WO2010035599A1 - 先端偏向操作可能カテーテル - Google Patents
先端偏向操作可能カテーテル Download PDFInfo
- Publication number
- WO2010035599A1 WO2010035599A1 PCT/JP2009/064692 JP2009064692W WO2010035599A1 WO 2010035599 A1 WO2010035599 A1 WO 2010035599A1 JP 2009064692 W JP2009064692 W JP 2009064692W WO 2010035599 A1 WO2010035599 A1 WO 2010035599A1
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- WO
- WIPO (PCT)
- Prior art keywords
- distal end
- leaf spring
- catheter
- operation wire
- wire
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6867—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive specially adapted to be attached or implanted in a specific body part
- A61B5/6869—Heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0144—Tip steering devices having flexible regions as a result of inner reinforcement means, e.g. struts or rods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires
- A61M2025/015—Details of the distal fixation of the movable mechanical means
Definitions
- the present invention relates to a tip-deflable manipulating catheter, and more specifically, by operating a proximal end side operation portion arranged outside the body, the direction of the distal end of the catheter inserted into the body cavity can be changed.
- the present invention relates to a catheter capable of tip deflection operation.
- the orientation of the distal end of the catheter inserted into the heart (fixed end of the tip electrode) is set to the proximal end of the catheter placed outside the body.
- a mechanism shown in Patent Document 1 below is known as a mechanism for operating and deflecting the distal end of the catheter on the proximal side.
- a leaf spring plate-shaped lead spring
- one surface and / or the other surface of the distal end portion of the leaf spring is arranged.
- the distal end of the operating wire is fixedly connected to the head. Then, by pulling the proximal end of the operation wire, the leaf spring can be bent and the direction of the distal end of the catheter can be changed.
- solder is usually used for connecting and fixing the distal end of the manipulation wire to one side and / or the other side of the leaf spring.
- the component material of the leaf spring for example, stainless steel, Ni—Ti alloy
- the component material of the operation wire for example, Stainless steel
- the operation wire may be detached from the surface of the leaf spring.
- the tip electrode fixed to the distal end of the catheter is connected and fixed (fixed) at two locations, the distal end of the catheter tube and the distal end of the leaf spring. It has only been done.
- connection and fixing of the tip electrode and the distal end of the catheter tube are usually performed by an adhesive, but the adhesive force may be reduced due to deterioration of the adhesive over time.
- solder is usually used for connecting and fixing the tip electrode and the leaf spring, but the material constituting the leaf spring (stainless steel and Ni—Ti alloy that exhibits good spring properties) It has poor wettability and is difficult to fix with solder.
- the tip tip electrode cannot be connected and fixed to the distal end of the catheter with a sufficient fixing force, and the tip tip electrode may fall into the living body during use of the electrode catheter. It is difficult to collect the tip electrode electrode that has fallen into the living body, and it is required that the tip electrode does not fall from the distal end of the catheter tube.
- the present applicant connects the distal end of the leaf spring (swing member) to the tip tip electrode, and independently of the connecting portion of the distal end of the leaf spring, the tip tip electrode.
- FIG. 10 is a cross-sectional view showing the inside of the distal end side of the catheter described in Patent Document 2.
- a leaf spring 120 as a swinging member is arranged in the vicinity of the distal end of the catheter tube 104, and the distal end of the leaf spring 120 is placed inside the tip electrode 110. It is connected and fixed to the tip electrode 110 by the filled solder 150.
- a notch is formed at the distal end of the leaf spring 120, and a temperature sensor protective tube 140 is disposed inside the notch.
- the proximal end of the leaf spring 120 is connected and fixed to the distal end of the coil tube 124 inside the catheter tube 104.
- 112 is a ring-shaped electrode attached to the distal end of the catheter tube 104
- 122 is a reinforcing plate connected to one side of a leaf spring 120.
- Reference numeral 130 denotes a pair of operation wires for bending and deforming the leaf spring 120 in the direction of arrow A or arrow B. At the distal end of the operation wire 130, a large-diameter portion for retaining (removal prevention) is provided. Part) 130a is formed. The distal ends of these operation wires 130 are disposed inside the solder 150 so as to be separated from the leaf springs 120 on both sides of the leaf spring 120, and come out of the solder 150 by the retaining large diameter portion 130a. It has been stopped.
- the proximal end side of the operation wire 130 is inserted into the operation tube 132 so as to be movable in the axial direction.
- the proximal end of the operation wire 130 is connected to a knob for performing a deflection movement operation (swinging operation) of the distal end portion of the catheter tube 104. By operating the knob, one of the operation wires is operated. Pulling 130 and deflecting leaf spring 120 allows the distal end of the catheter to be swung in the direction of arrow A or B.
- the tip end electrode 110 is not only connected and fixed to the distal end of the catheter tube 104 and the distal end of the leaf spring 120, but separately from the pair of operation wires.
- the distal end of 130 is also connected and fixed, if the distal tip electrode 110 and the distal end of the catheter tube 104 are not fixed, or the distal end of the distal tip electrode 110 and the leaf spring 120 is fixed. Even when the connection with the ends is broken, the tip chip electrode 110 is connected to the distal ends of the pair of operation wires 130, so that the tip chip electrode 110 can be prevented from falling off.
- the distal end of the manipulation wire is attached to the tip tip electrode independently of the connecting portion of the distal end of the leaf spring (away from the distal end of the leaf spring). Because the connection is fixed, when the operation wire is pulled, the distal end of the operation wire comes out of the solder filled in the tip electrode (disconnection from the tip electrode). There is a risk. That is, even if the large-diameter portion for retaining is formed, the contact area with the solder at the distal end of the operation wire is smaller than the contact area at the distal end of the leaf spring. In the case of a material having poor wettability with solder (for example, stainless steel), it is considered that the material will come off with a relatively low tensile force.
- solder for example, stainless steel
- the present invention has been made based on the above situation.
- the first object of the present invention is to firmly connect and fix the operation wire to the leaf spring regardless of the material of the leaf spring and the material of the operation wire.
- An object of the present invention is to provide a catheter capable of tip deflection operation that does not cause the operation wire to be detached from the surface.
- the second object of the present invention is to prevent the tip of the tip electrode fixed to the distal end of the catheter from falling off, and to fill the inside of the tip of the tip tip electrode when pulling the operation wire. It is an object of the present invention to provide a tip-deflable manipulating catheter capable of preventing the distal end of the manipulating wire from coming off from the solder that is used.
- a third object of the present invention is to provide a catheter capable of operating a tip deflection which is superior in manufacturing efficiency as compared with the conventional one.
- the distal deflection operable catheter of the present invention is A catheter tube; A tip electrode fixed to the distal end of the catheter tube; A leaf spring for swinging that is disposed along the axial direction inside the distal end side (near the distal end) of the catheter tube and is deformable in the bending direction; An operation wire that is arranged so as to extend along the axial direction inside the catheter tube, and whose proximal end is capable of pulling operation; And a ring-shaped member for caulking and fixing the distal end portion of the operating wire to one surface and / or the other surface of the distal end portion of the leaf spring.
- the constituent material of the leaf spring and the manipulation wire can be reduced. Regardless of the constituent material, the operation wire can be firmly connected and fixed to the leaf spring.
- the distal end of the leaf spring fixed by caulking with the ring-shaped member and the distal end portion of the manipulation wire is filled with solder filled in the distal tip electrode. It is preferably connected and fixed to the chip electrode.
- the distal end portion of the leaf spring, the distal end portion of the operation wire, and the ring-shaped member for caulking and fixing them are in contact with the solder filled in the tip chip electrode. Therefore, the tip electrode fixed to the distal end of the catheter tube is added to the distal end of the catheter tube and the distal end of the leaf spring by a ring-shaped member. It is also connected and fixed (fixed) to the distal end portion of the operation wire that is caulked and fixed to the distal end portion of the spring, and the contact area with the solder increases due to the ring-shaped member being embedded. Further, the pulling resistance force (fixing force of the tip electrode) of the leaf spring and the operation wire from the solder increases. Therefore, it is possible to reliably prevent the distal tip electrode from dropping from the catheter tube.
- the distal end portion of the manipulation wire is caulked and fixed to one surface and / or the other surface of the distal end portion of the leaf spring by the ring-shaped member (the distal end portion of the leaf spring and the manipulation wire Since the distal end and the ring-shaped member are in contact with the solder), the distal end of the leaf spring and the ring-shaped member are pulled out against the force to pull out the operation wire. Acts as a stop (pull-out resistance). Thereby, when the operation wire is pulled, it is possible to reliably prevent the distal end of the operation wire from coming out of the solder filled in the tip electrode.
- one end and the other end of the operation wire are proximal ends, the inside of the catheter tube extends from the one end (proximal end) in the distal direction, and the leaf spring
- the distal end portion of the operation wire is caulked and fixed on one surface and the other surface of the distal end portion of the leaf spring.
- the direction of the distal end of the catheter is changed in both directions by bending and deforming the leaf spring to the one surface side and the other surface side with a single wire having the folded portion as the distal end. Therefore, the number of parts can be reduced, and the manufacture is facilitated.
- a notch or a through hole for guiding the return of the operation wire is formed at the distal end portion of the leaf spring.
- the manipulation wire comprises a wire having one end as a proximal end, extending in the distal direction inside the catheter tube, and the other end as a distal end,
- the distal end of the manipulation wire may be caulked and fixed on one surface or the other surface of the distal end of the leaf spring.
- a retaining sleeve is attached to the distal end of the operation wire, and the distal end of the operation wire is attached to the distal end of the operation wire.
- a large-diameter portion having a diameter larger than the inner diameter of the sleeve is formed, and the proximal end surface of the sleeve is brought into contact with the distal end surface of the ring-shaped member, whereby one or the other surface of the leaf spring is aligned.
- the sleeve is restricted from moving in the proximal direction, and the large-diameter portion of the distal end of the manipulation wire is brought into contact with the distal end surface of the sleeve, whereby the manipulation wire is moved to the sleeve. It is preferable that the movement in the proximal direction is restricted.
- the ring-shaped member is made of copper or a copper alloy.
- the fixing work can be easily performed. Can do.
- copper and copper alloys have good wettability with solder, and by fixing by caulking with a ring-shaped member made of copper or copper alloy, the connection strength between the ring-shaped member and the tip electrode is increased, and the tip It is possible to more reliably prevent the electrode from falling off.
- the distal end portion of the manipulation wire is caulked and fixed to the one surface and / or the other surface of the distal end portion of the leaf spring by the ring-shaped member. Therefore, regardless of the material of the leaf spring and the material of the operation wire, the operation wire can be firmly connected and fixed to the leaf spring. Does not leave.
- the tip tip electrode can be prevented from falling off, and the tip tip electrode is filled when the manipulation wire is pulled. It is possible to reliably prevent the distal end of the operating wire from coming out of the solder that is applied.
- the inside of the catheter tube extends from one end (proximal end) in the distal direction, passes through one surface side of the leaf spring, turns back at the distal end portion of the leaf spring, and passes through the other surface side of the leaf spring.
- a manipulation wire comprising a single wire extending in the proximal direction to the other end (proximal end), the distal end of the manipulation wire on one side and the other side of the distal end of the leaf spring
- FIG. 3 is a sectional view taken along the line II in FIG. 2. It is a top view which shows the shape of the leaf
- the electrode catheter 2 according to the present embodiment shown in FIG. 1 is used, for example, for diagnosis or treatment of arrhythmia in the heart.
- 4 is a catheter tube
- 10 is a tip electrode fixed to the distal end of the catheter tube
- 12 is a ring electrode attached to the distal end of the catheter tube
- 6 is a catheter.
- Connectors (handles) 7 attached to the proximal end of the tube 4 are knobs attached to the connector 6 for performing a deflection movement operation (swinging operation) of the distal end of the catheter tube 4. From the connector 6, lead wires (not shown) that are electrically connected to the tip electrode 10 and the ring electrode 12 are drawn out.
- the electrode catheter 2 of the present embodiment includes a catheter tube 4, a tip electrode 10 fixed to the distal end of the catheter tube 4, and a distal end portion of the catheter tube 4.
- the catheter tube 4 is constituted by a hollow tube member.
- the catheter tube 4 may be composed of a tube having the same characteristics along the axial direction, but is formed integrally with the distal end portion having relatively high flexibility and the distal end portion in the axial direction. And having a proximal end portion that is relatively more rigid than the distal end portion.
- Examples of the constituent material of the catheter tube 4 include synthetic resins such as polyolefin, polyamide, polyether polyamide, and polyurethane.
- the outer diameter of the catheter tube 4 is generally about 0.6 to 3 mm, and the inner diameter is about 0.5 to 2.5 mm.
- Conductive wires (not shown) connected to the distal tip electrode 10 and the ring electrode 12 are respectively insulated and passed through the axial lumen of the catheter tube 4.
- the tip electrode 10 fixed to the distal end of the catheter tube 4 is formed by integrally forming a bullet-shaped tip portion 101 and a cylindrical portion 102 continuous therewith.
- the catheter tube 4 is inserted into the inner hole from the distal end and fixed by an adhesive.
- the constituent material of the tip electrode 10 include metals having good thermal conductivity such as aluminum, copper, stainless steel, gold, and platinum.
- the tip electrode 10 is preferably made of platinum or the like in order to provide good contrast for X-rays.
- the outer diameter of the tip electrode 10 is not particularly limited, but is preferably about the same as the outer diameter of the catheter tube 4 and is usually about 0.6 to 3 mm.
- Examples of the constituent material of the ring-shaped electrode 12 attached to the distal end portion of the catheter tube 4 include the same metals as those exemplified as the constituent material of the tip electrode 10.
- the outer diameter of the ring electrode 12 is not particularly limited, but is preferably about the same as the outer diameter of the catheter tube 4 and is usually about 0.6 to 3 mm.
- the number of ring-shaped electrodes attached to the distal end of the catheter tube 4 is not limited to two.
- the leaf spring 20 disposed inside the distal end side of the catheter tube 4 is a swinging member that can be deformed in the bending direction.
- the distal end 203 of the leaf spring 20 is formed with a notch 20 C for guiding the return of the operation wire.
- the axial length (L) of the leaf spring 20 is not particularly limited and is, for example, 40 to 300 mm.
- the width (W) of the leaf spring 20 is not particularly limited as long as it fits inside the catheter tube 4.
- the material of the leaf spring 20 is not particularly limited, and examples thereof include metal materials such as stainless steel, Ni—Ti alloy, and Co—Ni alloy, and polymer materials such as fluorine resin and polyamide resin.
- caulking is adopted as means for connecting and fixing the operation wire 30 to the leaf spring 20, and solder is not used as in the prior art. It is possible to use a metal material (for example, stainless steel, Ni—Ti alloy) that is inferior in properties, and it is also possible to use a polymer material that is inferior in heat resistance compared to a metal material.
- the proximal end of the leaf spring 20 is connected and fixed to the catheter tube 4 or connected to and fixed to the distal end of a coil tube (not shown) that receives the reaction force of the pulling force acting on the operation wire 30.
- the operation wire 30 extending in the axial direction inside the catheter tube 4 has a proximal end disposed so as to be capable of being pulled.
- One end and the other end of the operation wire 30 are proximal ends, and the inside of the catheter tube 4 extends from one end (proximal end) in the distal direction (upward in FIGS. 2 and 3).
- 201 passes through the 201 side, is guided by a notch formed in the distal end portion 203 of the leaf spring 20, and is folded back (therefore, the folded portion becomes the distal end of the operation wire 30). It consists of a single wire that runs through the side in the proximal direction (downward) to the other end (proximal end).
- One end and the other end, which are proximal ends of the operation wire 30, are connected to a knob 7 for performing a deflection movement operation (swing operation) of the distal end portion of the catheter tube 4.
- the operation wire 30 can be made of, for example, a metal such as stainless steel or a Ni—Ti superelastic alloy, but is not necessarily made of a metal.
- the operation wire 30 is made of a high-strength non-conductive wire. May be. By configuring the operation wire with a non-conductive wire, the cause of high-frequency noise can be reduced.
- the ring-shaped member 40 is for fixing the distal end 303 of the operation wire 30 to the one surface 201 and the other surface 202 of the distal end 203 of the leaf spring 20 by caulking.
- the distal end 303 (the portion before and after folding) of the operation wire 30 can be firmly connected and fixed to the one surface 201 and the other surface 202 of the distal end 203 of the leaf spring 20. Since the caulking is used as the connecting and fixing means of the operation wire 30 to the leaf spring 20 (one surface 201 and the other surface 202) and solder is not used, the operation wire 30 is low in wettability with solder. Can be used.
- the constituent material of the ring-shaped member 40 can be appropriately selected from metals that can be easily subjected to caulking (connection and fixing of the operation wire 30 to the leaf spring 20). Further, as will be described later, the distal end portion 203 of the leaf spring 20 and the distal end portion 303 of the operation wire 30 fixed by caulking with the ring-shaped member 40 are filled in the tip tip electrode 10 (inner concave portion).
- the constituent material of the ring-shaped member 40 is preferably a metal material having good wettability with respect to solder. From this point of view, copper or a copper alloy can be cited as a suitable constituent material for the ring-shaped member 40.
- the constituent material of the leaf spring 20 and the constituent material of the operation wire 30 have low wettability with solder (for example, stainless steel, Ni—Ti alloy). ), The distal end portions of the leaf spring 20 and the operation wire 30 can be firmly connected and fixed to the tip electrode 10.
- the distal end portion 203 of the leaf spring 20 and the distal end portion 303 of the operation wire 30 that are caulked and fixed by the ring-shaped member 40 are provided.
- the tip tip electrode 10 is connected and fixed to the tip tip electrode 10 by solder 50 filled in the tip tip electrode 10. That is, the distal end portion 203 of the leaf spring 20, the distal end portion 303 of the operation wire 30, and the ring-shaped member 40 are embedded in the solder 50 filled in the tip chip electrode 10.
- the material of the solder 50 filled in the tip electrode 10 is not particularly limited, and examples thereof include Sn—Pb, Sn—Pb—Ag, and Sn—Pb—Cu, and Pb It is also possible to use free solder such as Sn—Ag—Cu, Sn—Cu, Sn—Ag, Sn—Ag—Cu—Bi.
- the knob 7 of the connector 6 By operating the knob 7 of the connector 6, either one end or the other end of the operation wire 30 is pulled in the proximal direction, and the leaf spring 20 is bent.
- the distal end of the catheter 2 can be swung in the direction indicated by the arrow A or B.
- the distal end portion 303 (the portion before and after folding) of the operation wire 30 with respect to each surface of the one surface 201 and the other surface 202 of the distal end portion 203 of the leaf spring 20. Is fixed by caulking with the ring-shaped member 40, the operation wire 30 can be firmly connected and fixed to the leaf spring 20 regardless of the material of the leaf spring 20 and the material of the operation wire 30. The operation wire 30 is not detached from the one surface 201 or the other surface 202 of the leaf spring 20 during use of the catheter (in the procedure).
- the distal end 203 of the leaf spring 20, the distal end 303 of the operation wire 30, and the ring-shaped member 40 for caulking and fixing them are the tip.
- the tip electrode 10 In contact with the solder 50 filled in the inside of the electrode 10 (implanted), the tip electrode 10 is in addition to the distal end of the catheter tube 4 and the distal end 203 of the leaf spring 20, The solder 50 is fixedly connected (fixed) to the distal end 303 of the operation wire 30 that is caulked and fixed to the distal end of the leaf spring 20 and the ring-shaped member 40 is embedded.
- the distal end 303 of the operation wire 30 is caulked and fixed to the one surface 201 and the other surface 202 of the distal end 203 of the leaf spring 20 by the ring-shaped member 40 (the distal end of the leaf spring 20).
- the distal end portion 303 of the operation wire 30 and the ring-shaped member 40 are in contact with the solder 50), so that the force to pull out the operation wire 30 from the solder 50 can be reduced.
- the distal end portion 203 of the leaf spring 20 and the ring-shaped member 40 act as a retaining (pull-out resistance). Thereby, when the operation wire 30 is pulled, it is possible to reliably prevent the distal end of the operation wire 30 from coming out of the solder 50 filled in the tip electrode 10. .
- ⁇ Second Embodiment> 6 and 7 are a partially broken front view and a partially broken plan view of the distal end side of an electrode catheter according to another embodiment of the present invention.
- symbol is used for the component which is the same as that of 1st Embodiment, or respond
- the external shape of the electrode catheter of this embodiment is the same as that of the first embodiment shown in FIG. As shown in FIGS. 6 and 7, the electrode catheter of the present embodiment is attached to the catheter tube 4, the tip electrode 10 fixed to the distal end of the catheter tube 4, and the distal end of the catheter tube 4.
- the operation wire 35 arranged to extend, the ring-shaped member 40 for caulking and fixing the distal end portion of the operation wire 35 to the surface 252 at the distal end portion of the leaf spring 25, and the operation wire 35
- a retaining sleeve 60 attached to the distal end of the sleeve.
- the leaf spring 25 constituting the electrode catheter of the present embodiment has the same configuration as that of the leaf spring 20 constituting the first embodiment, except that a notch is not formed at the distal end thereof.
- One end of the operation wire 35 constituting the electrode catheter of this embodiment is a proximal end, and the inside of the catheter tube 4 (the surface 252 side of the leaf spring 25) is in the distal direction (upward in FIGS. 6 and 7).
- the other end is a wire that extends to the distal end.
- the proximal end of the operation wire 35 is arranged so that it can be pulled. That is, the proximal end of the operation wire 35 is connected to a knob (knob 7 shown in FIG. 1) for performing a deflection movement operation of the distal end portion of the catheter tube 4.
- a large-diameter portion for retaining (a retaining portion) 35a is formed.
- a method of forming the retaining portion 35a for example, a method of forming by TIG welding can be exemplified.
- the distal end portion of the operation wire 35 is caulked and fixed to the surface 252 of the distal end portion of the leaf spring 25 by the ring-shaped member 40. Thereby, by operating the knob of the connector and pulling the operation wire 35, the leaf spring 25 is bent toward the surface 252 side, and the distal end of the electrode catheter is deflected in one direction (direction indicated by arrow B). It is possible.
- the retaining sleeve 60 constituting the electrode catheter of the present embodiment is attached (extrapolated) to the distal end portion of the operation wire 35 (distal end side from the fixing position by the ring-shaped member 40).
- the outer diameter of the sleeve 60 is set such that the sleeve 60 is not inserted into the space surrounded by the inner peripheral surface of the ring-shaped member 40 and the surface 252 of the leaf spring 25. Thereby, since the proximal end surface of the sleeve 60 is contact
- the inner diameter of the sleeve 60 is slightly larger than the outer diameter of the operation wire 35, but is smaller than the diameter of the retaining portion 35 of the operation wire 35.
- the constituent material of the sleeve 60 is not particularly limited, and for example, stainless steel can be used. However, it is preferable to use a metal material having good wettability with the solder 50 (for example, phosphor bronze).
- the distal end of the leaf spring 25 and the distal end of the operation wire 35 fixed by caulking with the ring-shaped member 40 are the tip. It is connected and fixed to the tip electrode 10 by solder 50 filled in the electrode 10. That is, the distal end portion of the leaf spring 25, the distal end portion of the operation wire 35, the ring-shaped member 40, and the sleeve 60 are embedded in the solder 50 filled in the tip electrode 10. Yes.
- one end (proximal end) of the operation wire 35 is pulled in the proximal direction and the leaf spring 25 is bent, thereby the distal end of the electrode catheter
- the end can be swung in one direction.
- one end (proximal end) of the operation wire 35 is pulled in the proximal direction, and the leaf spring 25 is bent toward the surface 252 side.
- the distal end of the catheter is swung in the direction indicated by arrow B.
- the distal end portion of the operation wire 35 is caulked and fixed to the surface 252 at the distal end portion of the leaf spring 25 by the ring-shaped member 40. Regardless of the constituent material and the constituent material of the operation wire 35, the operation wire 35 can be firmly connected and fixed to the leaf spring 25, and the surface of the leaf spring 25 can be used while the catheter is being used (in the procedure). The operating wire 35 is not detached from 252.
- the distal end portion of the leaf spring 25, the distal end portion of the operation wire 35, the ring-shaped member 40 for caulking and fixing them, and the far end of the operation wire 35 are provided.
- the sleeve 60 attached to the distal end portion contacts (embeds) the solder 50 filled in the tip tip electrode 10, and the tip tip electrode 10 is connected to the distal end of the catheter tube 4 and the leaf spring 25.
- the distal end portion of the operation wire 35 is caulked and fixed to the surface 252 at the distal end portion of the leaf spring 25 by the ring-shaped member 40 (the distal end portion of the leaf spring 20 and the operation wire 35).
- the distal end portion of the coil, the ring-shaped member 40, and the sleeve 60 are in contact with the solder 50), so that the leaf spring against the force for pulling the operation wire 35 out of the solder 50
- the distal end portion of 25, the ring-shaped member 40 and the sleeve 60 act as a stopper (pull-out resistance). Thereby, when the operation wire 35 is pulled, it is possible to reliably prevent the distal end of the operation wire 35 from coming out of the solder 50 filled in the tip electrode 10. .
- ⁇ Third Embodiment> 8 and 9 are a partially broken front view and a partially broken plan view of the distal end side of an electrode catheter according to another embodiment of the present invention.
- symbol is used for the component which is the same as that of 2nd Embodiment, or respond
- the external shape of the electrode catheter of this embodiment is the same as that of the first embodiment shown in FIG. As shown in FIGS. 8 and 9, the electrode catheter of this embodiment has the same configuration as that of the second embodiment, and further extends to the surface 251 side of the leaf spring 25 inside the catheter tube 4. And an anti-removal sleeve 61 attached to the distal end of the operation wire 36.
- One end of the operation wire 36 constituting the electrode catheter of the present embodiment is a proximal end, and the inside of the catheter tube 4 is distal (upward in FIGS. 8 and 9) on the surface 251 side of the leaf spring 25. It is a wire that extends and has the other end as a distal end, and has the same configuration as the operation wire 35 that extends toward the surface 252 of the leaf spring 25, and a retaining portion is also provided at the distal end of the operation wire 36. 36a is formed.
- the proximal end of the operation wire 36 is arranged so that it can be pulled. That is, the proximal end of the operation wire 36 is connected to a knob (knob 7 shown in FIG. 1) for performing a deflection movement operation of the distal end portion of the catheter tube 4.
- the distal end portion of the operation wire 36 is caulked and fixed to the surface 251 of the distal end portion of the leaf spring 25 by the ring-shaped member 40.
- the sleeve 61 constituting the electrode catheter of this embodiment is attached (extrapolated) to the distal end portion of the operation wire 36.
- the sleeve 61 has the same configuration as the sleeve 60 attached to the distal end portion of the operation wire 35, and the sleeve 61 is brought into contact with the distal end surface of the ring-shaped member 40 by contacting the proximal end surface of the sleeve 61.
- the movement of 61 in the proximal direction is restricted.
- the retaining portion 36 a of the operation wire 36 is brought into contact with the distal end surface of the sleeve 61, the movement of the operation wire 36 in the proximal direction in the sleeve 61 is restricted.
- the distal end of the leaf spring 25 As shown in FIGS. 8 and 9, in the electrode catheter of this embodiment, the distal end of the leaf spring 25, the distal end of the operation wire 35 and the sleeve 60 attached thereto, and the operation wire
- the distal end portion of 36, the sleeve 61 attached thereto, and the ring-shaped member 40 are embedded in the solder 50 filled in the tip electrode 10.
- the distal end of the catheter can be swung in the direction of arrow A or B by operating the knob of the connector. For example, by rotating the knob 7 shown in FIG. 1 counterclockwise, one end (proximal end) of the operation wire 36 is pulled in the proximal direction, and the leaf spring 25 is bent toward the surface 251 side. The distal end of the electrode catheter is swung and deflected in the direction indicated by arrow A.
- one end (proximal end) of the operation wire 35 is pulled in the proximal direction, and the leaf spring 25 is bent toward the surface 252 side, so that the distal end of the electrode catheter The end can be swung and deflected in the direction indicated by arrow B.
- the distal end of the operation wire 35 is caulked and fixed to the surface 252 at the distal end of the leaf spring 25 by the ring-shaped member 40, and the distal end of the leaf spring 25 is fixed. Since the distal end portion of the operation wire 36 is caulked and fixed to the surface 251 at the end portion, regardless of the constituent material of the leaf spring 25 and the constituent materials of the operation wires 35 and 36, The operation wires 35 and 36 can be firmly connected and fixed, and the operation wires 36 and 35 are detached from the surfaces 251 and 252 of the leaf spring 25 during the use of the catheter (in the procedure). Absent.
- the distal end portion of the leaf spring 25, the operation wire 35, the sleeve 60, the operation wire 36, the sleeve 61, and the ring-shaped member 40 are arranged at the tip.
- the tip electrode 10 is in contact with (embedded with) the solder 50 filled inside the tip electrode 10, and the tip electrode 10 is added to the distal end of the catheter tube 4 and the distal end of the leaf spring 25.
- the operation wire 35 that is caulked and fixed to the distal end portion of the leaf spring 25 and the distal end portion of the operation wire 36 are also connected and fixed (fixed), and the ring-shaped member 40, the sleeve 60, and the sleeve
- the increase in contact area with the solder 50 due to the embedded 61, the ring-shaped member 40 is made of copper or a copper alloy, and the sleeve 60 and the sleeve 61 are made of phosphor bronze.
- the effect of improving the wettability to Sunda 50, the leaf spring 25, operating wire 35, pull-out resistance force against the solder 50 of the operating wire 36 (adhesive force of the distal tip electrode 10) is increased. Thereby, it is possible to reliably prevent the distal tip electrode 10 from dropping from the catheter tube 4.
- the distal ends of the operation wires 35 and 36 are caulked and fixed to the surfaces 252 and 251 at the distal end of the leaf spring 25 by the ring-shaped member 40 (the distal end of the leaf spring 20 and The distal end of the operation wire 35, the sleeve 60, the distal end of the operation wire 36, the sleeve 61, and the ring-shaped member 40 are in contact with the solder 50).
- the distal end of the leaf spring 25, the ring-shaped member 40, and the sleeve 60 or 61 act as a retaining (extraction resistance) against the force for extracting the operation wire 35 or the operation wire 36 from the solder 50. To do. Accordingly, when the operation wire 35 or the operation wire 36 is pulled, the distal end of the operation wire 35 or the operation wire 36 is pulled out from the solder 50 filled in the tip electrode 10. Can be reliably prevented.
- the distal end of the leaf spring and the distal end of the operation wire that are caulked and fixed by a ring-shaped member may be connected and fixed to the tip electrode by means other than solder.
- a mode in which the distal end portion of the leaf spring and the distal end portion of the operation wire that are caulked and fixed by the ring-shaped member are not connected and fixed to the tip electrode is included in the scope of the present invention.
Abstract
Description
この特許文献1に示す機構では、柔軟性を持つカテーテルの遠位端部の内部に、板バネ(板状のリードバネ)を配置し、その板バネの遠位端部の一面および/または他面に操作用ワイヤの遠位端を接続固定してある。そして、操作用ワイヤの近位端を引張り操作することにより、板バネを撓ませ、カテーテルの遠位端の向きを変えることができる。
ここに、板バネの一面および/または他面への操作用ワイヤの遠位端の接続固定には、通常ハンダが使用される。
また、先端チップ電極と板バネとの接続固定には、通常、ハンダが使用されているが、板バネの構成材料(良好なバネ性を発現するステンレス、Ni-Ti合金)は、ハンダとの濡れ性が悪く、ハンダによる接続固定が困難である。
同図に示すように、カテーテルチューブ104の遠位端近傍の内部には、首振り部材としての板バネ120が配置してあり、板バネ120の遠位端は、先端チップ電極110の内部に充填してあるハンダ150により、先端チップ電極110に接続固定してある。板バネ120の遠位端には、切り欠きが形成され、切り欠きの内部には、温度センサ用保護管140が配置されている。板バネ120の近位端は、カテーテルチューブ104の内部で、コイルチューブ124の遠位端に接続固定してある。同図において、112は、カテーテルチューブ104の遠位端部に装着されたリング状電極、122は、板バネ120の片面に連結してある補強板である。
上記のような構成のカテーテルにおいて、先端チップ電極110は、カテーテルチューブ104の遠位端および板バネ120の遠位端に接続固定してあるのみでなく、それらとは別に、一対の操作用ワイヤ130の遠位端に対しても接続固定してあるため、仮に、先端チップ電極110とカテーテルチューブ104の遠位端との固定が外れた場合、あるいは先端チップ電極110と板バネ120の遠位端との連結が外れた場合においても、先端チップ電極110は、一対の操作用ワイヤ130の遠位端に接続してあるため、先端チップ電極110の脱落を防止することができる。
本発明の第1の目的は、板バネの構成材料および操作用ワイヤの構成材料に関わらず、板バネに対して操作用ワイヤを強固に接続固定することができ、使用中に、板バネの表面から操作用ワイヤが脱離するようなことのない先端偏向操作可能カテーテルを提供することにある。
本発明の第2の目的は、カテーテルの遠位端に固定されている先端チップ電極の脱落を防止することができるとともに、操作用ワイヤの引張り操作を行う際に、先端チップ電極
の内部に充填されているハンダから操作用ワイヤの遠位端が抜けてしまうことを防止することができる先端偏向操作可能カテーテルを提供することにある。
本発明の第3の目的は、従来のものと比較して製造効率の優れた先端偏向操作可能カテーテルを提供することにある。
カテーテルチューブと、
前記カテーテルチューブの遠位端に固定された先端チップ電極と、
前記カテーテルチューブの遠位端側(遠位端近傍)の内部に軸方向に沿って配置され、撓み方向に変形可能な首振り用の板バネと、
前記カテーテルチューブの内部に軸方向に沿って延在するように配置され、その近位端が引張り操作可能な操作用ワイヤと、
前記板バネの遠位端部の一面および/または他面に前記操作用ワイヤの遠位端部をカシメ固定するリング状部材と、を備えていることを特徴とする。
また、このような操作用ワイヤを2本用意し、これらの遠位端部を、板バネの遠位端部の一面および他面にそれぞれカシメ固定することにより、2本のワイヤによって、板バネを一面側および他面側の両方向に撓み変形させて、カテーテルの遠位端の向きを両方向に変化させることができる。
また、銅および銅合金はハンダとの濡れ性が良好であり、銅または銅合金からなるリング状部材によりカシメ固定することにより、リング状部材と先端チップ電極との接続強度が高くなり、先端チップ電極の脱落を更に確実に防止することができる。
また、本発明(請求項2)の先端偏向操作可能カテーテルによれば、先端チップ電極の脱落を防止することができるとともに、操作用ワイヤの引張り操作を行う際に、先端チッ
プ電極の内部に充填されているハンダから操作用ワイヤの遠位端が抜けてしまうことを確実に防止することができる。
さらに、カテーテルチューブの内部を一端(近位端)から遠位方向に延び、板バネの一面側を通って、当該板バネの遠位端部で折り返し、当該板バネの他面側を通って、近位方向に延びて他端(近位端)に至る、1本のワイヤからなる操作用ワイヤを備え、板バネの遠位端部の一面および他面において、操作用ワイヤの遠位端部がカシメ固定されている本発明(請求項3)の先端偏向操作可能カテーテルによれば、1本の操作用ワイヤによって、板バネを一面側および他面側の両方向に撓み変形させることができるので、部品点数を削減することができ、従来のものと比較して製造効率にも優れている。
以下、本発明を、図面に示す実施形態に基いて説明する。
図1に示す本実施形態に係る電極カテーテル2は、例えば、心臓における不整脈の診断または治療に用いられるものである。
図1において、4はカテーテルチューブ、10は、カテーテルチューブ4の遠位端に固定された先端チップ電極、12は、カテーテルチューブ4の遠位端部に装着されたリング状電極、6は、カテーテルチューブ4の近位端に装着されたコネクタ(ハンドル)、7は、コネクタ6に装着されてカテーテルチューブ4の遠位端部の偏向移動操作(首振り操作)を行うための摘みである。コネクタ6からは、先端チップ電極10およびリング状電極12の各々に電気的に接続される導線(図示省略)が引き出される。
カテーテルチューブ4の外径は、一般に0.6~3mm程度であり、その内径は0.5~2.5mm程度である。カテーテルチューブ4の軸方向ルーメンには、先端チップ電極10およびリング状電極12の各々に接続される導線(図示省略)が、それぞれ絶縁されて通してある。
101と、これに連続する円筒状部分102とが一体的に成形されてなり、この円筒状部分102が、カテーテルチューブ4の遠位端からその内孔に挿入され、接着剤により固着されている。
先端チップ電極10の構成材料としては、例えばアルミニウム、銅、ステンレス、金、白金など、熱伝導性の良好な金属を挙げることができる。なお、X線に対する造影性を良好に持たせるために、先端チップ電極10は、白金などで構成されることが好ましい。
先端チップ電極10の外径は特に限定されないが、カテーテルチューブ4の外径と同程度であることが好ましく、通常0.6~3mm程度である。
リング状電極12の外径は特に限定されないが、カテーテルチューブ4の外径と同程度であることが好ましく、通常0.6~3mm程度である。
なお、カテーテルチューブ4の遠位端部に装着されるリング状電極の数は2個に限定されるものでないことは勿論である。
図5(1)にも示すように、板バネ20の遠位端部203には、操作用ワイヤの折り返しを案内するための切り欠き20Cが形成されている。なお、図5(2)に示すように、切り欠きに代えて貫通孔20Pが形成されている板バネ20’を使用することも可能である。板バネ20の軸方向長さ(L)は、特に限定されず、例えば40~300mmである。板バネ20の幅(W)は、カテーテルチューブ4の内部に収まる程度であれば特に限定されるものではない。
板バネ20の材質は特に限定されず、例えばステンレス、Ni-Ti合金、Co-Ni合金などの金属材料、フッ素樹脂、ポリアミド樹脂などの高分子材料などを挙げることができる。
板バネ20の近位端部は、カテーテルチューブ4に接続固定され、あるいは操作用ワイヤ30に作用する引っ張り力の反力を受けるコイルチューブ(図示省略)の遠位端に接続固定されている。
操作用ワイヤ30は、その一端および他端が近位端となり、カテーテルチューブ4の内部を一端(近位端)から遠位方向(図2および図3において上方)に延び、板バネ20の一面201側を通り、板バネ20の遠位端部203に形成された切り欠きに案内されて折り返し(従って、折り返し部分が操作用ワイヤ30の遠位端となる)、板バネ20の他面202側を通って、近位方向(下方)に延びて他端(近位端)に至る1本のワイヤからなる。
操作用ワイヤ30の近位端である一端および他端は、カテーテルチューブ4の遠位端部の偏向移動操作(首振り操作)を行うための摘み7に接続してある。
イヤなどで構成してもよい。操作用ワイヤを非導電性ワイヤで構成することにより、高周波ノイズの原因を低減することができる。
これにより、板バネ20の遠位端部203における一面201および他面202に対して、操作用ワイヤ30の遠位端部303(折り返し前後の部分)を強固に接続固定することができる。
板バネ20(一面201および他面202)への操作用ワイヤ30の接続固定手段としてカシメを採用してハンダを使用しないため、操作用ワイヤ30の構成材料として、ハンダとの濡れ性の低いものを使用することが可能となる。
また、後述するように、リング状部材40によりカシメ固定された板バネ20の遠位端部203および操作用ワイヤ30の遠位端部303を、先端チップ電極10の内部(内側凹部)に充填されたハンダ50により、当該先端チップ電極10に接続固定するために、リング状部材40の構成材料は、ハンダに対する濡れ性の良好な金属材料であることが好ましい。かかる観点から、リング状部材40の好適な構成材料として銅または銅合金を挙げることができる。リング状部材40の構成材料として銅または銅合金を使用することにより、板バネ20の構成材料および操作用ワイヤ30の構成材料として、ハンダとの濡れ性の低いもの(例えばステンレス、Ni-Ti合金)を使用しても、板バネ20および操作用ワイヤ30の遠位端部を先端チップ電極10に対して強固に接続固定することができる。
すなわち、板バネ20の遠位端部203と、操作用ワイヤ30の遠位端部303と、リング状部材40とが、先端チップ電極10の内部に充填されたハンダ50に埋め込まれている。
このように、1本の操作用ワイヤ30により、板バネ20を一面201側(矢印A方向)および他面202側(矢印B方向)の両方向に撓み変形させることができるので、部品
点数を削減すること(従来2本必要とされていたワイヤを1本にすること)ができ、製造も容易となる。
なお、コネクタ6を軸回りに回転させれば、体腔内に挿入された状態で、電極カテーテル2に対するAまたはB方向の向きを自由に設定することができる。
図6および図7は、本発明の他の実施形態である電極カテーテルの遠位端側の一部破断正面図および一部破断平面図である。
なお、第1の実施形態と同一または対応する構成要素には同一の符号を用いている。
操作用ワイヤ35は、その近位端が引張り操作可能に配置されている。すなわち、操作用ワイヤ35の近位端は、カテーテルチューブ4の遠位端部の偏向移動操作を行うための摘み(図1に示す摘み7)に接続してある。
これにより、コネクタの摘みを操作して操作用ワイヤ35を引張ることで、板バネ25が面252側に撓み、電極カテーテルの遠位端が一方向(矢印Bで示す方向)に首振り偏向が可能になっている。
スリーブ60の外径は、リング状部材40の内周面と、板バネ25の面252とにより囲まれる空間に、スリーブ60が挿入されない大きさとされる。これにより、スリーブ60の近位端面が、リング状部材40の遠位端面と当接されるので、スリーブ60が近位方向へ移動することが規制される。
また、スリーブ60の内径は、操作用ワイヤ35の外径よりも僅かに大きいが、操作用ワイヤ35の抜け止め部35の直径より小さい。これにより、操作用ワイヤ35の抜け止め部35aがスリーブ60の遠位端面に当接され、操作用ワイヤ35がスリーブ60の内部を近位方向へ移動することが規制される。
このようなスリーブ60を操作用ワイヤ35の遠位端部に装着することにより、操作用ワイヤ35を引張ったときに、操作用ワイヤ35がカテーテルチューブ4の内部を近位方向へ移動すること(カシメ固定されている操作用ワイヤ35が、リング状部材40から外れて抜けること)を確実に防止することができる。
すなわち、板バネ25の遠位端部と、操作用ワイヤ35の遠位端部と、リング状部材40と、スリーブ60とが、先端チップ電極10の内部に充填されたハンダ50に埋め込まれている。
例えば、図1に示す摘み7を時計方向に回すことにより、操作用ワイヤ35の一端(近
位端)が近位方向に引っ張られて、板バネ25が面252側に撓むことにより、電極カテーテルの遠位端が、矢印Bで示す方向に首振り偏向する。
図8および図9は、本発明の他の実施形態である電極カテーテルの遠位端側の一部破断正面図および一部破断平面図である。
なお、第2の実施形態と同一または対応する構成要素には同一の符号を用いている。
摘み(図1に示す摘み7)に接続してある。
操作用ワイヤ36の遠位端部は、リング状部材40により、板バネ25の遠位端部の面251にカシメ固定されている。
スリーブ61は、操作用ワイヤ35の遠位端部に装着されたスリーブ60と同様の構成であり、スリーブ61の近位端面がリング状部材40の遠位端面と当接されることにより、スリーブ61が近位方向へ移動することが規制される。また、操作用ワイヤ36の抜け止め部36aがスリーブ61の遠位端面に当接されることにより、操作用ワイヤ36がスリーブ61の内部を近位方向へ移動することが規制される。
このようなスリーブ61を操作用ワイヤ36の遠位端部に装着することにより、操作用ワイヤ36を引張ったときに、操作用ワイヤ36がカテーテルチューブ4の内部を近位方向へ移動すること(カシメ固定されている操作用ワイヤ36が、リング状部材40から外れて抜けること)を確実に防止することができる。
例えば、図1に示す摘み7を反時計方向に回すことにより、操作用ワイヤ36の一端(近位端)が近位方向に引っ張られて、板バネ25が面251側に撓むことにより、電極カテーテルの遠位端が、矢印Aで示す方向に首振り偏向する。また、摘み7を時計方向に回すことにより、操作用ワイヤ35の一端(近位端)が近位方向に引っ張られて、板バネ25が面252側に撓むことにより、電極カテーテルの遠位端が、矢印Bで示す方向に首振り偏向させることができる。
以上、本発明の実施形態について説明したが、本発明はこれらに限定されるものではなく、種々の変更が可能である。
例えば、リング状部材によりカシメ固定されている板バネの遠位端部および操作用ワイヤの遠位端部をハンダ以外の手段によって先端チップ電極に接続固定してもよい。
また、リング状部材によりカシメ固定されている板バネの遠位端部および操作用ワイヤの遠位端部を先端チップ電極に接続固定しない態様も本発明の範囲に包含される。
4 カテーテルチューブ
6 コネクタ
7 摘み
10 先端チップ電極
101 先端部分
102 円筒状部分
12 リング状電極
20 板バネ
201 一面
202 他面
203 板バネの遠位端部
25 板バネ
251 面
252 面
30 操作用ワイヤ
303 操作用ワイヤの遠位端部
35,36 操作用ワイヤ
40 リング状部材
50 ハンダ
60,61 抜け止め用のスリーブ
Claims (8)
- カテーテルチューブと、
前記カテーテルチューブの遠位端に固定された先端チップ電極と、
前記カテーテルチューブの遠位端側の内部に軸方向に沿って配置され、撓み方向に変形可能な首振り用の板バネと、
前記カテーテルチューブの内部に軸方向に沿って延在するように配置され、その近位端が引張り操作可能な操作用ワイヤと、
前記板バネの遠位端部の一面および/または他面に前記操作用ワイヤの遠位端部をカシメ固定するリング状部材と、
を備えていることを特徴とする先端偏向操作可能カテーテル。 - 前記リング状部材によりカシメ固定されている前記板バネおよび前記操作用ワイヤの遠位端部が、前記先端チップ電極の内部に充填されたハンダにより、当該先端チップ電極に接続固定されていることを特徴とする請求項1に記載の先端偏向操作可能カテーテル。
- 前記操作用ワイヤは、その一端および他端が近位端となり、前記カテーテルチューブの内部を前記一端から遠位方向に延び、前記板バネの一面側を通って、当該板バネの遠位端部で折り返し、当該板バネの他面側を通って、近位方向に延びて前記他端に至る、1本のワイヤからなり、前記板バネの遠位端部の一面および他面において、前記操作用ワイヤの遠位端部がカシメ固定されていることを特徴とする請求項1または請求項2に記載の先端偏向操作可能カテーテル。
- 前記板バネの遠位端部には、前記操作用ワイヤの折り返しを案内する切り欠きが形成されていることを特徴とする請求項3に記載の先端偏向操作可能カテーテル。
- 前記板バネの遠位端部には、前記操作用ワイヤの折り返しを案内する貫通孔が形成されていることを特徴とする請求項3に記載の先端偏向操作可能カテーテル。
- 前記操作用ワイヤは、その一端が近位端となり、前記カテーテルチューブの内部を遠位方向に延びて、その他端が遠位端となるワイヤからなり、前記板バネの遠位端部の一面または他面において、前記操作用ワイヤの遠位端部がカシメ固定されていることを特徴とする請求項1または請求項2に記載の先端偏向操作可能カテーテル。
- 前記操作用ワイヤの遠位端部には、抜け止め用のスリーブが装着されるとともに、前記操作用ワイヤの遠位端には、前記スリーブの内径よりも径の大きい大径部が形成され、
前記スリーブの近位端面が前記リング状部材の遠位端面に当接されることにより、前記板バネの一面または他面に沿って、前記スリーブが近位方向へ移動することが規制され、
前記操作用ワイヤの遠位端の大径部が前記スリーブの遠位端面に当接されることにより、前記操作用ワイヤが前記スリーブの内部を近位方向へ移動することが規制されていることを特徴とする請求項6に記載の先端偏向操作可能カテーテル。 - 前記リング状部材が銅または銅合金からなることを特徴とする請求項1乃至請求項7の何れかに記載の先端偏向操作可能カテーテル。
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KR1020117005161A KR101300884B1 (ko) | 2008-09-26 | 2009-08-24 | 선단 편향 조작 가능 카테터 |
CN2009801365081A CN102159278B (zh) | 2008-09-26 | 2009-08-24 | 前端能偏向操作的导管 |
HK11110622.2A HK1155991A1 (en) | 2008-09-26 | 2011-10-06 | Catheter having deflectable leading end |
Applications Claiming Priority (2)
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JP2008248473A JP4526585B2 (ja) | 2008-09-26 | 2008-09-26 | 先端偏向操作可能カテーテル |
JP2008-248473 | 2008-09-26 |
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WO2010035599A1 true WO2010035599A1 (ja) | 2010-04-01 |
Family
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PCT/JP2009/064692 WO2010035599A1 (ja) | 2008-09-26 | 2009-08-24 | 先端偏向操作可能カテーテル |
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JP (1) | JP4526585B2 (ja) |
KR (1) | KR101300884B1 (ja) |
CN (1) | CN102159278B (ja) |
HK (1) | HK1155991A1 (ja) |
WO (1) | WO2010035599A1 (ja) |
Cited By (8)
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EP2732845A1 (en) * | 2012-11-14 | 2014-05-21 | Biosense Webster (Israel), Ltd. | Catheter with flat beam deflection in TIP |
JP2014097389A (ja) * | 2012-11-14 | 2014-05-29 | Biosense Webster (Israel) Ltd | 非対称曲率の2方向偏向を提供する平坦梁をともなうカテーテル |
EP2764886A1 (en) * | 2013-02-06 | 2014-08-13 | Biosense Webster (Israel), Ltd. | Catheter having flat beam deflection tip with fiber puller members |
WO2015048682A1 (en) * | 2013-09-30 | 2015-04-02 | St. Jude Medical, Cardiology Division, Inc. | Catheter having an active return-to-straight mechanism |
US9174023B2 (en) | 2013-01-07 | 2015-11-03 | Biosense Webster (Israel) Ltd. | Unidirectional catheter control handle with tensioning control |
JP2019531128A (ja) * | 2016-09-29 | 2019-10-31 | コーニンクレッカ フィリップス エヌ ヴェKoninklijke Philips N.V. | カテーテルアセンブリのためのプルワイヤクラウン及びクラウンスリーブ |
US11471650B2 (en) | 2019-09-20 | 2022-10-18 | Biosense Webster (Israel) Ltd. | Mechanism for manipulating a puller wire |
US11918762B2 (en) | 2018-10-03 | 2024-03-05 | St. Jude Medical, Cardiology Division, Inc. | Reduced actuation force electrophysiology catheter handle |
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CN102551874B (zh) * | 2011-10-20 | 2015-07-22 | 上海微创电生理医疗科技有限公司 | 肾动脉射频消融导管 |
US10737066B2 (en) | 2016-09-18 | 2020-08-11 | St. Jude Medical, Cardiology Division, Inc. | Loop catheter with activation tether coupled to pre-formed loop structure |
EP3375477A1 (en) | 2017-03-16 | 2018-09-19 | Basecamp Vascular | Flexible elongated structure having a steerable end |
WO2019156059A1 (ja) * | 2018-02-06 | 2019-08-15 | 株式会社カネカ | カテーテルおよびその製造方法 |
CN113491816B (zh) * | 2021-07-06 | 2023-06-27 | 上海康德莱医疗器械股份有限公司 | 一种电定位可控弯导丝 |
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- 2009-08-24 WO PCT/JP2009/064692 patent/WO2010035599A1/ja active Application Filing
- 2009-08-24 KR KR1020117005161A patent/KR101300884B1/ko active IP Right Grant
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JP2014097389A (ja) * | 2012-11-14 | 2014-05-29 | Biosense Webster (Israel) Ltd | 非対称曲率の2方向偏向を提供する平坦梁をともなうカテーテル |
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EP2732845A1 (en) * | 2012-11-14 | 2014-05-21 | Biosense Webster (Israel), Ltd. | Catheter with flat beam deflection in TIP |
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US9545499B2 (en) | 2013-01-07 | 2017-01-17 | Biosense Webster (Israel) Ltd. | Unidirectional catheter control handle with tensioning control |
JP2014151200A (ja) * | 2013-02-06 | 2014-08-25 | Biosense Webster (Israel) Ltd | 繊維引込部材を備える、扁平梁偏向先端部を有するカテーテル |
EP2764886A1 (en) * | 2013-02-06 | 2014-08-13 | Biosense Webster (Israel), Ltd. | Catheter having flat beam deflection tip with fiber puller members |
US9849268B2 (en) | 2013-02-06 | 2017-12-26 | Biosense Webster (Israel), Ltd. | Catheter having flat beam deflection tip with fiber puller members |
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WO2015048682A1 (en) * | 2013-09-30 | 2015-04-02 | St. Jude Medical, Cardiology Division, Inc. | Catheter having an active return-to-straight mechanism |
JP2019531128A (ja) * | 2016-09-29 | 2019-10-31 | コーニンクレッカ フィリップス エヌ ヴェKoninklijke Philips N.V. | カテーテルアセンブリのためのプルワイヤクラウン及びクラウンスリーブ |
JP7118053B2 (ja) | 2016-09-29 | 2022-08-15 | コーニンクレッカ フィリップス エヌ ヴェ | カテーテルアセンブリのためのプルワイヤクラウン及びクラウンスリーブ |
US11918762B2 (en) | 2018-10-03 | 2024-03-05 | St. Jude Medical, Cardiology Division, Inc. | Reduced actuation force electrophysiology catheter handle |
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US11964115B2 (en) | 2019-09-20 | 2024-04-23 | Biosense Webster (Israel) Ltd. | Mechanism for manipulating a puller wire |
Also Published As
Publication number | Publication date |
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CN102159278A (zh) | 2011-08-17 |
JP2010075530A (ja) | 2010-04-08 |
KR101300884B1 (ko) | 2013-08-27 |
JP4526585B2 (ja) | 2010-08-18 |
HK1155991A1 (en) | 2012-06-01 |
CN102159278B (zh) | 2013-08-28 |
KR20110058790A (ko) | 2011-06-01 |
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