WO2013047616A1 - Fil guide - Google Patents

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Publication number
WO2013047616A1
WO2013047616A1 PCT/JP2012/074782 JP2012074782W WO2013047616A1 WO 2013047616 A1 WO2013047616 A1 WO 2013047616A1 JP 2012074782 W JP2012074782 W JP 2012074782W WO 2013047616 A1 WO2013047616 A1 WO 2013047616A1
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WO
WIPO (PCT)
Prior art keywords
wire
tubular body
coil
distal end
guide wire
Prior art date
Application number
PCT/JP2012/074782
Other languages
English (en)
Japanese (ja)
Inventor
幸彦 村田
晋 日下部
Original Assignee
テルモ・クリニカルサプライ株式会社
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 テルモ・クリニカルサプライ株式会社 filed Critical テルモ・クリニカルサプライ株式会社
Publication of WO2013047616A1 publication Critical patent/WO2013047616A1/fr

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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
    • A61M25/09—Guide wires
    • 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
    • A61M25/09—Guide wires
    • A61M2025/09058—Basic structures of guide wires
    • A61M2025/09083—Basic structures of guide wires having a coil around a core
    • 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
    • A61M25/09—Guide wires
    • A61M2025/09175—Guide wires having specific characteristics at the distal tip

Definitions

  • the present invention relates to a guide wire.
  • the present invention relates to a guide wire used when a catheter is introduced into a small blood vessel such as a cerebral blood vessel.
  • the guide wire is used to guide a catheter used for treatment of a site where surgical operation is difficult, treatment for the purpose of minimally invasive to the human body, and examination such as angiography.
  • the blood vessel is intricately curved, and the distal end portion of the guide wire is pre-shaped into a curved shape in one direction in order to facilitate insertion into the target blood vessel in consideration of the selected target blood vessel.
  • the guide wire it is not easy to insert the guide wire while imagining the three-dimensional shape of the blood vessel so that the bending direction of the distal end portion of the guide wire follows the shape of the blood vessel.
  • the shape given in advance may not be able to be inserted satisfactorily. In that case, the guide wire is removed from the blood vessel, the tip is shaped into another shape, and then inserted into the blood vessel again. A procedure is required.
  • Patent Document 1 a guide wire that can deform the tip shape of the guide wire by hand operation as disclosed in JP 2010-207251 (Patent Document 1).
  • the guide wire of Patent Document 1 is a flexible tubular tube 2 and a flexible tube that is inserted into the tube 2 so as to be movable along the longitudinal direction, and has a distal end portion protruding from the distal end of the tube 2.
  • an elastic member 4 having both ends fixed to the distal end of the wire 3 and the distal end of the tube 2, and the elastic member 4 contracts in a substantially linear shape along the longitudinal direction of the tube 2.
  • the tube 2 has a contracted state having flexibility substantially equal to or lower than that of the tube 2 and is stretched while curving the tip in a predetermined direction with respect to the longitudinal direction of the tube 2 so as to have higher flexibility than the tube 2.
  • the wire 3 can be elastically deformed between the stretched state and the wire 3 has higher flexibility than the stretched elastic member 4 at least at the distal end portion.
  • a fixing mechanism for fixing the positions of the tube 2 and the wire 3 in the longitudinal direction for example, a screw or a ratchet that meshes with each other may be provided on each base end side.
  • steering-wheel 5 provided in the base end part of the wire 3 is larger diameter than the tube 2, and the guide wire insertion of a catheter is carried out.
  • the type of catheter that can not be inserted into the hole from the handle side is limited.
  • a fixing mechanism for fixing the position in the longitudinal direction of the tube 2 and the wire 3 may be provided, but what is specifically shown is the handle shown in FIG. 5, the thread 5c is provided in the insertion portion 5a, and the thread groove 5d is provided on the inner surface of the tube 2 on the proximal end side. It is not easy to rotate the small handle provided at the proximal end of the guide wire in a state where the surgical gloves are worn, and since the handle is gradually deformed by the rotation of the handle, the response is poor.
  • an object of the present invention is to allow a guide wire whose shape of the distal end portion can be deformed by hand operation, and can be inserted not only from the distal end side of the guide wire but also from the proximal end side into the guide wire insertion hole of the catheter. Furthermore, the tip of the guide wire can be easily and quickly deformed by towing the operating portion without being turned, and the guide wire can be deformed and released by towing. A guide wire that is easy and has good operability is provided.
  • a tubular body a wire that is slidably inserted through the tubular body, a coil portion that encloses a distal end portion of the wire, and a wire operation portion provided at a proximal end portion exposed from the tubular body of the wire
  • a maximum diameter portion of the wire operating portion is equal to or smaller than an outer diameter of the tubular body, and the coil portion can be shaped into a linear shape, a curved shape, or a curved shape.
  • the distal end portion of the guide wire encapsulated in the coil portion can be deformed from the linear shape to the curved shape or from the curved shape to a substantially linear shape by pulling in the proximal direction of the wire.
  • the wire and the tubular body have a deformed state holding mechanism for a guide wire distal end portion for holding the deformation and deformation of the distal end portion by an operation in the axial direction of the wire operation portion. Provided by which the guide wire.
  • a tubular body a wire that is slidably inserted through the tubular body, a coil portion that encloses a distal end portion of the wire, and a wire operation portion provided at a proximal end portion exposed from the tubular body of the wire
  • a maximum diameter portion of the wire operating portion is equal to or smaller than an outer diameter of the tubular body, and the coil portion can be shaped into a curved shape or a curved shape, and
  • the wire is not joined to the coil portion and the tubular body, and is movable in the coil portion and the tubular body. Further, the wire corrects the curved shape of the coil portion to a substantially straight line.
  • the coil portion can be deformed into an arbitrary shape from the curved shape to a substantially linear shape by operating the ear operation portion in the axial direction, and the pressure contact between the pressure contact sliding portion and the inner surface of the tubular body
  • a guide wire capable of holding a deformed form of a coil portion.
  • FIG. 1 is a partially omitted front view of an embodiment of a guide wire according to the present invention.
  • FIG. 2 is a longitudinal sectional view of the guide wire shown in FIG. 3 is a cross-sectional view taken along line AA in FIG.
  • FIG. 4 is an explanatory diagram for explaining the operation of the guide wire shown in FIG.
  • FIG. 5 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 6 is an explanatory diagram for explaining the operation of the guide wire shown in FIG.
  • FIG. 7 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 1 is a partially omitted front view of an embodiment of a guide wire according to the present invention.
  • FIG. 2 is a longitudinal sectional view of the guide wire shown in FIG. 3 is a cross-sectional view taken along line AA in FIG.
  • FIG. 4 is an explanatory
  • FIG. 8 is an external view of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 9 is an explanatory diagram for explaining the structure of the proximal end portion of the guide wire shown in FIG.
  • FIG. 10 is an explanatory diagram for explaining the structure of the proximal end portion of the guide wire shown in FIG.
  • FIG. 11 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 12 is an explanatory diagram for explaining the operation of the guide wire shown in FIG.
  • FIG. 13 is an explanatory view for explaining the structure of the base end portion of another embodiment of the guide wire of the present invention.
  • FIG. 14 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 15 is an explanatory diagram for explaining the operation of the guide wire shown in FIG. 16 is a cross-sectional view taken along line BB in FIG. 17 is a cross-sectional view taken along the line CC of FIG.
  • FIG. 18 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 19 is an external view of the base end portion of another embodiment of the guide wire of the present invention.
  • FIG. 20 is a cross-sectional view of the proximal end portion of the guide wire shown in FIG. FIG.
  • FIG. 21 is an explanatory diagram for explaining the operation of the guide wire shown in FIGS. 19 and 20.
  • FIG. 22 is a front view of the distal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 23 is an explanatory diagram for explaining the internal structure of the guide wire shown in FIG.
  • FIG. 24 is an explanatory diagram for explaining the operation of the guide wire shown in FIG.
  • FIG. 25 is an explanatory view for explaining the structure of the distal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 26 is an explanatory view for explaining the structure of the distal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 27 is an explanatory view for explaining the structure of the distal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 28 is an explanatory view for explaining the structure of the distal end portion of another embodiment of the guide wire of the present invention.
  • 29 is a cross-sectional view taken along the line DD of FIG.
  • FIG. 30 is an explanatory view for explaining the internal structure of another embodiment of the guide wire of the present invention.
  • FIG. 31 is a cross-sectional view of another embodiment of the guide wire of the present invention.
  • FIG. 32 is an explanatory diagram for explaining the action of the guide wire shown in FIG.
  • FIG. 33 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 34 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • the guide wire of the present invention will be described using an embodiment shown in the drawings.
  • the guide wire 1 of the present invention includes a tubular body 2, a wire 4 that is slidably inserted in the tubular body 2, a coil portion 3 that encloses the distal end portion of the wire 4, and the tubular body 2 of the wire 4. And a wire operation unit 7 provided at the exposed base end.
  • the maximum diameter portion of the wire operation portion 7 is equal to or smaller than the outer diameter of the tubular body 2, and the coil portion 3 can be formed into a linear shape, a curved shape, or a curved shape, and the coil portion 3 is covered with the coil portion 3.
  • the distal end portion of the wrapped guide wire 4 can be deformed from a straight shape to a curved shape or from a curved shape to a substantially straight shape by pulling in the proximal direction of the wire 4, and the wire 4 and the tubular body 2 are
  • a guide wire distal end portion deformed state holding mechanism is provided for maintaining the deformation and deformation of the distal end portion by operating the wire operation portion 7 in the axial direction.
  • the guide wire 1 of this embodiment includes a tubular body 2, a wire 4 that is slidably inserted through the tubular body, and a coil portion 3 that encloses a distal end portion of the wire 4. Furthermore, in the guide wire 1 of this embodiment, as shown in FIGS. 1 to 3, the guide wire distal end portion deformed state holding mechanism is provided on the wire side provided at the distal end side of the wire operation portion 7 of the wire 4. A shape holding portion 41 and a tubular body side shape holding portion provided in the tubular body 2 are provided, and a deformed shape of the wire tip portion is held by pressure contact between the wire side shape holding portion and the tubular body side shape holding portion. ing.
  • the wire 4 includes a deformed portion (wire side shape holding portion) 41 provided in the axial direction at a portion on the tip side from the wire operation portion 7, and the inner surface 21 (tubular body side shape holding portion) of the tubular body 2.
  • the guide wire tip portion deformed state holding mechanism is configured by the deformable portion 41 and the inner surface 21 of the proximal end portion of the tubular body 2.
  • the coil portion 3 is linear, and the distal end portion of the guide wire encapsulated in the coil portion 3 is pulled from the linear shape by pulling in the proximal direction of the wire 4. It is deformed into a curved shape.
  • the tubular body 2 is a hollow body having a certain degree of flexibility penetrating from the distal end to the proximal end.
  • Tubular body 2 includes polyolefin-based, polyamide-based, polyacetal-based, polyimide-based, and fluorine-based resin tubes that are catheter materials, metal tubes such as stainless steel (SUS304, SUS316, etc.), and superelastic metal tubes such as NiTi-based alloys.
  • a flexible tubular body such as a composite tube in which a wire of resin and stainless steel (SUS304, SUS316, etc.) or the like is coil-wound or blade-wound is preferably used.
  • the outer diameter of the tubular body 2 is preferably 0.17 to 0.97 mm, particularly preferably 0.30 to 0.46 mm.
  • the wall thickness of the tubular body 2 is preferably 35 to 150 ⁇ m.
  • the length of the tubular body 2 is preferably 290 to 4490 mm.
  • the wire 4 is slidably inserted in the tubular body 2 described above, and the distal end portion projects from the distal end of the tubular body 2 and the proximal end portion projects from the proximal end.
  • a superelastic alloy such as a Ni—Ti alloy
  • various metal materials such as stainless steel and piano wire are used.
  • the total length of the wire 4 is 300 mm to 4500 mm, preferably 1000 mm to 2000 mm.
  • the outer diameter of the wire 4 is 0.10 to 0.60 mm, preferably 0.15 to 0.25 mm.
  • the wire 4 may have a distal end portion that is more flexible than a proximal end portion.
  • the wire 4 includes a wire operation unit 7 provided at the base end portion 42 exposed from the tubular body 2.
  • the wire operation portion 7 is formed by fixing an operation member to the proximal end portion 42 of the wire 4.
  • the maximum diameter portion of the wire operation portion 7 is smaller than the outer diameter of the tubular body 2, and the wire operation portion is inserted into the guide wire insertion hole of the catheter in which the guide wire is used.
  • the guide wire can be inserted from the proximal end side.
  • the distal end portion of the wire 4 includes a coil portion 3 that encapsulates the distal end portion of the wire 4 and is fixed to the distal end portion of the wire 4 by the distal end portion 6a.
  • the coil portion 3 includes a substantially hemispherical coil portion distal end portion 11, a coil body 6 having a distal end 6 a fixed to the coil portion distal end portion 11, and a proximal end of the coil body 6. 6b.
  • the coil body 6 has an inner surface that does not substantially contact the outer surface of the wire 4. For this reason, at the time of wire pulling, the wire and the coil body do not slidably contact each other, and the wire pulling and the coil body deformation are ensured.
  • the coil part 3 has a total length of 10 mm to 500 mm, preferably 20 mm to 300 mm.
  • the outer diameter of the coil part 3 is 0.17 to 0.97 mm, preferably 0.30 to 0.46 mm. .
  • the coil portion 3 is linear on the entire length when the wire is not pulled.
  • the coil body 6 is preferably formed of a wire such as a superelastic alloy such as a Ni—Ti alloy, a noble metal such as stainless steel, gold, or platinum.
  • the distal end of the coil body 6 is fixed by a substantially hemispherical coil portion distal end portion 11 formed at the distal end of the wire 4.
  • the coil portion tip portion 11 is formed of, for example, a solder.
  • the substantially hemispherical shape means that it is substantially formed into a curved surface, and includes shapes such as a bell shape and a bullet shape.
  • the tip 45 of the wire 4 is fixed to the coil portion tip 11. Therefore, by pulling the wire 4, the coil portion distal end portion 11 is pulled toward the proximal end side.
  • the distal end portion of the wire 4 includes a tapered portion 46 having a diameter reduced toward the distal end side, and a thin plate portion 47 provided on the distal end side of the tapered portion 46.
  • the distal end portion of the thin plate portion 47 is fixed to the coil portion distal end portion 11.
  • the thickness of the thin plate portion 47 is thinner than the outer diameter of the tip of the tapered portion 46, and the width is wider than the outer diameter of the tip of the tapered portion 46.
  • the boundary portion 48 (in other words, the base end portion of the thin plate portion 47) 48 between the tapered portion 46 and the thin plate portion 47 forms an easy bending point when the wire is pulled. Further, the deformation direction is restricted by the thin plate portion 47. Since the physical properties of the wire 4 change in the boundary portion 48, when the wire 4 is pulled, the wire 48 is likely to be bent at the boundary portion 48. In other words, the wire 4 is reliably bent and the direction thereof is a thin plate. It is the front side or the back side of the portion 47. The possibility that the thin plate portion 47 is curved in the side direction is extremely low.
  • the coil portion 3 that encloses the thin plate portion 47 also bends, and the distal end portion of the guide wire 1 is deformed as indicated by a broken line in FIG.
  • the tapered portion 46 of the wire 4 and the coil portion 3 encapsulating the wire 4 are also bent so that the wire portion 4 is pulled by the deformation of the coil portion 3 encapsulating the thin plate portion 47. .
  • the length of the tapered portion 46 of the wire 4 is 50 to 400 mm, preferably 80 to 300 mm.
  • the minimum outer diameter of the tapered portion 46 of the wire 4 is 40 to 300 ⁇ m, and preferably 50 to 250 ⁇ m.
  • the length of the thin plate portion 47 is 5 to 50 mm, preferably 10 to 30 mm, the thickness is 10 to 100 ⁇ m, preferably 20 to 60 ⁇ m, and the width is 0.03. Is 0.3 to 0.3 mm, and preferably 0.05 to 0.2 mm.
  • the proximal end portion of the coil body 6 covers the distal end portion of the tubular body 2 whose diameter is reduced, and both are fixed by the fixing agent 8.
  • Fixing is preferably performed by soldering, and as the solder that is the fixing agent 8, a hard solder such as a silver solder or a gold solder can be suitably used.
  • the wire 4 includes a deforming portion 41 provided at a position closer to the distal end side than the wire operation portion 7.
  • transformation part 41 forms the wire side form holding
  • transformation part 41 is provided with the some bending part (projection part) 43 provided so that it might adjoin in the axial direction and may be spaced apart a little.
  • the inner surface 21 of the proximal end portion of the tubular body 2 is slidably pressed against the deformable portion 41, and constitutes a tubular body-side shape holding portion.
  • the portion of the wire 4 on the distal end side of the predetermined length from the operation portion 7 is a deformed portion 41 deformed in a zigzag shape, and the deformed portion 41 has a vertex facing the inner surface direction of the tubular body 2.
  • a plurality of bent portions 43 are provided.
  • the inner surface 21 of the proximal end portion of the tubular body 2 has a sliding resistance when the wire 4 moves in the axial direction of the tubular body 2 by simultaneously pressing (sliding) at least two vertices 43 of the deformable portion 41. Cause it to occur. For this reason, the operation part 7 moves in the direction of the arrow in FIG.
  • the operation unit 7 is separated from the proximal end of the tubular body 2.
  • the wire 4 maintains its state (its position and the shape of the distal end portion of the guide wire) unless the wire 4 is pulled to the proximal end side or pushed into the distal end side with a force greater than the sliding resistance with the tubular body 2. It has become a thing. Then, by adjusting the pulling amount (pulling length) of the wire 4, the deformation state of the distal end portion of the guide wire, in other words, the degree of bending deformation of the distal end portion of the guide wire can be selected. It is possible to restore the shape (linear shape) or to deform in a direction approaching the linear shape.
  • maintenance part) of the tubular body 2 are the frictional force between both in arbitrary positions.
  • the degree of deformation of the distal end portion of the guide wire is not gradual, and can be arbitrarily set, which enables delicate manipulation of the distal end portion.
  • the surgeon can make a desired shape of the distal end portion during the operation, so that it can be selectively inserted into a branch blood vessel that is usually difficult to select.
  • the position where the deformed portion 41 is formed is positioned on the distal end side of the predetermined length from the proximal end of the wire 4 and, as shown in FIG. However, the deformable portion 41 is not exposed from the proximal end portion of the tubular body 2 and prevents kinks caused by the exposed deformable portion.
  • FIG. 5 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 6 is an explanatory diagram for explaining the operation of the guide wire shown in FIG.
  • the wire 4a and the tubular body 2a are engaged by pulling the wire operation portion 7 in the proximal direction, and the coil portion 3 is held in a compressed state and the wire operation portion 7 is operated.
  • an engagement mechanism guide wire tip portion deformation state holding mechanism capable of releasing the compression holding state is provided.
  • the holding mechanism engagement mechanism is not engaged in the state where the wire operation unit 7 is not pulled in the proximal direction, but is engaged by being pulled.
  • the engagement mechanism between the wire 4a and the tubular body 2a includes a plurality of deformation portions provided in the axial direction at a portion closer to the distal end side than the wire operation portion 7 of the wire 4a, and the tubular body.
  • a plurality of axially-arranged inner surfaces of the base end portion of 2a are formed by recesses that can be engaged with the deformable portions.
  • the portion of the wire 4a on the tip side of the predetermined length from the operation part 7 is a deformed part 35 deformed in a zigzag shape, and the deformed part 35 has a vertex facing the inner surface direction of the tubular body 2a.
  • a plurality of bent portions 35a are provided.
  • the proximal end inner surface 21 of the tubular body 2a is provided with a plurality of annular recesses 22 provided with an annular edge 22a. And the vertex of the bending part 35a of the wire 4a can engage with the annular edge 22a of the annular recessed part 22 of the tubular body 2a. For this reason, the wire 4a is pulled, and the apex of one of the bent portions 35a of the wire 4a is engaged with the annular edge 22a of one of the annular recesses 22 of the tubular body 2a. It is held.
  • the degree of deformation of the guide wire tip can be selected. Specifically, in a state where the apex of the bent portion 35a of the wire 4a shown in FIG. 5 and the annular edge 22a of the annular recess 22 of the tubular body 2a are not engaged, the coil portion 3 is substantially linear (pre-deformation shape). is there. Further, as shown in FIG.
  • FIG. 7 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • a plurality of guide wire tip portion deformed state holding mechanisms (mechanisms for engaging the wire 4a and the tubular body 2) are provided in the axial direction at a portion on the tip side of the wire operation portion 7 of the wire 4a. It is comprised by the deformation
  • transformation part transformation part
  • the wire 4a has a deformed portion deformed in a zigzag shape at the tip end side of the predetermined length from the operation unit 7, as in the case shown in FIGS. 35 is provided, and the deformable portion 35 includes a plurality of bent portions 35 a having apexes facing the inner surface direction of the tubular body 2.
  • the tubular body 2 does not have an annular recess like that shown in FIGS. 5 and 6, and the proximal end opening of the tubular body 2 is releasably engaged with the bent portion 35a of the deformable portion 35 of the wire 4a. It is supposed to be.
  • the degree of deformation of the distal end portion of the guide wire is selected by selecting the apex of the bent portion 35a of the wire 4a that engages with the proximal end opening of the tubular body 2.
  • the degree of state can be selected.
  • FIG. 8 is an external view of the proximal end portion of another embodiment of the guide wire of the present invention.
  • 9 and 10 are explanatory diagrams for explaining the structure of the proximal end portion of the guide wire shown in FIG.
  • the guide wire tip portion deformed state holding mechanism (engagement mechanism between the wire 4b and the tubular body 2b) is on the tip side of the wire operation portion 7 of the wire 4b.
  • the deformed portion 35 of the wire 4b is the same as that described in the guide wires 1a and 1b described above.
  • transformation part 35 is located in the front end side of predetermined length similarly to the guide wires 1a and 1b mentioned above, and even if the pulling operation of the wire 4b is performed as shown in FIG.
  • the tubular body 2b is not exposed from the base end portion.
  • a plurality of projecting portions 27a and 28a are provided on the inner surface of a portion that is slightly distal to the base end of the tubular body 2b.
  • the protrusions 27a and 28a are annular protrusions. Further, the two protruding portions 27a and 28a are slightly separated from each other. And the vertex of the bending part of the deformation
  • the distal end portion of the guide wire is deformed by pulling the wire 4b and engaging the apex of one of the bent portions of the deformed portion 35 of the wire 4b with one of the annular projecting portions of the tubular body 2b. (Compression state degree of the coil part 3) is maintained. Further, by changing the combination of the apex of the bent portion of the wire 4b to be engaged and the annular projecting portion of the tubular body 2b, the degree of deformation of the coil portion 3 into the compressed state, in other words, the linear state of the coil portion 3 can be reduced. You can choose.
  • the projecting portions 27a and 28a are annularly crimped from the outer surface of the tubular body 2b to provide the annular reduced diameter portions 27 and 28, and the annular projecting portion is formed on the inner surface. Is formed.
  • the formation position of the deforming portion 35 is located on the distal end side of a predetermined length from the proximal end of the wire 4b, and even if the pulling operation of the wire 4b is performed as shown in FIG. In other words, even when the maximum towable amount is towed, the deformable portion 35 is not exposed from the proximal end portion of the tubular body 2b, and kink caused by the exposed deformable portion is prevented.
  • FIG. 11 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 12 is an explanatory diagram for explaining the operation of the guide wire shown in FIG.
  • the guide wire tip portion deformed state holding mechanism (the engagement mechanism between the wire 4c and the tubular body 2c) is provided in the axial direction provided at the tip side of the wire operation portion 7 of the wire 4c.
  • an inner surface portion that is provided on the inner surface of the base end portion of the tubular body 2c and that can slide in the pressure contact state.
  • the protruding portion is formed by a diameter-expanding portion 44 provided at a portion on the distal end side of the wire operating portion 7 of the wire 4c, and the inner surface portion is tubular.
  • the diameter-expanded portion 44 of the wire 4c is constituted by a small-diameter portion 24 that can slide in a pressure contact state.
  • the engagement mechanism constituting member 23 is fixed to the proximal end opening of the tubular body 2c.
  • the engaging mechanism constituent member includes a flange portion that contacts the proximal end surface of the tubular body 2c, and a cylindrical portion (small diameter portion) 24 that protrudes from the flange portion and enters the proximal end portion of the tubular body 2c.
  • the wire 4c is provided with the enlarged diameter part 44 provided in the part which becomes a predetermined length front end side from the operation part 7, as shown in FIG.
  • the outer diameter of the enlarged diameter portion 44 is almost equal to the inner diameter of the cylindrical portion (small diameter portion) 24 of the component member 23, and as shown in FIG. It is possible to slide on the inner surface.
  • the enlarged diameter portion 44 and the cylindrical portion (small diameter portion) 24 of the component member 23 are engaged with each other by the frictional force between the enlarged diameter portion 44 and the cylindrical portion 24 in the state where the enlarged diameter portion 44 is located in the cylindrical portion 24. It can be retained.
  • the enlarged diameter portion of the wire 4c may be formed integrally with the wire 4c, or may be formed by fitting another member.
  • the engaging mechanism constituting member 23 may be formed of a metal material, but preferably has some elasticity, and may be formed of a resin such as polyolefin, polyamide, polyacetal, polyimide, or fluorine. Good. Further, like the guide wire 1e shown in FIG. 13, the small-diameter portion 29 in which the diameter-expanded portion of the wire is slidable in the pressure contact state may be directly formed at the proximal end portion of the tubular body 2d.
  • the protruding portion 4d may be formed by a rib 44a extending in the axial direction instead of the enlarged diameter portion.
  • the ribs 44a preferably extend linearly in the axial direction, but may extend spirally.
  • the number of ribs 44a is preferably 3 or more, and in the illustrated case, four ribs are provided.
  • the enlarged diameter portion 44 (or the rib 44a) is held at the arbitrary position of the small diameter portion 24 (or the small diameter portion 29) by the frictional force between them.
  • the degree of deformation of the distal end portion of the guide wire is not stepwise, and can be set arbitrarily, which enables delicate manipulation of the distal end portion.
  • the surgeon can make a desired shape of the distal end portion during the operation, so that it can be selectively inserted into a branch blood vessel that is usually difficult to select.
  • FIG. 14 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 15 is an explanatory diagram for explaining the operation of the guide wire shown in FIG. 16 is a cross-sectional view taken along line BB in FIG. 17 is a cross-sectional view taken along the line CC of FIG.
  • the guide wire tip portion deformed state holding mechanism (the engagement mechanism between the wire and the tubular body) is a shaft provided at the tip side of the wire operation portion 7 of the wire 4e.
  • a plurality of ribs 39 extending in the direction and a groove portion 25 provided on the inner surface of the proximal end portion of the tubular body 2e and extending in the axial direction capable of accommodating the rib 39 of the wire 4e. Then, by pulling the wire 4e and slightly rotating the wire operating portion 7 with the rib 39 exposed from the proximal end opening of the tubular body 2e, the rib 39 comes into contact with the proximal end surface of the tubular body 2e. It is to be engaged.
  • the wire 4 e is provided with a diameter-expanded portion 38 provided at a portion on the distal end side of the predetermined length from the operation portion 7, and the surface thereof is axially
  • a plurality of (specifically, three or more, four in the illustrated example) ribs 39 extending in parallel (in other words, parallel to the central axis of the wire) are provided.
  • a plurality (specifically, three or more) extending in the axial direction in which the rib 39 of the wire 4e can be accommodated (in other words, parallel to the central axis of the tubular body) is illustrated on the inner surface of the proximal end portion of the tubular body 2e.
  • the rib 39 of the wire 4e can slide in the groove 25 of the tubular body 2e.
  • FIG. 16 there is a slight clearance between the rib 39 of the wire 4e and the groove portion 25 of the tubular body 2e, and the sliding resistance of both is low, and the proximal end of the wire 4e Direction pulling is easy.
  • the wire operation portion 7 is slightly rotated to As shown in FIG. 15 and FIG. 17, the rib 39 abuts and engages with the proximal end surface of the tubular body 2 e, and maintains the state where the wire 4 e is pulled.
  • the wire operating portion 7 of the wire 4f includes a cylindrical portion 71 that enters the proximal end portion of the tubular body 2e, and has a plurality of ribs 72 that extend in the axial direction of the wire 4f on the outer surface thereof.
  • the inner surface of the proximal end portion of the tubular body 2e is provided with a groove portion 25 extending in the axial direction capable of accommodating the rib 72 of the operation portion 7 of the wire 4f.
  • the engagement mechanism is configured by a rib 72 provided on the outer surface of the tubular portion 71 of the wire operation portion 7 and a groove portion 25 capable of accommodating the rib 72 provided on the inner surface of the proximal end portion of the tubular body 2e. ing.
  • the rib 72 is caused to move to the proximal end surface of the tubular body 2e. Abut and engage.
  • FIG. 19 is an external view of the base end portion of another embodiment of the guide wire of the present invention.
  • FIG. 20 is a cross-sectional view of the proximal end portion of the guide wire shown in FIG.
  • FIG. 21 is an explanatory diagram for explaining the operation of the guide wire shown in FIGS. 19 and 20.
  • the guide wire tip portion deformed state holding mechanism is provided on the tip side from the wire operation portion 7a of the wire 4g, and the tip of the wire 4g is in pressure contact with the outer surface of the wire 4g.
  • the slide member 57 is slidable in the direction and the base end direction and can contact the base end portion of the tubular body 2f, and the base end portion of the tubular body 2f.
  • the wire 4g includes a slide member 57 provided on the distal end side with respect to the wire operation portion 7a.
  • the slide member 57 is slidable in the distal direction and the proximal direction of the wire 4g in a state of being in pressure contact with the outer surface of the wire 4g. It doesn't move.
  • the slide member 57 is entirely cylindrical and includes a lumen 59 through which the wire 4g passes.
  • An annular rib 58 for pressing the outer surface of the wire 4g is provided at the end of the lumen 59. As the slide member 57, the entire inner surface of the lumen 59 may be in pressure contact with the outer surface of the wire 4g.
  • the slide member 57 is moved in the distal direction and the proximal direction on the wire 4g by being pushed.
  • the coil portion 3 of the guide wire is in a curved state as shown in FIG. 22, but as shown in FIG. 21, the wire 4g is pulled from the state shown in FIG.
  • the coil portion 3 is substantially linear as shown in FIG. .
  • the slide member 57 is pressed by the rear end surface of the tubular body 2f, but does not move to the proximal end side of the wire 4g by the pressing force, and the state (the traction state of the coil and the deformation state of the coil portion) changes. Hold.
  • the coil operating portion 7a includes a base end member 73 fixed to the base end portion 42 of the wire 4g, and a predetermined long axis direction fixed to the base end portions of the base end member 73 and the wire 4g. It is formed by a cylindrical member 74 that extends. For this reason, the operation part 7a can be held with one hand and the slide operation part can be advanced and retracted with the other hand, and the coil pulling operation can be performed satisfactorily.
  • the coil part 3 is from the original curve state to substantially linear form. It can be of any shape in between.
  • the guidewire tip structure may be, for example, as shown in FIGS.
  • FIG. 22 is a front view of the distal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 23 is an explanatory diagram for explaining the internal structure of the guide wire shown in FIG.
  • FIG. 24 is an explanatory diagram for explaining the operation of the guide wire shown in FIG.
  • the tubular body 2g is a hollow body having a certain degree of flexibility penetrating from the distal end to the proximal end.
  • the outer diameter is a diameter-reduction taper part toward the front-end
  • the wire 4h is slidably inserted into the tubular body 2g described above, and the distal end portion projects from the distal end of the tubular body 2g and the proximal end portion projects from the proximal end.
  • the distal end portion of the wire 4h includes a coil portion 3 that encapsulates the distal end portion of the wire 4h and is fixed to the distal end portion of the wire 4h by the distal end portion 6a.
  • the coil portion 3 includes a substantially hemispherical coil portion distal end portion 11, a coil body 6 having a distal end 6 a fixed to the coil portion distal end portion 11, and a proximal end of the coil body 6. And a ring-shaped member 9 through which the wire 4h passes.
  • the coil body 6 has an inner surface that does not substantially contact the outer surface of the wire 4h.
  • the ring-shaped member 9 has an opening provided at the center thereof, and the wire 4h penetrates the opening without substantially contacting the inner surface of the opening. The member 9 is not in sliding contact, and the wire is easily pulled.
  • the coil portion 3 is shaped in advance in a curved shape as shown in FIGS.
  • the curved shape is not limited to the U-shape as shown in FIG. 22, and may be any curved shape such as an L shape, an S shape, or a loop shape.
  • the coil part 3 may not be shape
  • the coil portion 3 (specifically, the coil body 6) is formed of a material that can be plastically deformed.
  • the coil body 6 is preferably formed of a wire such as a superelastic alloy such as a Ni—Ti alloy, a noble metal such as stainless steel, gold, or platinum.
  • tip of the coil body 6 is being fixed by the substantially hemispherical coil part front-end
  • the coil portion tip portion 11 is formed of, for example, a solder.
  • the substantially hemispherical shape means that it is substantially formed into a curved surface, and includes shapes such as a bell shape and a bullet shape.
  • the tip 45 of the wire 4 h is fixed to the coil portion tip 11. For this reason, the coil part front-end
  • a ring-shaped member 9 through which the wire 4 h passes is fixed to the base end portion of the coil body 6. And the base end surface of this ring-shaped member 9 can contact
  • the base end portion (specifically, ring-shaped member 9) of the coil portion 3 is not fixed to the tubular body 2g.
  • the guide wire 10 of this embodiment by pulling the wire 4h in the proximal direction, the proximal end surface of the ring-shaped member 9 of the coil portion 3 comes into contact with the distal end surface of the tubular body 2g and is further pulled.
  • the coil body 6 is compressed between the coil portion distal end portion 11 and the distal end surface (ring-shaped member 9) of the tubular body 2g, and is deformed from a curved shape to a substantially linear state as shown in FIG.
  • the guidewire tip structure may be, for example, as shown in FIG.
  • FIG. 25 is an explanatory view for explaining the structure of the distal end portion of another embodiment of the guide wire of the present invention.
  • the ring-shaped member is not provided at the proximal end portion of the coil body 6, and the distal end portion of the tubular body 2h is not reduced in diameter.
  • the base end part of the coil body 6 is being fixed to the front end surface of the tubular body 2h. In this type, since the coil body 6 is fixed to the tubular body 2h, the coil body 6 and the tubular body 2h are not separated from each other.
  • the guide wire tip structure may be as shown in FIG. 26, for example.
  • FIG. 26 is an explanatory view for explaining the structure of the distal end portion of another embodiment of the guide wire of the present invention.
  • the coil portion 3 a includes a wire distal end fixing member 31 provided at a proximal end portion from the coil portion distal end portion 11, and the distal end of the wire 4 i is connected to the wire distal end fixing member 31.
  • the coil portion 3a is fixed and includes a distal end side coil portion 32 that is not affected by the pulling of the wire 4i.
  • tip 6a of the coil main body 6 is being fixed to the coil part front-end
  • the base end 6b is being fixed to the ring-shaped member 9, and the coil body 6 used as the base end side predetermined length rather than the front-end
  • the part 6 c is fixed to the wire tip fixing member 31.
  • the distal end side coil portion 32 that is not affected by the pulling of the wire 4i is a wire in which one end side is fixed to the coil portion distal end portion 11 and the other end is connected to the wire distal end portion fixing portion 31.
  • a shaped member 33 is provided.
  • the coil body 6 may be compressed and the deformability may be reduced by pulling the wire 4i, but the distal end side coil portion 32 may be compressed by pulling the wire 4i. Therefore, the initial properties can be maintained, and for example, good elasticity can be maintained.
  • the distal end side coil portion 32 that is not affected by the pulling of the wire 4i is substantially linear. Further, the distal end side coil portion 32 that is not affected by the pulling of the wire 4i may be easily plastically deformable and can be shaped.
  • the guidewire tip structure may be, for example, as shown in FIG.
  • FIG. 27 is an explanatory view for explaining the structure of the distal end portion of another embodiment of the guide wire of the present invention.
  • the coil portion 3b similarly to the guide wire 30 described above, the coil portion 3b includes a wire distal end fixing member 31 provided at a proximal end portion with respect to the coil portion distal end portion 11, and the distal end of the wire 4i. However, it is fixed to the wire tip portion fixing member 31, and the coil portion 3b includes a tip side coil portion 32a that is not affected by the pulling of the wire 4i.
  • the coil portion 3b includes a main body side coil member 61 having a distal end 61a fixed to the wire distal end portion fixing member 31, a distal end 62a fixed to the coil portion distal end portion 11, and a proximal end 62b.
  • a tip end side coil member 62 fixed to the wire tip end fixing member 31.
  • the base end 61 b of the main body side coil member 61 is fixed to the ring-shaped member 9.
  • the leading end side coil member 62 is different from the main body side coil member 61 in physical properties.
  • a distal end side coil portion 32 a that is not affected by the pulling of the wire 4 i is formed in a portion closer to the distal end than the distal end portion fixing member 31 including the distal end side coil member 62.
  • the physical properties of the main body side coil member 61 and the front end side coil member 62 can be variously selected according to the purpose of the guide wire.
  • the distal end side coil member 62 has higher plastic deformability than the main body side coil member 61 (the plastic deformability can be changed, for example, by selecting the material of the coil wire).
  • the distal end side coil member 62 should be more flexible than the proximal end side coil member 61 (coil flexibility can be achieved by, for example, providing a certain gap in the coil strands or bringing the strands into close contact with each other).
  • the tip side coil member has higher contrast than the main body side coil member 61.
  • the wire diameter of the tip side coil member 62 is smaller than the wire diameter of the main body side coil member 61.
  • the distal end side coil member 62 and the main body side coil member 61 have substantially the same outer diameter.
  • the length of the distal end side coil member 62 is preferably about 3 to 30 mm, and the length of the main body side coil member is preferably about 30 to 60 mm.
  • a superelastic alloy such as a Ni—Ti alloy
  • a noble metal such as stainless steel, gold, or platinum
  • the tip side coil member and the main body side coil member may be formed of the same material or different materials.
  • a noble metal such as gold or platinum
  • stainless steel is used as the main body side coil member
  • superelasticity is used as the tip side coil member. It is conceivable to use an alloy and use stainless steel as the main body side coil member.
  • the distal end side coil portion 32a that is not affected by the pulling of the wire 4i is a wire in which one end side is fixed to the coil portion distal end portion 11 and the other end is connected to the wire distal end portion fixing portion 31.
  • a shaped member 33 is provided.
  • the distal end portion structure of the guide wire may be as shown in FIGS. 28 and 29, for example.
  • FIG. 28 is an explanatory view for explaining the structure of the distal end portion of another embodiment of the guide wire of the present invention.
  • 29 is a cross-sectional view taken along the line DD of FIG.
  • the guide wire 70 of this embodiment is provided with a rotating torque applying mechanism for the coil portion 3.
  • the guide wire 70 of this embodiment is similar to the guide wire 10 described above.
  • the coil portion 3 includes a substantially hemispherical coil portion distal end portion 11 and a coil body 6 having a distal end 6a fixed to the coil portion distal end portion 11.
  • the wire 4j includes a torque applying member 51 that is slidably provided in the inner cavity of the ring-shaped member 9a.
  • the torque applying member 51 includes a plurality of ribs 52 (specifically, three or more, four in the illustrated example) extending in the axial direction (in other words, parallel to the central axis of the wire) on the outer surface thereof. ing.
  • the ring-shaped member 9a of the coil part 3 is extended in the axial direction (in other words, parallel to the center axis of the ring-shaped member) in which the rib 52 of the torque applying member 51 can slide on the inner surface of the lumen part (in other words, Specifically, three or more (four in the illustrated example) groove portions 91 are provided.
  • the rib 52 of the torque applying member 51 of the wire 4j can slide in the groove 91 of the ring-shaped member 9a, and the torque applying member 51 does not hinder the pulling of the wire 4j.
  • a rotational force for example, twisting the wire operating portion 7
  • the side surface of the rib 52 of the torque applying portion 51 is the side wall of the groove portion 91 of the ring-shaped member 9a. Therefore, a rotational torque is applied to the ring-shaped member 9a. Thereby, rotational torque is given to the whole coil part 3.
  • the slidability imparting member 53 is provided between the ring-shaped member 9a and the tubular body 50a, and the frictional resistance between the ring-shaped member 9a and the tubular body 50a is reduced. ing.
  • the slidability imparting member 53 is preferably fixed to the proximal end surface of the ring-shaped member 9a or the distal end surface of the tubular body 50a.
  • the slidability imparting member 53 is preferably formed of a fluorine-based resin having low friction resistance such as PTFE or ETFE. Further, without providing a slidability imparting member, an oil such as silicone oil may be imparted between the ring-shaped member 9a and the tubular body 50a to reduce the frictional resistance.
  • the guide wire of the present invention may be a guide wire 80 as shown in FIG. FIG. 30 is an explanatory view for explaining the internal structure of another embodiment of the guide wire of the present invention.
  • the guide wire tip portion deformation state holding mechanism is provided on the tip side of the wire operation portion 7a of the wire 4j.
  • a sliding member 57 that is slidable in the distal direction and proximal direction of the wire 4j while being in pressure contact with the outer surface of the wire 4j, and that can contact the proximal end portion of the tubular body 50a, and the proximal end portion of the tubular body 50a It is configured.
  • the coil portion 3b includes a wire distal end portion fixing member 31 provided at the proximal end side portion from the coil portion distal end portion 11 as in the guide wire 40 shown in FIG. 27, and the distal end of the wire 4j is
  • the coil portion 3b is fixed to the wire tip portion fixing member 31, and the coil portion 3b includes a tip side coil portion 32a that is not affected by the pulling of the wire 4j.
  • the coil portion 3b has a tip 61a on the wire tip portion fixing member 31.
  • the proximal end 61b is fixed to the ring-shaped member 9a
  • the distal end 62a is fixed to the coil distal end portion 11
  • the proximal end 62b is fixed to the wire distal end fixing member 31.
  • a coil member 62 is fixed to the wire distal end fixing member 31.
  • the tip side coil member 62 is different in physical properties from the main body side coil member 61. Furthermore, the coil part 3b is provided with the rotational torque provision mechanism of the coil part 3b similarly to the guide wire 70 shown in FIG. 28 and FIG. 29 mentioned above.
  • the guide wire 80 includes a torque applying member 51 that is fixed to the wire 4j and is provided so as to be slidable within the inner cavity of the ring-shaped member 9a.
  • the torque applying member 51 includes a plurality of axially extending ribs 52 on the outer surface thereof, and the ring-shaped member 9a of the coil portion 3b includes the ribs 52 of the torque applying member 51 on the inner surface of the lumen portion.
  • a plurality of groove portions 91 extending in the slidable axial direction are provided.
  • a rotational torque can be applied to the ring-shaped member 9a by applying a rotational force to the wire 4j (for example, twisting the wire operation portion 7a), and a rotational torque can be applied to the entire coil unit 3. It is possible.
  • FIG. 31 is a cross-sectional view of another embodiment of the guide wire of the present invention.
  • FIG. 32 is an explanatory diagram for explaining the action of the guide wire shown in FIG.
  • FIG. 33 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • FIG. 34 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • the guide wire 100 of this embodiment includes a tubular body 102, a wire 104 that is slidably inserted through the tubular body 102, a coil portion 103 that encapsulates a distal end portion of the wire 104, and a tubular body 102 of the wire 104. And a wire operation unit 7 provided at the more exposed base end.
  • the maximum diameter portion of the wire operation unit 7 is equal to or smaller than the outer diameter of the tubular body 102.
  • the coil portion 103 can be shaped into a curved shape or a curved shape.
  • the wire 104 is not joined to the coil portion 103 and the tubular body 102, and can move within the coil portion 103 and the tubular body 102.
  • the wire 104 corrects the curved shape of the coil portion 103 to be substantially linear.
  • a linear hard tip portion 105 and a pressure-contact sliding portion 43 that is provided on the tip side of the wire operation portion 7 and that can slide on the inner surface of the tubular body 102 and press-contact the inner surface of the tubular body 102.
  • the guide wire 100 can deform the coil portion 103 from a curved shape to an almost linear shape by an operation in the axial direction of the wire operation portion 7, and the pressure contact sliding portion and the tubular body 102 can be deformed.
  • the deformed form of the coil portion 103 can be held by the pressure contact between the inner surfaces.
  • the guide wire 100 of this embodiment includes a tubular body 102, a wire 104 that is slidably inserted through the tubular body, and a cylindrical coil portion 103 having a proximal end portion fixed to the distal end portion of the tubular body 102.
  • the coil portion 103 is substantially the same as the coil portion 3 described above except that the tip end portion of the wire 4 is not fixed.
  • the coil unit 103 includes a substantially hemispherical coil unit distal end 11, a coil body 6 having a distal end 6 a fixed to the coil unit distal end 11, and a base end 6 b of the coil body 6. I have. And as shown in FIG. 31 and FIG.
  • the coil part 103 of this Example has the recessed part 11a formed in the internal base end surface at the coil part front-end
  • the coil portion 103 is shaped into a curved shape.
  • the coil part 3 may be shapeable in arbitrary curved shapes at the time of use.
  • the tubular body 102 is substantially the same as the tubular body 2 described above, except that the tubular body 102 has a small diameter portion 29 for preventing a wire from being removed at the base end portion.
  • the wire 104 is slidably inserted through the tubular body 102, and the distal end portion can protrude from the distal end of the tubular body 102. Moreover, the base end part protrudes from the base end.
  • a superelastic alloy such as a Ni—Ti alloy, various metal materials such as stainless steel, piano wire, and the like are used.
  • the total length of the wire 104 is 300 mm to 4500 mm, preferably 1000 mm to 2000 mm.
  • the outer diameter of the wire 104 is 0.10 to 0.60 mm, preferably 0.15 to 0.25 mm. Further, the wire 104 may have a distal end portion that is more flexible than a proximal end portion.
  • the heel wire 104 is provided with the wire operation part 7 provided in the base end part 42 exposed from the tubular body 102.
  • the wire operation portion 7 is formed by fixing an operation member to the proximal end portion 42 of the wire 104.
  • the wire operation unit 7 may be formed by making the proximal end portion of the wire 104 large in diameter.
  • the maximum diameter portion of the wire operation portion 7 is smaller than the outer diameter of the tubular body 102, and the wire operation portion is inserted into the guide wire insertion hole of the catheter in which the guide wire is used. In other words, the guide wire can be inserted from the proximal end side.
  • the wire 104 includes a linear hard tip portion 105 for correcting the curved shape of the coil portion 103 to be substantially linear.
  • the coil portion 103 is shaped.
  • the coil portion 103 is straightened when the wire 104 is pushed in the distal direction and enters the coil portion 103. For this reason, the coil part 103 is gradually deformed from the curved state to the linear state as the linear hard tip 105 of the wire 104 advances.
  • the advancement of the wire 104 ends when the tip 105a of the linear hard tip 105 enters the recess 11a of the coil portion 103 described above. Then, by pulling the wire 104 toward the proximal end again, the coil unit 103 is restored from the linear state of FIG. 31 to the curved state of FIG.
  • the wire 104 is continuous with the linear hard tip portion 105, and is more flexible than the linear hard tip portion 105, and a reduced diameter portion that forms a boundary between the linear hard tip portion 105 and the main body portion 107. 106.
  • the length of the linear hard tip portion 105 of the wire 104 is substantially the same as the distance between the concave portions 11 a of the tip portion 11 of the coil portion 103 in a state of being linear with the tip of the tubular body 102.
  • the proximal end portion of the coil body 6 covers the distal end portion of the tubular body 102 whose diameter is reduced, and both are fixed by the fixing agent 8.
  • the wire 104 is provided at a position closer to the distal end side than the wire operation unit 7 and includes a press-contact sliding portion 43 that can slide on the inner surface of the tubular body 102 and press-contact the inner surface of the tubular body 102. As shown in FIG. 31 and FIG.
  • the wire 104 includes a deforming portion 41 provided at a position closer to the distal end side than the wire operation portion 7. And this deformation
  • transformation part 41 is provided with the some bending part (protrusion part) 43 which adjoins, This protrusion part 43 forms the press-contact sliding part.
  • the pressure contact sliding portion 43 is in pressure contact with the inner surface of the tubular body 102 to prevent the wire 104 from being inadvertently moved, whereby the deformed form of the coil portion 103 is maintained.
  • the deformed portion 41 of the wire 104 has a predetermined length, specifically, between the concave portion 11a of the distal end portion 11 of the coil portion 103 in a state of being linear with the entire length of the linear hard distal end portion 105 or the distal end of the tubular body 102.
  • the wire 104 is provided at a position on the distal end side of the operation portion 7 of the wire 104 by a length longer than the distance.
  • the deforming portion 41 includes a plurality of bent portions 43 having apexes facing the inner surface direction of the tubular body 102.
  • the inner surface 21 of the proximal end portion of the tubular body 102 has a sliding resistance when the wire 104 moves in the axial direction of the tubular body 102 by simultaneously pressing (sliding) at least two vertices 43 of the deformable portion 41. Cause it to occur. For this reason, the wire 104 is pulled in the proximal end side or pushed into the distal end side with a force greater than the sliding resistance with the tubular body 102, thereby causing the operation portion 7 to move in the arrow direction of FIG. 31 and the arrow direction of FIG. (Wire 104) moves.
  • the wire 104 maintains its state (its position and the shape of the distal end portion of the guide wire) unless the wire 104 is pulled to the proximal end side or pushed into the distal end side with a force greater than the sliding resistance with the tubular body 102. It has become a thing. Then, by adjusting the position of the wire 104 (the length of penetration of the linear hard tip 105 of the wire 104 into the coil portion 103), the deformed state of the tip of the guide wire, in other words, the tip of the guide wire The degree of bending deformation can be selected.
  • the tubular body 102 has a small-diameter portion 29 that is provided at the base end portion and through which the pressure contact sliding portion (projecting portion) 43 cannot pass. For this reason, the wire 104 cannot be removed from the tubular body 102.
  • the press-contact sliding part in the guide wire of this invention is not limited to what was mentioned above.
  • a pressure contact sliding part of a guide wire the thing with which the guide wire 110 shown in FIG. 33 is provided may be used, for example.
  • FIG. 33 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • the press-contact sliding portion is formed by a protruding portion 108 provided on the outer surface of the wire 104a.
  • the press-contact sliding portion 108 is a plurality of (specifically, two) annular ribs.
  • the protruding portion 108 may not be an annular rib but may be an enlarged diameter portion, and may further be a rib extending in the axial direction of the wire 104a.
  • the pressure contact sliding portion in the guide wire of the present invention may be of the type provided in the guide wire 120 shown in FIG. 34, for example.
  • FIG. 34 is an explanatory view for explaining the structure of the proximal end portion of another embodiment of the guide wire of the present invention.
  • the press-contact sliding portion (the press-contact mechanism between the wire 104b and the tubular body 102) is a protrusion that extends a predetermined length in the axial direction provided at a portion of the wire 104b on the tip side from the wire operation portion 7.
  • the portion 121 and a small diameter portion 29 provided on the inner surface of the proximal end portion of the tubular body 102 and capable of sliding the protruding portion 121 of the wire 104b in a pressure contact state. Therefore, the protruding portion 121 that is a pressure contact sliding portion slides in the compressed state in the small diameter portion.
  • the protrusion 121 is a shaft of a plurality (specifically, four) of the wires 104b provided at a position closer to the distal end side than the wire operation unit 7 of the wire 104b. It is formed by linear ribs extending in the direction. Further, in the guide wire 120 of this embodiment, as shown in FIG. 33, the tip of the protruding portion 121 is provided with a retaining protrusion 122 that cannot pass through the small diameter portion 29, and the tubular body 102 of the wire 104b. It prevents the withdrawal from.
  • the protrusion part 121 is the distance between the recessed parts 11a of the front-end
  • the wire 104 extends in the axial direction by a longer length.
  • the entire outer surface of the guide wire or the outer surface of a desired portion may be coated with a lubricity imparting agent for reducing the frictional resistance with the inner surface of the tubular body such as a catheter.
  • a lubricity-imparting agent a water-soluble polymer substance or a derivative thereof is preferable.
  • the guide wire of the present invention is as follows. (1) Provided in a tubular body, a wire that is slidably inserted through the tubular body, a coil portion that encloses a distal end portion of the wire, and a proximal end portion that is exposed from the tubular body of the wire.
  • a guide wire including a wire operation unit The maximum diameter portion of the wire operation portion is equal to or smaller than the outer diameter of the tubular body, the coil portion can be formed into a linear shape, a curved shape, or a curved shape, and the coil portion is covered with the coil portion.
  • the distal end portion of the wrapped guide wire can be deformed from the linear shape to the curved shape or from the curved shape to a substantially linear shape by pulling in the proximal direction of the wire, and further, the wire and the tubular shape
  • the body is provided with a guide wire tip portion deformation state holding mechanism for holding deformation and deformation of the tip portion by an operation of the wire operation portion in the axial direction. For this reason, the guide wire can be inserted into the guide wire insertion hole of the catheter from the wire operation unit side. Furthermore, the wire and the tubular body can deform the distal end portion of the guide wire by operating the wire operation portion in the axial direction, and can hold the deformed state of the distal end portion of the guide wire.
  • the tip of the guide wire can be easily and quickly deformed by pulling the wire operating portion without rotating, and the guide wire tip portion deformed state holding mechanism can secure the deformed state of the guide wire and Release is also easy. For this reason, the guide wire has good operability.
  • the guide wire tip portion deformed state holding mechanism includes a wire side shape holding portion provided in a portion of the wire that is on the tip side from the wire operation portion, and a tubular body side shape holding portion provided in the tubular body.
  • the coil portion is linear, and the distal end portion of the guide wire encapsulated in the coil portion is deformed from the linear shape to a curved shape by pulling in the proximal direction of the wire.
  • the guide wire according to any one of (1) to (3) above.
  • the wire includes a deformed portion provided in an axial direction at a portion closer to the distal end than the wire operation portion, and an inner surface of the tubular body is slidably pressed against the deformed portion.
  • the guide wire distal portion deformed state holding mechanism is the guide wire according to any one of the above (1) to (4), which is configured by the deformed portion and the inner surface of the proximal end portion of the tubular body.
  • the guide wire distal end portion deformed state holding mechanism includes a deformed portion provided at a position closer to the distal end side than the wire operation portion of the wire, and the deformed portion provided on the inner surface of the proximal end portion of the tubular body.
  • the guide wire according to any one of (1) to (4), wherein the guide wire is configured by a concave portion or a protruding portion that can be engaged with each other.
  • the guide wire distal end portion deformed state holding mechanism includes a plurality of deformed portions provided in the axial direction at a portion on the distal end side of the wire operation portion of the wire, and the tubular body engageable with the deformed portion.
  • the guide wire according to any one of (1) to (4), wherein the guide wire is configured by a base end opening portion.
  • the guide wire distal end portion deformed state holding mechanism is provided on a protruding portion extending in the axial direction provided at a portion of the wire on the distal end side from the wire operation portion, and on an inner surface of the proximal end portion of the tubular body.
  • the guide wire according to any one of (1) to (4), wherein the protruding portion of the wire is configured by an inner surface portion that is slidable in a pressure contact state.
  • the guide wire distal end portion deformed state holding mechanism is provided on the inner surface of the proximal end portion of the tubular body, and a plurality of ribs extending in the axial direction provided at a portion on the distal end side of the wire operation portion of the wire.
  • the wire is provided on the distal end side with respect to the wire operation portion, is slidable in the distal direction and the proximal direction of the wire in a state of being pressed against the outer surface of the wire, and the proximal end portion of the tubular body
  • the guide wire tip portion deformed state holding mechanism is provided with an abuttable slide member, and is configured by the slide member and a proximal end portion of the tubular body according to any one of the above (1) to (4). Guide wire.
  • the coil unit according to any one of (1) to (10), wherein the coil unit includes a substantially hemispherical coil portion tip and a coil body having a tip fixed to the coil portion tip.
  • Guide wire (12)
  • the coil portion includes a wire distal end fixing member provided at a proximal end portion with respect to the coil portion distal end, and the distal end of the wire is fixed to the wire distal end fixing member.
  • the guide wire according to (11), wherein the portion includes a distal coil portion that is not affected by the pulling of the wire.
  • the coil portion includes a body side coil member having a distal end fixed to the wire distal end fixing member, a distal end fixed to the coil portion distal end, and a proximal end fixed to the wire distal end fixing member.
  • the coil portion includes a substantially hemispherical coil portion distal end portion, a coil body having a distal end fixed to the coil portion distal end portion, a ring shape that is fixed to the proximal end of the coil body and penetrates the wire. And the ring-shaped member is not fixed to the tubular body.
  • the guide wire according to any one of (1) to (13), further including a rotation torque applying member to the coil portion that transmits to the coil.
  • the guide wire of the present invention is as follows. (15) A tubular body, a wire that is slidably inserted through the tubular body, a coil portion that encapsulates a distal end portion of the wire, and a proximal end portion that is exposed from the tubular body of the wire.
  • a guide wire including a wire operation unit, wherein a maximum diameter portion of the wire operation unit is equal to or smaller than an outer diameter of the tubular body, and the coil unit can be shaped into a curved shape or a curved shape.
  • the wire is not joined to the coil portion and the tubular body, and is movable within the coil portion and the tubular body, and the wire has a substantially straight line with the curved shape of the coil portion.
  • a linear hard tip for correcting the shape of the wire and a pressure-contact sliding portion provided at a position closer to the tip than the wire operation portion, capable of sliding on the inner surface of the tubular body and press-contacting the inner surface of the tubular body.
  • the coil portion can be deformed into an arbitrary shape from the curved shape to a substantially linear shape by the operation of the wire operation portion in the axial direction, and between the pressure contact sliding portion and the inner surface of the tubular body.
  • a guide wire capable of holding a deformed form of the coil portion by pressure welding.
  • the guide wire can deform the coil portion from a curved shape to an almost straight shape by operating the wire operation portion in the axial direction, and between the pressure-contact sliding portion and the inner surface of the tubular body.
  • the deformed form of the coil portion can be maintained by the pressure welding.
  • the tubular body includes a small-diameter portion provided on an inner surface, the press-contact sliding portion of the wire extends a predetermined length in an axial direction formed on the outer surface of the wire, and press-contacts the small-diameter portion.
  • the guide wire according to any one of (15) to (17), wherein the guide wire is a projecting portion slidable in a state.

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

Abstract

La présente invention concerne un fil-guide (1) doté d'un élément tubulaire (2), d'un fil (4), d'une partie bobine (3) qui couvre la section d'extrémité de pointe du fil, et d'une partie de manœuvre du fil (7). La partie de diamètre maximal de la partie de manœuvre du fil est de la même taille, ou plus petite, que le diamètre extérieur de l'élément tubulaire, la partie bobine est linéaire, et l'extrémité de pointe du fil-guide qui est couverte par la partie bobine est déformable d'une forme linéaire à une forme incurvée par mise en tension du fil dans la direction de son extrémité de base. Le fil (4) et l'élément tubulaire (2) sont dotés d'un mécanisme de rétention de l'état déformé de l'extrémité de pointe du fil guide, pour déformer l'extrémité de pointe et conserver sa déformation, au moyen de l'actionnement de la partie de manœuvre du fil (7) dans la direction axiale.
PCT/JP2012/074782 2011-09-29 2012-09-26 Fil guide WO2013047616A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2011214697A JP2014236757A (ja) 2011-09-29 2011-09-29 ガイドワイヤ
JP2011-214697 2011-09-29

Publications (1)

Publication Number Publication Date
WO2013047616A1 true WO2013047616A1 (fr) 2013-04-04

Family

ID=47995647

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2012/074782 WO2013047616A1 (fr) 2011-09-29 2012-09-26 Fil guide

Country Status (2)

Country Link
JP (1) JP2014236757A (fr)
WO (1) WO2013047616A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20200069361A1 (en) * 2017-06-29 2020-03-05 Asahi Intecc Co., Ltd. Plasma guide wire
CN113181513A (zh) * 2016-03-10 2021-07-30 朝日英达科株式会社 导丝

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10610308B2 (en) * 2017-02-01 2020-04-07 Acclarent, Inc. Navigation guidewire with interlocked coils
JP2021065245A (ja) * 2018-02-23 2021-04-30 テルモ株式会社 ガイドワイヤ

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2003265489A (ja) * 2002-03-15 2003-09-24 Medtronic Ave Inc 一時的な先端部塞栓保護用ガイドワイヤ装置
JP2004249095A (ja) * 2003-01-31 2004-09-09 Piolax Medical Device:Kk ガイドワイヤ
JP2005046603A (ja) * 2003-07-17 2005-02-24 Terumo Corp ガイドワイヤ
JP2005342470A (ja) * 2004-06-03 2005-12-15 Ys Medical:Kk 医療用ガイドワイヤ
JP2010207251A (ja) * 2009-03-06 2010-09-24 Olympus Corp ガイドワイヤ

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2003265489A (ja) * 2002-03-15 2003-09-24 Medtronic Ave Inc 一時的な先端部塞栓保護用ガイドワイヤ装置
JP2004249095A (ja) * 2003-01-31 2004-09-09 Piolax Medical Device:Kk ガイドワイヤ
JP2005046603A (ja) * 2003-07-17 2005-02-24 Terumo Corp ガイドワイヤ
JP2005342470A (ja) * 2004-06-03 2005-12-15 Ys Medical:Kk 医療用ガイドワイヤ
JP2010207251A (ja) * 2009-03-06 2010-09-24 Olympus Corp ガイドワイヤ

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113181513A (zh) * 2016-03-10 2021-07-30 朝日英达科株式会社 导丝
US20200069361A1 (en) * 2017-06-29 2020-03-05 Asahi Intecc Co., Ltd. Plasma guide wire
US11653970B2 (en) * 2017-06-29 2023-05-23 Asahi Intecc Co., Ltd. Plasma guide wire

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