルーン内かつ該バルーンの基端側とな る位置の前記内管の外面に設けられた造影性材料力 なる造影用マーカーとを備え る先端側部分を有するステントデリバリーカテーテルであって、  [1] An outer tube, an inner tube having a tip portion that is inserted through the outer tube and protrudes from the tip of the outer tube for a predetermined length, and a cylindrical portion that has a substantially uniform outer diameter when expanded, A distal catheter joining portion, a distal outer diameter changing portion located between a distal end of the tubular portion and a proximal end of the distal catheter joining portion, a proximal catheter joining portion, and the proximal end A proximal-side outer diameter changing portion located between the distal end of the side catheter joint and the proximal end of the tubular portion, and the distal catheter joint is fixed to the distal end of the inner tube, A balloon in which the proximal catheter connection portion is fixed to the outer tube; a stent that is attached to the outer surface of the balloon and is expanded by expansion of the balloon; and a proximal end of the balloon in the balloon A contrast marker provided on the outer surface of the inner tube at a certain position and having a contrast material force. A stent delivery catheter having a distal end portion,
前記外管は、前記バルーンの前記基端側カテーテル接合部よりも先端側に延び、 前記基端側外径変化部内に位置する先端部を備えており、  The outer tube includes a distal end portion that extends to a distal end side from the proximal catheter coupling portion of the balloon, and is positioned within the proximal outer diameter changing portion.
該ステントの基端は、前記ノ レーンの筒状部の基端部に位置しており、 前記マーカーの先端は、前記カテーテルの軸方向における前記ステントの基端に 対応する位置若しくは該位置より若干基端側に位置し、前記マーカーの基端は、前 記外管の先端より前記マーカーの全長の五分の一の長さ分基端側の位置から前記 外管の先端より lmm先端側の位置までの範囲内に位置することを特徴とするステン トデリバリーカテーテル。  The proximal end of the stent is located at the proximal end of the tubular portion of the nolane, and the distal end of the marker is at a position corresponding to the stent proximal end in the axial direction of the catheter or slightly from the position. Located at the base end side, the base end of the marker is one-fifth of the total length of the marker from the tip of the outer tube, and is lmm from the tip of the outer tube from the position of the base end side. A stent delivery catheter characterized by being located within the range up to the position.
[2] 前記マーカーの先端は、前記カテーテルの軸方向における前記ステントの基端に対 応する位置力 前記カテーテルの基端側 lmmまでの範囲内に位置して 、る請求項 1に記載のステントデリバリーカテーテル。  [2] The stent according to claim 1, wherein the distal end of the marker is located within a range of positional force corresponding to the proximal end of the stent in the axial direction of the catheter up to lmm on the proximal end side of the catheter. Delivery catheter.
[3] 前記造影用マーカーは、放射線造影用マーカーもしくは超音波造影用マーカーで ある請求項 1または 2に記載のステントデリバリーカテーテル。  [3] The stent delivery catheter according to [1] or [2], wherein the contrast marker is a radiographic marker or an ultrasound contrast marker.
[4] 前記放射線造影用マーカーは、金、白金、タングステンあるいはそれらの合金、銀— ノ ラジウム合金力もなる群のうち少なくともいずれか一つの金属もしくは 2つ以上の合 金力 形成されている請求項 3に記載のステントデリバリーカテーテル。  [4] The radiographic contrast marker is formed of at least one metal or two or more alloying forces of a group including gold, platinum, tungsten or alloys thereof, or silver-noradium alloy force. 3. The stent delivery catheter according to 3.
[5] 前記ステントデリバリーカテーテルは、前記内管の内腔により構成されるガイドワイヤ 一ルーメンを備えて 、る請求項 1な 、し 4の 、ずれかに記載のステントデリバリーカテ ーテノレ。 [5] The stent delivery catheter is a guide wire constituted by a lumen of the inner tube. The stent delivery catheter according to any one of claims 1 to 4, comprising a lumen.
[6] 前記ステントデリバリーカテーテルは、前記内管の内腔により構成されるガイドワイヤ 一ルーメンと、該ガイドワイヤールーメンと連通しかつ、該ステントデリバリー力テーテ ルの中間部にて開口するガイドワイヤ導入口を備えて 、る請求項 1な 、し 5の 、ずれ かに記載のステントデリバリーカテーテル。  [6] The stent delivery catheter has a guide wire lumen constituted by the lumen of the inner tube, and a guide wire introduction that communicates with the guide wire lumen and opens at an intermediate portion of the stent delivery force tail. The stent delivery catheter according to claim 1, further comprising a mouth.
[7] 前記ステントデリバリーカテーテルは、前記先端側部分を形成する先端側シャフトと、 該先端側シャフト内に先端側部分が挿入され固定された基部側シャフトとを備え、前 記先端側シャフトは、該先端側シャフトの基端部に形成され、前記内管内と連通する ガイドワイヤ導入口を備え、前記外管内に形成された内腔は、前記基部側シャフト内 に形成された基部側シャフト内腔と連通して 、るものである請求項 1な 、し 6の 、ずれ かに記載のステントデリバリーカテーテル。  [7] The stent delivery catheter includes a distal-side shaft that forms the distal-side portion, and a base-side shaft in which the distal-side portion is inserted and fixed in the distal-side shaft, A proximal-side shaft lumen formed in the base-side shaft is formed in a base-end portion of the distal-side shaft, and includes a guide wire introduction port communicating with the inside of the inner tube. The stent delivery catheter according to any one of claims 1 to 6, wherein the stent delivery catheter is in communication with the stent delivery catheter.
[8] 前記カテーテルは、該カテーテルの先端にて一端が開口し、他端がカテーテルの後 端部にて開口するガイドワイヤールーメンを備えるものである請求項 1な 、し 4の 、ず れかに記載のステントデリバリーカテーテル。  8. The catheter according to claim 1, further comprising a guide wire lumen having one end opened at a distal end of the catheter and the other end opened at a rear end of the catheter. The stent delivery catheter according to 1.
[9] 前記バルーンの基端側外径変化部は、前記外管の先端よりも先端側に延びており、 前記マーカーの全部または大部分は前記バルーンの基端側外径変化部内に位置し て 、る請求項 1な 、し 8の 、ずれかに記載のステントデリバリーカテーテル。  [9] The base-end-side outer diameter changing portion of the balloon extends to the tip side from the tip of the outer tube, and all or most of the marker is located in the base-end-side outer diameter changing portion of the balloon. The stent delivery catheter according to any one of claims 1 and 8, wherein
PCT/JP2006/316103 2005-09-26 2006-08-16 Stent delivery catheter WO2007034639A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2005278759 2005-09-26
JP2005-278759 2005-09-26

Publications (1)

Publication Number Publication Date
WO2007034639A1 true WO2007034639A1 (en) 2007-03-29

Family

ID=37888693

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2006/316103 WO2007034639A1 (en) 2005-09-26 2006-08-16 Stent delivery catheter

Country Status (1)

Country Link
WO (1) WO2007034639A1 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2011517994A (en) * 2008-04-16 2011-06-23 アビオメド インコーポレイテッド Method and apparatus for implanting an endoluminal prosthesis such as a prosthetic valve
WO2014162398A1 (en) 2013-04-01 2014-10-09 テルモ株式会社 Biological indwelling object delivery system
WO2016031071A1 (en) * 2014-08-29 2016-03-03 Usciジャパン株式会社 Medical catheter
JPWO2019065280A1 (en) * 2017-09-27 2020-09-03 テルモ株式会社 Balloon catheter
WO2020175462A1 (en) * 2019-02-26 2020-09-03 一般社団法人細胞シート再生医療推進機構 Inner tube, catheter, and method for manufacturing inner tube

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10118187A (en) * 1996-10-15 1998-05-12 Terumo Corp Blood vessel dilation appliance
JP2001513374A (en) * 1997-08-08 2001-09-04 サンスコープ インターナショナル インコーポレイテッド Balloon catheter and method of using the same
JP2003102844A (en) * 2001-09-28 2003-04-08 Kanegafuchi Chem Ind Co Ltd Stent delivery catheter
JP2004298269A (en) * 2003-03-28 2004-10-28 Nippon Zeon Co Ltd Catheter and its production method

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10118187A (en) * 1996-10-15 1998-05-12 Terumo Corp Blood vessel dilation appliance
JP2001513374A (en) * 1997-08-08 2001-09-04 サンスコープ インターナショナル インコーポレイテッド Balloon catheter and method of using the same
JP2003102844A (en) * 2001-09-28 2003-04-08 Kanegafuchi Chem Ind Co Ltd Stent delivery catheter
JP2004298269A (en) * 2003-03-28 2004-10-28 Nippon Zeon Co Ltd Catheter and its production method

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2011517994A (en) * 2008-04-16 2011-06-23 アビオメド インコーポレイテッド Method and apparatus for implanting an endoluminal prosthesis such as a prosthetic valve
WO2014162398A1 (en) 2013-04-01 2014-10-09 テルモ株式会社 Biological indwelling object delivery system
CN105228560A (en) * 2013-04-01 2016-01-06 泰尔茂株式会社 Organism indwelling thing induction system
JP5960910B2 (en) * 2013-04-01 2016-08-02 テルモ株式会社 In-vivo indwelling delivery system
WO2016031071A1 (en) * 2014-08-29 2016-03-03 Usciジャパン株式会社 Medical catheter
JPWO2016031071A1 (en) * 2014-08-29 2017-05-25 Usciジャパン株式会社 Medical catheter
JPWO2019065280A1 (en) * 2017-09-27 2020-09-03 テルモ株式会社 Balloon catheter
JP7086089B2 (en) 2017-09-27 2022-06-17 テルモ株式会社 Balloon catheter
WO2020175462A1 (en) * 2019-02-26 2020-09-03 一般社団法人細胞シート再生医療推進機構 Inner tube, catheter, and method for manufacturing inner tube

Similar Documents

Publication Publication Date Title
JP4535868B2 (en) catheter
JP3523765B2 (en) Living organ dilator
JP2017077323A (en) catheter
JP5791521B2 (en) Stent delivery system
US20200238057A1 (en) Balloon catheter
JP5164283B2 (en) Balloon catheter
JP2009131397A (en) Living body organ dilator
EP3811899B1 (en) Stent for bypass between hollow organs and stent delivery system including stent for bypass between hollow organs
WO2007034639A1 (en) Stent delivery catheter
JP2013223663A (en) Protective sleeve for balloon catheter, balloon catheter system, and stent delivery system
JP2011206124A (en) Balloon catheter
JP5826592B2 (en) Dilatation catheter
WO2019198210A1 (en) Catheter
JP2002102359A (en) Instrument for expanding biological organ
JP2013223664A (en) Protective sleeve for balloon catheter, balloon catheter system, and stent delivery system
JP4955162B2 (en) Balloon for living organ dilator and living organ dilator
JP5960910B2 (en) In-vivo indwelling delivery system
JP2008086340A (en) Stent delivery catheter
CN113556992A (en) Medical tubular body transport device
JP7329042B2 (en) Medical tubular body conveying device
US20230129088A1 (en) Catheter
WO2021192636A1 (en) Stent for indwelling in living body and stent delivery system
JP6035033B2 (en) Stent expansion balloon, balloon catheter and stent delivery system
JP4828117B2 (en) Guide wire
JP5248165B2 (en) In vivo indwelling stent and biological organ dilator

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application
NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 06796462

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: JP