WO2009133614A1 - Cathéter à ballonnet - Google Patents

Cathéter à ballonnet Download PDF

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Publication number
WO2009133614A1
WO2009133614A1 PCT/JP2008/058327 JP2008058327W WO2009133614A1 WO 2009133614 A1 WO2009133614 A1 WO 2009133614A1 JP 2008058327 W JP2008058327 W JP 2008058327W WO 2009133614 A1 WO2009133614 A1 WO 2009133614A1
Authority
WO
WIPO (PCT)
Prior art keywords
balloon
lumen
inflation lumen
guide wire
tip
Prior art date
Application number
PCT/JP2008/058327
Other languages
English (en)
Japanese (ja)
Inventor
川尻健司
金澤哲也
中丸俊一
神茂雄
Original Assignee
東レ・メディカル株式会社
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 東レ・メディカル株式会社 filed Critical 東レ・メディカル株式会社
Priority to PCT/JP2008/058327 priority Critical patent/WO2009133614A1/fr
Publication of WO2009133614A1 publication Critical patent/WO2009133614A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/958—Inflatable balloons for placing stents or stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/065—Y-shaped blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/065—Y-shaped blood vessels
    • A61F2002/067—Y-shaped blood vessels modular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M2025/0183—Rapid exchange or monorail catheters

Definitions

  • the present invention relates to a medical balloon catheter, and more particularly, to a medical balloon catheter suitable for dilatation treatment of a stenosis part formed in a branch pipe part such as a blood vessel, an esophagus, a trachea, a urethra, and a bile duct.
  • a branch pipe part such as a blood vessel, an esophagus, a trachea, a urethra, and a bile duct.
  • the catheter system using a balloon catheter the stent delivery system and related stents are widely used for the treatment of stenosis, aneurysms, lesions and other abnormalities in blood vessels and other body lumens.
  • a medical device called a stent is sent to a predetermined stenosis or occlusion, and then the balloon is expanded, and the stent is plastically deformed by the expansion force of the balloon to form an inner surface of the stenosis.
  • the affected area is expanded by close contact.
  • an object of the present invention is to provide a balloon catheter suitable for indwelling a stent accurately and accurately according to a target position of a branch pipe part, thereby forming a branch pipe part such as a blood vessel, an esophagus, a trachea, a urethra, and a bile duct.
  • the purpose of this invention is to make it possible to perform dilation treatment more easily and appropriately.
  • the balloon catheter according to the present invention is provided with two guide wire lumens into which a guide wire is inserted in a balloon inflation lumen in which an uninflated balloon is attached to the outer periphery of the distal end portion. It consists of what is characterized by.
  • the two guide wires branched and inserted into each branch of the branch tube are separated into separate guide wire lumens. Since the distal end portion of the balloon catheter is sent to the branch tube portion while being inserted into the branch tube portion, the balloon mounting portion of the balloon inflation lumen is branched by two guide wires that are branched and inserted into the branches. The balloon is in a state of being locked by the shape portion, and the balloon inflation lumen and the distal end portion of the balloon are stopped at the branch pipe portion or a target position immediately before the branch tube portion. As a result, the stent mounted on the outer periphery of the balloon is also positioned at the most desirable target position, and can be accurately and accurately placed at the target position after balloon inflation.
  • the balloon catheter may have a structure in which the balloon tip side portion of the balloon inflated lumen is substantially composed only of a margin portion for joining the balloon for balloon sealing.
  • the length in the lumen extending direction of the adhesive margin portion for balloon bonding is not particularly limited, but is preferably in the range of 1 mm to 5 mm, for example. This makes it possible to send the balloon tip to the back of the branch pipe part, that is, to the position where it hits the branch part of the branch pipe part or to the position immediately before that while securing the minimum glue margin for balloon sealing. It can prevent being detained at a position in front of the branch pipe part.
  • the two guide wire lumens of the balloon catheter may be extended in the balloon inflation lumen from the tip of the balloon inflation lumen to the connector joint portion at the rear end of the balloon inflation lumen (this structure is an over-the-wire ( Sometimes called OTW) type).
  • the two guide wire lumens extend from the tip of the balloon inflated lumen to the inside of the balloon inflated lumen, and in the middle of the section to the connector joint at the rear end of the balloon inflated lumen, It may be led out of the lumen (this structure is sometimes referred to as a rapid exchange (RX) type).
  • RX rapid exchange
  • a structure combining the above two forms that is, one of the two guide wire lumens extends from the tip of the balloon inflated lumen to the connector joint at the rear end of the balloon inflated lumen.
  • the other side extends from the tip of the balloon inflated lumen to the inside of the balloon inflated lumen, and goes out of the balloon inflated lumen in the middle of the section to the connector joint at the rear end of the balloon inflated lumen. It is also possible to have a derived structure.
  • two guide wire lumens are simultaneously provided in the balloon inflation lumen, and one guide wire is inserted into each branch of the branch pipe portion in advance, and the balloon inflation lumen is inserted.
  • the balloon, and further, the distal end of the stent on the outer periphery of the balloon can be stopped at the optimum target position with respect to the branch pipe, thereby preventing the catheter or stent from entering one of the branches.
  • the balloon tip side part of the balloon inflation lumen substantially consist only of the glue margin part that joins the balloon for balloon sealing, the balloon tip is moved to the position just before the branch pipe part. Therefore, the stent can be prevented from being placed in front of the branch pipe portion.
  • any guide wire inserted into each branch of the branch tube is not sandwiched between the stent and the inner wall of the blood vessel, preparation for treatment can be performed without recrossing the guide wire.
  • the work procedure can be simplified and the work time can be shortened.
  • FIG. 1 is an overall schematic configuration diagram of a balloon catheter according to an embodiment of the present invention. It is comparison explanatory drawing of the conventional method and this invention in the stent arrangement
  • Balloon catheter 2 Balloon inflation lumen 3: Guide wire lumen 4: Balloon 5: Balloon joint glue margin 6: Guide wire 7: Connector 8: Connector joint portion 10: Stent 11: Branch 12: Branch stent
  • FIG. 1 shows a balloon catheter according to an embodiment of the present invention.
  • a balloon distal end portion of a balloon inflation lumen is substantially composed only of a margin portion for joining the balloon for balloon sealing.
  • the structure is shown.
  • a balloon catheter 1 has a balloon inflation lumen 2, and two guide wire lumens 3 are provided in the balloon inflation lumen 2.
  • the balloon catheter 1 has a balloon bonding paste margin 5 at the distal end portion, and the balloon 4 is bonded to the outer periphery of the distal end portion of the balloon catheter 1 via the balloon bonding paste margin 5 so as to be inflatable.
  • the two guide wires 6 are relatively inserted into the respective guide wire lumens 3.
  • the tip of the balloon inflation lumen 2 has a sealing structure, and only the installation portion of the guide wire lumen 3 has the inside of the guide wire lumen 3 opened to the sealing end.
  • the guide wire 6 can be inserted into the guide wire lumen 3.
  • the balloon joining structure in the balloon catheter according to the present invention is not particularly limited, but the balloon tip side portion of the balloon inflation lumen is substantially only a glue margin portion for joining the balloon for balloon sealing.
  • the margin portion 5 for joining the balloon is in the range of 1 mm to 5 mm. Since the balloon tip side portion is substantially composed only of the glue margin portion, it becomes easier to place the stent attached to the balloon tip at a position immediately before the branch pipe portion.
  • the extending form of the guide wire lumen in the balloon inflation lumen can take various forms.
  • various configurations can be adopted for the extension configuration of the guide wire lumen 3 with respect to the connector 7 connected to the rear end of the balloon inflation lumen 2 and its joint portion 8.
  • two guide wire lumens 3 are both connected from the front end of the balloon inflated lumen 2 to the connector connecting portion 8 (shown in FIG. 3) at the rear end of the balloon inflated lumen 2. It can be set as the form extended in a fret lumen.
  • two guide wire lumens 3 both extend from the tip of the balloon inflation lumen 2 in the balloon inflation lumen 2, and the balloon inflation It can also be set as the form led out of the balloon inflation lumen 2 in the middle of the section to the connector joint portion 8 at the rear end of the lumen 2. Furthermore, the structure in which both the above-described forms are combined, that is, one of the two guide wire lumens 3 is connected to the balloon inflation lumen 2 from the tip of the balloon inflation lumen 2 to the connector joint portion at the rear end of the balloon inflation lumen 2. The other is extended in the balloon inflated lumen 2 from the tip of the balloon inflated lumen 2 and in the middle of the section to the connector joint portion at the rear end of the balloon inflated lumen 2. It is also possible to adopt a form that is led out of the balloon inflation lumen 2.
  • an introduction tube called a sheath introducer (not shown) is inserted into a blood vessel connected to a branching tube stenosis.
  • a sheath introducer (not shown) is inserted into a blood vessel connected to a branching tube stenosis.
  • the upper arm or thigh is often selected as the insertion site.
  • a guiding catheter (not shown) is inserted into the blood vessel via the introduction tube, and the distal end of the guiding catheter is disposed up to the vicinity of the branch tube stenosis.
  • two guide wires 6 are inserted through the guiding catheter to the branch stenosis, and arranged so that one guide wire 6 passes through each branch from the guiding catheter via the branch stenosis.
  • an unexpanded stent is attached to the balloon 4 of the balloon catheter 1, and the two guide wires 6 are passed through the respective guide wire lumens 3 from the balloon tip side portion of the balloon catheter 1.
  • the balloon catheter 1 is sent along the guide wire 6 to the branch stenosis, and the balloon inflation lumen is sent so that the tip of the balloon inflation lumen 2 is locked by the branch shape of the two guide wires 6.
  • the distal end of the balloon inflation lumen 2 is positioned at a desired position immediately before the branch tube portion, and thereby the unexpanded stent attached to the balloon 4 is disposed at a desired position of the branch tube stenosis portion.
  • a liquid for example, a diluted contrast medium
  • pressure is applied to inject the balloon into the balloon 4 to inflate the balloon 4, and the branch tube
  • the stent disposed at a desired position of the stenosis is plastically deformed and brought into close contact with the inside of the tube.
  • the balloon catheter 1 is removed from the branch stenosis along the guide wire 6 so that the stent adheres to the inside of the tube. In this state, it is left at a desired position.
  • FIG. 4 shows an outline of the stent placement method using the balloon catheter as described above in comparison with the conventional method.
  • FIG. 4 (A) illustrates a stent placement method according to a conventional technique.
  • a balloon catheter 1 having a stent 10 attached to the tip of a balloon is placed along a guide wire 6 at a target position of a branch pipe. It shows how to do.
  • FIG. 4A it is difficult to prevent the stent 10 from entering the branch 11 with the conventional technique.
  • FIG. 4B when stent placement is performed using the balloon catheter according to the present invention, as shown in FIG. 4B, the balloon catheter 1 with the stent 10 attached to the tip of the balloon is branched and inserted into each branch. Since the two guide wires 6 are locked to the branched shape, the balloon tip is not inserted into the branch 11, and the stent 10 attached to the balloon is placed at the target position immediately before the branch pipe portion. It becomes possible.
  • FIG. 5 (A) shows a state in which the stent 10 is plastically deformed from the state of FIG. 4 (B) and brought into close contact with the inside of the tube, and after the balloon 4 is deflated, the balloon catheter 1 is removed from the branch tube portion. is there.
  • FIG. 5 (A) since two guide wires 6 are both arranged through the lumen of the stent 10 to the respective branches 11, as shown in FIG.
  • the branching stent 12 having a size capable of passing through the ten lumens, the branching stent 12 can be easily arranged on each branch 11.
  • the balloon catheter according to the present invention can be applied to all fields of application involving stent placement in a branch vessel, and is particularly suitable for appropriately placing a stent in a branch stenosis of a coronary artery.

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

Abstract

La présente invention concerne un cathéter à ballonnet, caractérisé en ce que deux lumières de fils de guidage, dans lesquelles des fils de guidage doivent être insérés, sont prévues dans une lumière de gonflage de ballonnet comportant un ballonnet non gonflé fixé à la périphérie externe à l’extrémité de ladite lumière. Par l’introduction des deux lumières de fils de guidage et de la lumière de gonflage du ballonnet, tel que décrit ci-dessus, vers la ramification du tube le long des deux fils de guidage que l’on a au préalable fait passer de la ramification du tube vers les branches respectives, l’extrémité de la lumière peut être placée de façon très précise à la position située immédiatement avant la ramification du tube. Ainsi, l’endoprothèse sur la périphérie externe du ballonnet peut être placé à la position cible optimale.
PCT/JP2008/058327 2008-05-01 2008-05-01 Cathéter à ballonnet WO2009133614A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2008/058327 WO2009133614A1 (fr) 2008-05-01 2008-05-01 Cathéter à ballonnet

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2008/058327 WO2009133614A1 (fr) 2008-05-01 2008-05-01 Cathéter à ballonnet

Publications (1)

Publication Number Publication Date
WO2009133614A1 true WO2009133614A1 (fr) 2009-11-05

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ID=41254844

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2008/058327 WO2009133614A1 (fr) 2008-05-01 2008-05-01 Cathéter à ballonnet

Country Status (1)

Country Link
WO (1) WO2009133614A1 (fr)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006223338A (ja) * 2005-02-15 2006-08-31 Humed Co Ltd カテーテル
JP2007082707A (ja) * 2005-09-21 2007-04-05 Asahi Intecc Co Ltd 薬液注入装置及びその製造方法

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006223338A (ja) * 2005-02-15 2006-08-31 Humed Co Ltd カテーテル
JP2007082707A (ja) * 2005-09-21 2007-04-05 Asahi Intecc Co Ltd 薬液注入装置及びその製造方法

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