WO2013089247A1 - Cathéter d'expansion - Google Patents

Cathéter d'expansion Download PDF

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Publication number
WO2013089247A1
WO2013089247A1 PCT/JP2012/082565 JP2012082565W WO2013089247A1 WO 2013089247 A1 WO2013089247 A1 WO 2013089247A1 JP 2012082565 W JP2012082565 W JP 2012082565W WO 2013089247 A1 WO2013089247 A1 WO 2013089247A1
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WO
WIPO (PCT)
Prior art keywords
balloon
lens
expansion
image
outline
Prior art date
Application number
PCT/JP2012/082565
Other languages
English (en)
Japanese (ja)
Inventor
賢一 雲山
木下　康
達 末原
リヤー アラスト
Original Assignee
テルモ株式会社
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.)
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Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2013089247A1 publication Critical patent/WO2013089247A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/233—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the nose, i.e. nasoscopes, e.g. testing of patency of Eustachian tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00096—Optical elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00174—Optical arrangements characterised by the viewing angles

Definitions

  • the present invention relates to an dilatation catheter that can dilate a natural mouth narrowed by sinusitis.
  • Inflammation that has occurred in the nasal cavity due to colds or allergies may spread to the paranasal sinus, which is an intraosseous cavity adjacent to the nasal cavity.
  • the inflammation that occurs in the sinuses in this way is called sinusitis.
  • the sinuses communicate with the nasal cavity through a small hole called the natural mouth, but when sinusitis causes mucosal edema or thickening in the vicinity of the natural mouth, the natural mouth becomes narrowed. It is difficult for secretions and bacteria to be discharged into the nasal cavity, and airflow obstruction occurs.
  • Patent Document 1 discloses expanding a natural mouth by operating a balloon catheter under an endoscope.
  • an object of the present invention is to provide an expansion catheter that can realize an accurate, safe, and prompt treatment by confirming the front of the catheter and confirming an expansion body such as a balloon.
  • an expansion catheter of the present invention includes an elongated main body, an expandable expansion body provided on the outer periphery of the main body, and provided on the main body, at least more than the distal end of the main body.
  • a lens that accommodates the front and the outline of the expanded body before expansion in a field of view; and an imaging unit that captures an image through the lens.
  • both the front side of the front end of the main body and the outline of the dilatation body before dilation are within the field of view of the lens. For this reason, the surgeon can advance the dilatation catheter to the target location in the body while confirming the state of the front of the dilatation catheter, and expand the target location in the body while confirming the position and expansion operation of the expansion body. it can. Therefore, for example, the arrangement of the extension body at a position different from the intended position and the extension of the extension body at the wrong position or the readjustment of the position of the extension body can be prevented.
  • the dilatation catheter thus made can achieve an accurate, safe, and quick treatment.
  • a plurality of the imaging units are provided, and if the image from the lens can be divided and captured, only a necessary image among the divided images can be used, and for each divided image Since image processing can be performed, it is easy to confirm the state of a desired portion of what is captured.
  • a plurality of lenses are provided, and at least a lens that accommodates the front of the main body in the field of view and a lens that accommodates at least the outline of the extension body in the field of view, it is desired to see different lenses. Since it is possible to take a wider field of view in the direction, it is easier to confirm the state in that direction.
  • the main body has a bent portion that is bent non-parallel to the extending direction of the extension body on the rear end side of the extension body, and the lens and the imaging unit are provided on the extension body of the bent portion. If the imaging unit is configured to capture the outline of the expansion body before expansion from the rear end side, the expansion body easily fits in the field of view. In addition, the expansion operation can be confirmed more reliably.
  • the main body is formed in a tapered shape that expands from the tip toward the expansion body, and if the lens is provided along a tapered slope, the lens is inclined toward the tip side. Therefore, it is possible to fit the outline of the expansion body in the field of view while taking a wide field of view on the tip side.
  • the dilation system 10 of this embodiment that can be used for dilatation of a natural mouth constricted by sinusitis has a balloon catheter 100 (dilatation catheter) that can be inserted into the natural mouth.
  • the expansion system 10 of this embodiment includes a pressure supply device 20, a light source device 30, and a display device 40 connected to the balloon catheter 100.
  • the pressure supply device 20 communicates with the inside of a balloon 120 (expanded body) provided in the balloon catheter 100.
  • the pressure supply device 20 supplies a liquid such as a physiological saline or a contrast medium into the balloon 120, for example.
  • the balloon 120 expands when pressurized liquid is supplied from the pressure supply device 20, and contracts when the liquid is discharged from the inside of the balloon 120 to the pressure supply device 20.
  • the pressure supply device 20 is, for example, an indeflator, a syringe, or a pump.
  • the light source device 30 generates light emitted from the irradiation units 130 and 131 provided in the balloon catheter 100. Light generated by the light source device 30 is guided to the irradiation units 130 and 131 by an optical fiber disposed inside the balloon catheter 100.
  • the display device 40 displays images acquired by the imaging elements 150, 151, 152, and 153 (imaging unit) provided in the balloon catheter 100.
  • the display device 40 can display all of a plurality of images acquired by the imaging elements 150, 151, 152, and 153.
  • the display device 40 can also display only necessary ones of a plurality of images acquired by the imaging elements 150, 151, 152, and 153. Images acquired by the imaging elements 150, 151, 152, and 153 are displayed in the imaging window 41 on the screen of the display device 40, respectively.
  • the display device 40 is, for example, a PC (personal computer).
  • the balloon catheter 100 has a long main body 110 and an expandable balloon 120 provided on the outer periphery of the main body 110.
  • the balloon catheter 100 also has a lens 140 provided on the main body 110.
  • the image sensors 150, 151, 152, and 153 capture images through the lens 140.
  • the irradiation units 130 and 131 emit light and illuminate the imaging target.
  • the main body 110 has a flexible outer tube 111 and a flexible inner tube 112 disposed inside the outer tube 111.
  • the main body 110 also has a tip protrusion 115 provided at the tip of the inner tube 112 and protruding axially toward the tip of the balloon 120, and a hub 116 connected to the rear ends of the outer tube 111 and the inner tube 112. .
  • the outer tube 111 is made of, for example, polyolefin such as polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or a mixture of two or more thereof, soft polyvinyl chloride resin, polyamide, It is formed of polyamide elastomer, polyester, polyester elastomer, polyurethane, fluororesin, acrylic resin or other thermoplastic resin, silicone rubber, latex rubber or the like.
  • polyolefin such as polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or a mixture of two or more thereof, soft polyvinyl chloride resin, polyamide, It is formed of polyamide elastomer, polyester, polyester elastomer, polyurethane, fluororesin, acrylic resin or other thermoplastic resin, silicone rubber, latex rubber
  • the inner tube 112 is composed of an inner layer tube 113 and an outer layer tube 114 that overlap each other.
  • the inner layer tube 113 may have a mesh shape, for example, or may have a shape in which an outer peripheral wall is closed unlike the mesh shape.
  • the mesh shape includes a net shape or a shape in which a plurality of holes are formed in a thin plate-like outer peripheral wall.
  • the inner layer tube 113 is made of a metal material such as Ni—Ti, brass, SUS, or aluminum.
  • the material forming the outer tube 114 is the same as that of the outer tube 111.
  • the outer layer pipe 114 is deformed in accordance with the deformation of the inner layer pipe 113.
  • the proximal end side of the outer tube 111 may be made of a metal material that is different from the distal end side and has higher rigidity than the distal end side. With such a configuration, pushability and torque transmission are improved, and operability is improved.
  • the cable 161 that connects the image sensors 150, 151, 152, and 153 and the display device 40 and the optical fiber 160 that guides light to the irradiation units 130 and 131 pass through the inner tube 112.
  • the plurality of optical fibers 160 are bundled by being accommodated in a tube 162 disposed in the inner tube 112.
  • the cable 161 and the optical fiber 160 are drawn from the rear end of the hub 116.
  • the hub 116 has a flow path 117 that communicates with the outer tube 111.
  • the channel 117 communicates with the pressure supply device 20.
  • the liquid that expands the balloon 120 is supplied from the pressure supply device 20 to the balloon 120 through the flow path 117 and the outer tube 111, and is discharged from the balloon 120 to the pressure supply device 20.
  • the rear end of the outer tube 111 is liquid-tightly bonded to the hub 116, and the rear end of the inner tube 112 protrudes from the rear end of the outer tube 111 and is liquid-tightly bonded to the hub 116.
  • the hub 116 is formed of a thermoplastic resin such as polycarbonate, polyamide, polysulfone, polyarylate, or methacrylate-butylene-styrene copolymer.
  • the tip protrusion 115 is formed in a taper shape that expands from the tip toward the balloon 120.
  • the tip protrusion 115 is fixed to the tip of the inner tube 112 and holds the lens 140, the irradiation units 130 and 131, and the image sensors 150, 151, 152, and 153.
  • the tip protrusion 115 can be formed of the same material as the hub 116.
  • the lens 140 is provided along the tapered inclination of the tip protrusion 115.
  • the lens 140 is located in front of the tip of the tip protrusion 115, more preferably, the tip of the tip protrusion 115 in addition to this.
  • the lens 140 keeps the outline of the balloon 120 before expansion, more preferably, the outline of the balloon 120 before and after expansion in the field of view.
  • the outline of the balloon 120 that fits in the field of view of the lens 140 is preferably an arc shape that forms the outer periphery of the portion of the balloon 120 having the largest diameter of the tapered portion 121 whose diameter increases from the front end side toward the rear end side.
  • the lens 140 is preferably a fisheye lens having a field of view of 180 ° or greater, or other wide angle lens having a field of view close to 180 °.
  • the balloon 120 is provided so as to cover the outer periphery of the portion of the inner tube 112 protruding from the tip of the outer tube 111.
  • the distal end portion of the balloon 120 in the extending direction is liquid-tightly bonded to the outer periphery of the inner tube 112.
  • a rear end portion in the extending direction of the balloon 120 is liquid-tightly bonded to the outer periphery of the outer tube 111.
  • adhesion known adhesion means such as welding, fusing, gluing or brazing can be used.
  • the balloon 120 is formed of various resin materials generally used in the field of stent delivery systems.
  • polytetramethylene adipamide nylon 46
  • polycaprolactam nylon 6
  • polyhexamethylene adipamide nylon 66
  • polyhexamethylene sebamide nylon 610
  • polyhexamethylene dodeca Homopolymers such as amide (nylon 612), polyundecanolactam (nylon 11), polydodecanolactam (nylon 12), caprolactam / lauryl lactam copolymer (nylon 6/12), caprolactam / aminoundecanoic acid copolymer Copolymer (nylon 6/11), caprolactam / ⁇ -aminononanoic acid copolymer (nylon 6/9), caprolactam / hexamethylene diammonium adipate copolymer (nylon 6/66), copolymer of adipic acid and metaxylenediamine Polymer or hexamethylene Polyamide resins such as copolymers such as copolymers such as copo
  • a nylon elastomer which is a block copolymer having a polyalkylene glycol, polyether, aliphatic polyester or the like as a soft segment can be employed.
  • it is preferable to have high pressure resistance so as not to rupture when expanded.
  • it may be formed of polyamide, polyethylene terephthalate, high-density polyethylene, or the like.
  • the balloon 120 may be expanded and contracted by changing the state between the folded state and the expanded state, or may be expanded and contracted by expanding and contracting the balloon 120 itself.
  • the irradiation unit 130 illuminates the front end of the front end protrusion 115 that fits in the field of view of the lens 140, more preferably, the front end of the front end protrusion 115.
  • the irradiation unit 130 is provided on the tip side of the lens 140. In the present embodiment, four irradiation units 130 are provided, and are arranged at substantially equal intervals around the axis.
  • the irradiation unit 131 illuminates the outline of the balloon 120 that falls within the field of view of the lens 140 and the vicinity thereof. For example, as shown in FIGS. 3 and 4, when the balloon 120 is disposed in the narrowed natural mouth S, the irradiation unit 131 uses the narrowed natural mouth S in contact with the balloon 120 in addition to the outline of the balloon 120. Illuminate.
  • the irradiation unit 131 is provided on the rear end side with respect to the lens 140. In the present embodiment, two irradiation units 131 are provided, and are arranged on the side where the lens 140 is provided when viewed in a cross section passing through the lens 140 and the axis of the balloon catheter 100 as shown in FIG. .
  • the plurality of image pickup devices 150, 151, 152, and 153 each pick up images of different fields of view obtained by dividing the field of view of the lens 140.
  • the image sensor 150 captures an image 1-1 about the field of view in which the front of the tip protrusion 115 falls.
  • the image 1-1 preferably includes the tip of the tip protrusion 115.
  • the image sensor 151 captures an image 1-2 adjacent to the image 1-1.
  • the image sensor 152 captures an image 1-3 adjacent to the image 1-2.
  • the image sensor 153 captures an image 1-4 adjacent to the image 1-3 and a field of view in which the outline of the balloon 120 is accommodated.
  • the image sensors 150, 151, 152, and 153 are, for example, CCD image sensors or CMOS image sensors.
  • the display device 40 can display all of the images 1-1 to 1-4, and can also display only a part of them.
  • the balloon 120 is placed at a target position in the body while looking at the front of the balloon catheter 100 and the balloon 120, and after the placement process, the balloon 120 is seen while looking at the outline of the balloon 120.
  • the expansion method of the present embodiment includes a contraction process for contracting the balloon 120 while viewing the outline of the balloon 120 after the expansion process, and a recovery process for recovering the balloon catheter 100 after the contraction process.
  • each process will be described with an example of expansion of a natural mouth constricted by sinusitis.
  • the operator advances the balloon catheter 100 inserted into the nasal cavity N to the natural mouth S that allows the nasal cavity N and the sinus cavity A to communicate with each other, and the balloon 120 is naturally moved. Insert into mouth S and place.
  • the operator bends and shapes the main body 110 in advance.
  • the inner layer tube 113 is plastically deformed, so that the main body 110 can be shaped into a desired shape.
  • the surgeon advances the balloon catheter 100 to the natural mouth S while confirming the front of the balloon catheter 100 from the image displayed on the display device 40.
  • the surgeon inserts and arranges the balloon 120 into the natural mouth S while confirming the front of the balloon catheter 100 and the balloon 120 based on the image displayed on the display device 40.
  • the surgeon can confirm the state of the front of the balloon catheter 100 from the images 1-1 to 1-4, in particular, the image 1-1. Further, the surgeon can confirm the state of the balloon 120 from the images 1-1 to 1-4, in particular, the image 1-4.
  • the pre-expansion reference line L1 is displayed.
  • the position of the boundary L3 as shown in FIG. It is displayed below the pre-expansion reference line L1.
  • the boundary L3 displayed in the imaging window 41 is displayed. The position substantially coincides with the pre-expansion reference line L1.
  • the tapered portion 121 has a smaller diameter than the cylindrical portion 122. Therefore, when the balloon 120 is in contact with the natural mouth S at the tapered portion 121, the natural mouth S is sufficiently expanded when the balloon 120 is expanded.
  • the surgeon moves the balloon 120 to the natural mouth S while looking at the display device 40 until the position of the boundary L3 substantially matches the pre-dilation reference line L1.
  • the balloon 120 and the natural mouth S are brought into contact with each other at the cylindrical portion 122.
  • the surgeon expands the narrowed natural mouth S by pressurizing and expanding the balloon 120 with the pressure supply device 20.
  • the surgeon expands the balloon 120 while confirming the appearance of the outline of the balloon 120 based on the image displayed on the display device 40, particularly the image 1-4.
  • an expanded reference line L2 that serves as a reference for the position of the boundary L3 between the balloon 120 after expansion and the natural mouth S formed in contact with each other in the imaging window 41. Is displayed. The surgeon expands the balloon 120 until the boundary L3 substantially coincides with the expanded reference line L2.
  • the balloon 120 may not be sufficiently expanded, so that the narrowing of the natural mouth S may not be improved. is there. Further, when the boundary L3 is significantly above the post-expansion reference line L2, the balloon 120 may be excessively expanded and an excessive force may be applied to the natural mouth S.
  • the post-expansion reference line L2 is a guideline indicating how much the balloon 120 should be expanded in order to satisfactorily widen the narrowed natural mouth S.
  • the operator contracts the balloon 120 while confirming the state of the balloon 120 by the same imaging window 41 in the contraction process. Let The operator contracts the balloon 120 until the boundary L3 substantially coincides with the pre-dilation reference line L1.
  • the operator pulls the balloon catheter 100 to remove the balloon 120 from the natural mouth S, and then removes the balloon catheter 100 from the nasal cavity N and collects it.
  • both the front side of the tip protruding portion 115 and the outline of the balloon 120 before expansion are within the field of view of the lens 140.
  • the surgeon can advance the balloon catheter 100 to the target natural mouth while confirming the state of the front of the balloon catheter 100, and dilate the narrowed natural mouth while confirming the position and expansion operation of the balloon 120. it can. Therefore, for example, since the balloon 120 is placed at a position different from the intended position, and the expansion of the balloon 120 or the readjustment of the position of the balloon 120 is prevented. An accurate, safe and quick treatment can be realized.
  • the tip of the tip protrusion 115 is within the field of view of the lens 140 so that the balloon catheter 100 can be more accurately determined in which direction. Can be advanced.
  • the balloon 120 can be arranged at an appropriate position of the natural mouth.
  • the burden on the patient is less than when the internal state is confirmed by X-rays.
  • the outline of the balloon 120 after dilation is also included in the field of view, so that it can be understood how much the balloon 120 has been dilated. Appropriate force can be applied to the natural mouth.
  • the expanded reference line L2 is displayed on the display device 40, so that it is possible to more accurately know how much the balloon 120 should be expanded. Can act on the natural mouth.
  • the plurality of image sensors 150, 151, 152, and 153 divide the image from the lens 140 and capture the image. For this reason, only necessary images among the divided images 1-1 to 1-4 can be used, and image processing can be performed for each of the divided images, so that a desired portion of the imaged image can be confirmed. Easy to do.
  • the lens 140 is the fish-eye lens 140
  • distortion occurs in the image around the lens 140.
  • the plurality of image sensors 150, 151, 152, and 153 divide and capture the images from the lens 140.
  • the peripheral distortion can be corrected by performing image processing for each of the divided images. Therefore, it is easy to confirm the front of the balloon catheter 100 and the state of the balloon 120 from the images 1-1 and 1-4.
  • the lens 140 is provided along the tapered inclination of the tip protrusion 115 that expands from the tip toward the balloon 120, the lens 140 is inclined toward the tip side.
  • the outline can be kept in the field of view.
  • the balloon catheter 200 of the second embodiment is different from the balloon catheter 100 of the first embodiment in that it has two lenses 240 and 241. Further, the balloon catheter 200 of the second embodiment includes a tip protrusion 215 having a shape different from that of the tip protrusion 115 of the first embodiment.
  • the balloon catheter 200 includes imaging elements 250 and 251 that capture an image through the lens 240 and an irradiation unit 230 that illuminates the field of view of the lens 240 in the distal protrusion 215.
  • the balloon catheter 200 includes imaging elements 252 and 253 that capture images through the lens 241 and an irradiation unit 231 that illuminates the field of view of the lens 241 at the distal protrusion 215.
  • the balloon catheter 200 is substantially the same as the balloon catheter 100 of the first embodiment except for the lenses 240 and 241, the tip protrusion 215, the imaging elements 250, 251, 252 and 253, and the irradiation units 230 and 231. . Therefore, the same constituent elements are denoted by the same reference numerals, and redundant description is omitted.
  • the configuration of the expansion system is substantially the same except for the balloon catheter 200 in the second embodiment and the first embodiment. Therefore, the overlapping description of the pressure supply device 20, the light source device 30, and the display device 40 is omitted. Further, the expansion method using the balloon catheter 200 is the same as the first embodiment in the second embodiment.
  • each of the lens 240 and the lens 241 is substantially the same as that of the lens 140 of the first embodiment, and preferably a fisheye lens having a field of view of 180 ° or more, or another having a field of view close to 180 °. It is a wide-angle lens.
  • the lens 240 is disposed on the distal end side of the lens 241, and is provided along the tapered inclined portion that extends from the distal end toward the balloon 120 in the distal end protruding portion 215.
  • the lens 240 only needs to be in front of the tip of the tip protrusion 215, more preferably, the tip of the tip protrusion 215 in addition to the fisheye lens having the field of view of 180 ° or more, or 180 °. It is not limited to other wide-angle lenses having a near field of view, and may be a standard lens with a narrower field of view than a fish-eye lens or a wide-angle lens.
  • the lens 241 is disposed on the rear end side from the lens 240, and is provided on the rear end side where the inclination is gentler than that of the inclined portion where the lens 240 is provided in the front end protrusion 215.
  • the lens 241 accommodates the outline of the balloon 120 before expansion, more preferably the outline of the balloon 120 before and after expansion.
  • the outline of the balloon 120 that fits in the field of view of the lens 241 is preferably formed on the rear end side of the arcuate outline that forms the outer periphery of the portion with the largest diameter of the tapered portion 121 or the tapered portion 121. This is an arcuate outline that forms the outer periphery of the substantially cylindrical portion 122.
  • the irradiation unit 230 illuminates the front of the tip protrusion 215 that fits in the field of view of the lens 240, more preferably, the tip of the tip protrusion 215 in addition to this.
  • four irradiation units 230 are provided, and are arranged at substantially equal intervals around the axis.
  • the irradiation unit 231 illuminates the outline of the balloon 120 and the vicinity thereof, which are within the field of view of the lens 241. For example, when the balloon 120 is disposed in a narrowed natural mouth, the irradiation unit 231 illuminates the narrowed natural mouth in contact with the balloon 120 in addition to the outline of the balloon 120.
  • the irradiation unit 231 is provided on the rear end side with respect to the lens 241. In the present embodiment, two irradiation units 231 are provided, and are arranged on the side where the lens 241 is provided as viewed in a cross section passing through the lens 241 and the axis of the balloon catheter 200 as shown in FIG. .
  • the image sensors 250 and 251 are disposed in proximity to the lens 240.
  • the image sensors 250 and 251 respectively capture images of different fields of view obtained by dividing the field of view of the lens 240.
  • the image sensor 250 captures an image 2-1 about the field of view in which the front of the tip protrusion 215 fits.
  • the imaging element 251 captures an image 2-2 for a field of view that is adjacent to the image 2-1 and that fits in front of the tip protrusion 215.
  • Image 2-1 and image 2-2 preferably include the tip of tip protrusion 215.
  • the image sensors 252 and 253 are disposed in proximity to the lens 241.
  • the image sensors 252 and 253 respectively capture images of different fields of view obtained by dividing the field of view of the lens 241.
  • the image sensor 253 captures an image 2-4 for the field of view in which the outline of the balloon 120 fits.
  • the imaging element 252 captures an image 2-3 adjacent to the image 2-4.
  • the image of the outline of the balloon 120 after expansion is included in the image 2-3 or the image 2-4.
  • the image sensors 250, 251, 252, and 253 are, for example, CCD image sensors or CMOS image sensors. Signals from the image sensors 250, 251, 252, and 253 are sent to the display device 40 through the cable 161.
  • the display device 40 can display all of the images 2-1 to 2-4, and can also display only a part of them.
  • the balloon catheter 200 includes the lens 240 and the lens 241, and includes the direction desired to be viewed, that is, the front of the tip protrusion 215 and the outline of the balloon 120.
  • the rear side of the tip protrusion 215 is stored in the field of view.
  • the orientation of the lens 240 and the lens 241 can be freely set so as to widen the field of view in the direction desired to be viewed, compared to the case where both of these are accommodated in the field of view by the single lens 140 as in the first embodiment.
  • the inclination of the tip protrusion 215 of the portion where the lens 240 is provided is larger than the inclination of the tip protrusion 115 of the first embodiment.
  • the lens 140 of the first embodiment Compared to the lens 140 of the first embodiment, it is inclined more toward the tip side. Further, the inclination of the tip protrusion 215 at the portion where the lens 241 is provided is smaller than the inclination of the tip protrusion 115 of the first embodiment, and therefore the lens 241 is different from the lens 140 of the first embodiment. Compared to the rear end side, it is inclined. Accordingly, since the field of view can be taken wider, the balloon catheter 200 of the second embodiment can be seen in front of the tip protrusion 215 and behind the tip protrusion 215 in addition to the effects of the first embodiment. There is an effect that it is easier to confirm.
  • the balloon catheter 300 of the third embodiment is the first embodiment in that it includes a lens 340, an imaging element 350, 351, and an irradiation unit 330 disposed on the rear end side of the balloon 120.
  • the balloon catheter 300 is substantially the same as the balloon catheter 100 of the first embodiment. Therefore, the same constituent elements are denoted by the same reference numerals, and redundant description is omitted.
  • the configuration of the expansion system is substantially the same except for the balloon catheter 300 in the third embodiment and the first embodiment. Further, the expansion method using the balloon catheter 300 is the same as the first embodiment in the third embodiment.
  • the configuration of the lens 340 itself is substantially the same as the lens 140 of the first embodiment, and is preferably a fisheye lens having a field of view of 180 ° or more, or another wide-angle lens having a field of view close to 180 °.
  • the lens 340 is provided on the outer tube 111.
  • the lens 340 accommodates the outline of the balloon 120 before expansion, more preferably the outline of the balloon 120 before and after expansion.
  • the outline of the balloon 120 that fits in the field of view of the lens 340 is preferably an arc shape that forms the outer periphery of the portion of the balloon 120 having the largest diameter of the tapered portion 123 that expands from the rear end side toward the front end side. Or an arcuate outline that forms the outer periphery of a substantially cylindrical portion 122 formed on the tip side of the tapered portion 123.
  • the irradiation unit 330 is provided in the outer tube 111.
  • the irradiating unit 330 illuminates the outline of the balloon 120 and the vicinity thereof that fall within the field of view of the lens 340.
  • the irradiation unit 330 illuminates the narrowed natural mouth in contact with the balloon 120 in addition to the outline of the balloon 120.
  • the irradiation unit 330 is preferably provided on the rear end side of the lens 340. Since the irradiation unit 330 is provided on the rear end side of the lens 340, the irradiation unit 330 does not interfere with the visual field, so that the outline of the balloon 120 can be more easily seen.
  • the optical fiber 160 that guides light to the irradiation unit 330 passes through the outer circumferences of the tube 162 and the inner tube 112 and is drawn into the outer tube 111.
  • the optical fiber 160 is pulled out from the rear end of the hub 116 and optically connects the irradiation unit 330 and the light source device 30.
  • the image sensors 350 and 351 are provided in the inner tube 112.
  • the image sensors 350 and 351 respectively capture images of different fields of view obtained by dividing the field of view of the lens 340.
  • the image sensor 350 captures an image 3-1 for the field of view in which the outline of the balloon 120 before expansion is accommodated.
  • the image sensor 351 captures an image 3-2 adjacent to the image 3-1.
  • the image of the outline of the balloon 120 after expansion is included in the image 3-1 or the image 3-2.
  • the imaging elements 350 and 351 are, for example, CCD image sensors or CMOS image sensors.
  • a cable 161 for sending signals from the image sensors 350 and 351 to the display device 40 penetrates the outer periphery of the inner tube 112 and is electrically connected to the image sensors 350 and 351.
  • the cable 161 is pulled out from the rear end of the hub 116 and electrically connects the image sensors 350 and 351 and the display device 40.
  • the display device 40 can display all of the images 1-1 to 1-4 and the images 3-1 and 3-2, and can also display only a part of them.
  • the through hole is surrounded by a partition wall 360 provided between the inner tube 112 and the outer tube 111. For this reason, the liquid that moves in the outer tube 111 for expansion / contraction of the balloon 120 does not touch the imaging elements 350 and 351 and does not flow into the inner tube 112 through the above-described through holes.
  • the balloon catheter 300 of the present embodiment includes the lens 340 and the imaging elements 350 and 351 in addition to the configuration of the first embodiment.
  • the outline of the balloon 120 is also imaged from the rear end side of 120. Therefore, the balloon catheter 300 of the third embodiment has an effect that the position and expansion operation of the balloon 120 can be confirmed more reliably in addition to the effect of the first embodiment.
  • the balloon catheter 400 of the fourth embodiment has an outer tube 411 and an inner tube 412 each having a bent portion 415 bent non-parallel to the extending direction of the balloon 120 on the rear end side of the balloon 120. This is different from the balloon catheter 100 of the first embodiment.
  • the balloon catheter 400 is different from the balloon catheter 100 of the first embodiment in that the balloon catheter 400 includes a lens 440, an imaging element 450, and an irradiation unit 430 disposed in the bent portion 415.
  • the balloon catheter 400 is substantially the same as the balloon catheter 100 of the first embodiment. Therefore, the same constituent elements are denoted by the same reference numerals, and redundant description is omitted.
  • the configuration of the expansion system is substantially the same in the fourth embodiment and the first embodiment except for the balloon catheter 400. Further, the expansion method using the balloon catheter 400 is substantially the same as the first embodiment in the fourth embodiment.
  • the outer tube 411 is shaped so as to maintain the shape of the bent portion 415, and the bent portion 415 has flexibility similar to other portions different from the bent portion 415. For this reason, the outer tube 411 can bend flexibly while maintaining the shape of the bent portion 415.
  • the inner tube 412 includes an outer layer tube 414 provided with a bent portion 415 and an inner layer tube 413 provided along the outer layer tube 414.
  • the material forming the outer layer tube 414 is the same as that of the outer layer tube 114 of the first embodiment.
  • the material forming the inner layer tube 413 is the same as that of the inner layer tube 113 of the first embodiment, and the inner layer tube 413 has a mesh shape similarly to the inner layer tube 113 of the first embodiment.
  • the outer tube 414 is shaped so as to maintain the shape of the bent portion 415, and the bent portion 415 has flexibility similar to other portions different from the bent portion 415.
  • the inner layer tube 413 deforms following the deformation of the outer layer tube 414. Therefore, the inner tube 412 can bend flexibly while maintaining the shape of the bent portion 415.
  • the outer tube 411 and the inner tube 412 are substantially the same as the outer tube 111 and the inner tube 112 of the first embodiment, and thus redundant description is omitted.
  • the lens 440 is provided at a position facing the balloon 120 in the bent portion 415 so that the balloon 120 is within the visual field.
  • the lens 440 is provided on the outer tube 411.
  • the lens 440 only needs to be able to accommodate the balloon 120 in the field of view.
  • the lens 440 may be a standard lens having a narrow field of view as compared with the fish-eye lens or the wide-angle lens used in the above-described embodiment.
  • the lens 440 accommodates the outline of the balloon 120 before expansion, more preferably the outline of the balloon 120 before and after expansion.
  • the lens 440 is not limited to a standard lens, and may be a fisheye lens or a wide-angle lens as described above. In this case, the field of view is wider than that of the standard lens, so that the balloon 120 and its vicinity can be confirmed in a wider range, and the rear end side than the lens 440 can be confirmed.
  • the irradiation unit 430 is provided in the outer tube 411.
  • the irradiation unit 430 illuminates the outline of the balloon 120 and the vicinity thereof, which are within the field of view of the lens 440.
  • the irradiation unit 430 illuminates the narrowed natural mouth in contact with the balloon 120 in addition to the outline of the balloon 120.
  • the irradiation unit 430 is preferably provided on the rear end side of the lens 440. Since the irradiation unit 430 is provided on the rear end side of the lens 440, the irradiation unit 430 does not interfere with the visual field, so that the outline of the balloon 120 can be more easily seen.
  • the optical fiber 160 that guides light to the irradiation unit 430 passes through the outer circumferences of the tube 162 and the inner tube 412 and is drawn into the outer tube 411.
  • the optical fiber 160 is pulled out from the rear end of the hub 116 and optically connects the irradiation unit 430 and the light source device 30.
  • the image sensor 450 is provided in the inner tube 412.
  • the image sensor 450 captures the image 4 within the field of view of the lens 440 from the rear end side of the balloon 120.
  • the image sensor 450 is, for example, a CCD image sensor or a CMOS image sensor.
  • a cable 161 for sending a signal from the image sensor 450 to the display device 40 penetrates the outer periphery of the inner tube 412 and is electrically connected to the image sensor 450.
  • the cable 161 is pulled out from the rear end of the hub 116 and electrically connects the image sensor 450 and the display device 40.
  • the display device 40 can display all of the images 1-1 to 1-4 and the image 4, and can also display only a part of them.
  • the through-hole formed in the inner tube 412 through which the cable 161 connected to the image sensor 450 and the image sensor 450 passes, and the through-hole formed in the inner tube 412 through which the optical fiber 160 that guides light to the irradiation unit 430 passes The wall 460 is surrounded by a partition wall 460 provided between the inner tube 412 and the outer tube 411. Therefore, the liquid that moves in the outer tube 411 for expansion / contraction of the balloon 120 does not touch the image sensor 450 and does not flow into the inner tube 412 through the aforementioned through-hole.
  • the balloon catheter 400 of the present embodiment includes the bent portion 415 and the lens 440 disposed in the bent portion 415. Therefore, the lens 440 is provided. Is inclined so as to face toward the balloon 120, the outline of the balloon 120 is likely to be within the field of view of the lens 440. Therefore, the balloon catheter 400 of the present embodiment has an effect that the position and expansion operation of the balloon 120 can be confirmed more reliably in addition to the effect of the first embodiment.
  • the lens 440 and the imaging element 450 image the outline of the balloon 120 not only from the front end side of the balloon 120 but also from the rear end side of the balloon 120. For this reason, the balloon catheter 400 of the fourth embodiment has an effect that the position and expansion operation of the balloon 120 can be confirmed more reliably.
  • a plurality of image sensors are provided for one lens, but the present invention is not limited to this.
  • the front of the main body and the outline of the balloon may be visually recognized.
  • the present invention includes a form without the imaging elements 152 and 153 in the balloon catheter 300 of the third embodiment.
  • the outline of the balloon 120 is imaged exclusively from the rear end side of the balloon 120 by the image sensor 350 or the image sensors 350 and 351.
  • the present invention includes a form without the imaging elements 152 and 153.
  • the outline of the balloon 120 is imaged exclusively from the rear end side of the balloon 120 by the image sensor 450.
  • the lens 140 does not have to hold the balloon 120 in the field of view, and thus may be a standard lens having a narrower field of view than a fisheye lens or a wide-angle lens.
  • the imaging unit is not limited to an imaging element such as a CCD image sensor as in the above embodiment, and may be, for example, a bundle of optical fibers that can receive light from a lens.
  • the expansion body is not limited to the balloon as long as it can expand the narrowed natural mouth.
  • the expandable body may be another expandable member having a configuration like a stent, for example.
  • the irradiating unit is an emission port of light generated by the light source device, but is not limited to this as long as it can illuminate the imaging target, and may be, for example, an LED light that emits light itself.
  • a cable that supplies power to the LED light as the irradiation unit is provided instead of the optical fiber that guides light to the irradiation unit.
  • 10 expansion system 20 pressure supply device, 30 light source device, 40 display device, 100, 200, 300, 400 Balloon catheter (dilatation catheter), 110, 210, 310, 410 body, 111, 411 outer tube, 112, 412 inner pipe, 113, 413 inner layer pipe, 114, 414 outer tube, 115, 215 tip protrusion, 120 balloon (expanded body), 140, 240, 241, 340, 440 lens, 150, 151, 152, 153 imaging device (imaging unit), 250, 251, 252, 253 Image sensor (imaging unit), 350, 351 imaging device (imaging unit), 450 imaging device (imaging part), 415 bent part, A sinuses, N nasal cavity, S Natural mouth.
  • Balloon catheter dilation catheter
  • 110, 210, 310, 410 body 111, 411 outer tube, 112, 412 inner pipe, 113, 413 inner layer pipe, 114, 414 outer tube, 115, 215 tip protrusion, 120 balloon (expanded body

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Abstract

La présente invention concerne un cathéter d'expansion qui est configuré de telle sorte qu'à la fois ne vue avant du cathéter et la vue du corps d'expansion, tel qu'un ballonnet, peuvent être observées pour permettre un traitement rapide, sûr et précis. Un cathéter d'expansion (100) a : un corps long (110) ; un corps d'expansion extensible (120) qui se situe sur la périphérie extérieure du corps ; une lentille (140) qui est située sur le corps et qui peut obtenir au moins à la fois une vue avant de l'extrémité distale du corps et la vue d'ensemble du corps d'expansion avant l'expansion ; et une section de capture d'image (150, 151, 152, 153) pour capturer une image à travers la lentille.
PCT/JP2012/082565 2011-12-15 2012-12-14 Cathéter d'expansion WO2013089247A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2011274847A JP2015037452A (ja) 2011-12-15 2011-12-15 拡張カテーテル
JP2011-274847 2011-12-15

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WO2013089247A1 true WO2013089247A1 (fr) 2013-06-20

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JP (1) JP2015037452A (fr)
WO (1) WO2013089247A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006034008A2 (fr) * 2004-09-17 2006-03-30 Acclarent, Inc. Dispositifs et methodes permettant de dilater et de modifier les orifices des sinus paranasaux et d'autres structures intranasales ou paranasales
JP2006239156A (ja) * 2005-03-03 2006-09-14 Olympus Medical Systems Corp バルーンダイレータ
WO2010096294A1 (fr) * 2009-02-17 2010-08-26 Entellus Medical, Inc. Appareil et procédés de gonflement de cathéter à ballonnet

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006034008A2 (fr) * 2004-09-17 2006-03-30 Acclarent, Inc. Dispositifs et methodes permettant de dilater et de modifier les orifices des sinus paranasaux et d'autres structures intranasales ou paranasales
JP2006239156A (ja) * 2005-03-03 2006-09-14 Olympus Medical Systems Corp バルーンダイレータ
WO2010096294A1 (fr) * 2009-02-17 2010-08-26 Entellus Medical, Inc. Appareil et procédés de gonflement de cathéter à ballonnet

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