WO2014073420A1 - Cathéter - Google Patents

Cathéter Download PDF

Info

Publication number
WO2014073420A1
WO2014073420A1 PCT/JP2013/079270 JP2013079270W WO2014073420A1 WO 2014073420 A1 WO2014073420 A1 WO 2014073420A1 JP 2013079270 W JP2013079270 W JP 2013079270W WO 2014073420 A1 WO2014073420 A1 WO 2014073420A1
Authority
WO
WIPO (PCT)
Prior art keywords
imaging unit
balloon
catheter
main body
inner tube
Prior art date
Application number
PCT/JP2013/079270
Other languages
English (en)
Japanese (ja)
Inventor
泰佳 中野
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.)
Filing date
Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2014073420A1 publication Critical patent/WO2014073420A1/fr

Links

Images

Classifications

    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
    • G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
    • G02B23/2476—Non-optical details, e.g. housings, mountings, supports
    • 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
    • A61B1/00179—Optical arrangements characterised by the viewing angles for off-axis viewing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/24—Surgical instruments, devices or methods, e.g. tourniquets for use in the oral cavity, larynx, bronchial passages or nose; Tongue scrapers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A61B2017/22065—Functions of balloons
    • A61B2017/22069—Immobilising; Stabilising
    • 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
    • A61M25/02—Holding devices, e.g. on the body
    • A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible

Definitions

  • the present invention relates to a catheter having at least a balloon.
  • Patent Document 1 discloses an endoscope system including an endoscope and a balloon catheter.
  • the balloon is provided at the distal end portion of the catheter.
  • the lens portion of the endoscope is disposed on the proximal end side of the balloon. Yes.
  • the imaging device is also required to have a function of searching for a target site such as a natural mouth at the tip of the device.
  • the observation window is arranged at the proximal end portion of the balloon as in Patent Document 1
  • the balloon becomes an obstacle, and the visual field formation of the target portion such as the natural mouth cannot be performed clearly. There's a problem.
  • the present invention has been invented to solve the above-described problems, and can visually recognize the positional relationship between the balloon and the stenosis, and can clearly form a front visual field through which the catheter enters. It is an object to provide a catheter that can be used.
  • a catheter according to the present invention that achieves the above-described object includes an expandable expansion body, a long and hollow main body portion to which the expansion body is attached at the distal end, and a forward and backward movement along the longitudinal direction of the main body portion inside the main body portion.
  • An imaging unit that is movably disposed.
  • the main body has an observation window for observing the direction in which the imaging unit is directed, and the imaging unit is capable of moving back and forth at least from the base end side to the distal end side beyond the expansion body. It is a feature.
  • FIG. 4 is a cross-sectional view showing an inner tube constituting the main body at the position of line 4-4 in FIG.
  • FIGS. 5A to 5D are views showing a state where the balloon is viewed from the observation window.
  • FIG. 1 is a diagram showing a schematic configuration of an expansion system including a catheter according to Embodiment 1 of the present invention
  • FIG. 2 is a cross-sectional view showing a state where an imaging unit constituting the catheter is arranged at a distal end portion
  • FIG. 5 is a cross-sectional view showing a state in which the imaging unit constituting the lens is disposed at the proximal end portion of the balloon or the insertion portion of the balloon in the inner tube constituting the main body portion.
  • 4 is a cross-sectional view showing the inner tube constituting the main body at the position of line 4-4 in FIG.
  • the dilation system 10 of the first embodiment used for dilatation of the sinus natural mouth constricted by sinusitis has a catheter 100 that can be inserted into the natural mouth.
  • the expansion system 10 includes a pressure supply unit 200, a light source 300, and a display unit 400 connected to the catheter 100.
  • the pressure supply means 200 communicates with the outer tube 121 constituting the main body 120 which is a component of the catheter 100, and a liquid such as physiological saline or a contrast agent or a gas such as helium is passed through the outer tube 121 to the distal end of the outer tube 121. It supplies to the balloon 110 which comprises the catheter 100 connected. The balloon 110 is expanded by supplying a liquid or gas to be filled into the balloon 110 and contracted by suction.
  • the pressure supply means 200 is, for example, an indeflator, a syringe, or a pump, but is not limited thereto.
  • the light source 300 generates light emitted from the irradiation unit 142 that is a component of the catheter 100 provided at the distal end of the imaging unit 141 that is a component of the catheter 100.
  • the light generated by the light source 300 is guided to the irradiation unit 142 by the optical fiber 143 that is a component of the catheter 100 disposed inside the catheter.
  • the display unit 400 displays video information or image information acquired by the imaging unit 141 attached to the distal end portion of the camera catheter 140 that is a constituent element of the catheter 100.
  • the display means 400 is, for example, a monitor part of a PC (personal computer).
  • the catheter 100 includes an expandable balloon (expanded body) 110, a long main body 120 to which the balloon 110 is attached to a distal end portion, and a longitudinal direction of the main body 120 within the main body 120. And an imaging unit 141 arranged so as to be movable forward and backward.
  • the imaging unit 141 can move at least from the proximal end portion 126 of the balloon 110 to the distal end portion 130 of the balloon 110.
  • the imaging unit 141 is attached to the distal end of the camera catheter 140.
  • the balloon 110 is configured to be transparent in this embodiment so that the positional relationship between the balloon 110 and the narrowed natural mouth can be confirmed from the inside of the balloon 110 when expanded.
  • the balloon 110 is made of various resin materials. More specifically, polytetramethylene adipamide (nylon 46), polycaprolactam (nylon 6), polyhexamethylene adipamide (nylon 66), polyhexamethylene sebamide (nylon 610), polyhexamethylene dodeca Homopolymers such as imide (nylon 612), polyundecanolactam (nylon 11), polydodecanolactam (nylon 12), caprolactam / lauryl lactam copolymer (nylon 6/12), caprolactam / aminoundecanoic acid copolymer Polymer (nylon 6/11), caprolactam / ⁇ -aminononanoic acid copolymer (nylon 6/9), caprolactam / hexamethylene diammonium adip
  • polyalkylene A nylon elastomer that is a block copolymer having a soft segment of glycol, polyether, aliphatic polyester, or the like can be used. Among these, 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 main body 120 has an outer tube 121 and an inner tube 122.
  • the outer tube 121 is a hollow tube, and the balloon 110 is attached to the outer periphery of the tip so as to communicate with the balloon 110.
  • the outer tube 121 is made of a metal having rigidity such as stainless steel, but is not limited thereto. It may be made of an elastic metal such as a nickel titanium alloy, or may have a structure in which flexibility is increased by processing grooves or the like in stainless steel, or a hard resin material may be used.
  • the base end portion 126 of the balloon 110 in the outer tube 121 is formed as an observation window 123 (corresponding to an observation window) with a transparent material such as polypropylene.
  • the type of the observation window is not limited as long as it is transparent, and it may be made of a flexible material such as silicone as well as a hard member such as glass.
  • the inner tube 122 is a hollow member capable of moving a medical instrument such as a camera catheter 140 with the imaging unit 141 attached to the tip thereof in the longitudinal direction.
  • the inner tube 122 is inserted through the inside of the balloon 110 attached to the tip of the outer tube 121 as shown in FIG. 2, and is joined to the balloon 110 by fusion or the like at the tip of the balloon 110.
  • the base end portion 126 of the balloon 110 in the inner tube 122 is made of a transparent material such as polypropylene so that the imaging unit 141 disposed inside the inner tube 122 can visually recognize the balloon 110. Equivalent to a window).
  • the insertion portion 127 of the balloon 110 in the inner tube 122 is formed as an observation window 125 (corresponding to another observation window).
  • protrusions 131 to 134 are formed on the inner surface of the inner tube 122 so that the imaging unit 141 can be arranged and held at a fixed position.
  • the protrusions 131 to 134 incline the imaging unit 141 attached to the distal end of the camera catheter 140 from the axis of the inner tube 122 toward the imaging target.
  • the protrusions 131 to 134 the protrusions 131 and 132 are provided at the proximal end 126 of the balloon 110 in the inner tube 122, and the protrusions 133 and 134 (corresponding to other protrusions) are inserted into the balloon 110 in the inner tube 122.
  • the protrusions 131 to 134 are arranged in pairs on the inner surface of the inner tube 122 in the circumferential direction, for example, at intervals of 180 degrees.
  • the protrusions 131 to 134 are not located at the same position in the longitudinal direction as shown in FIGS. 2 and 3, but are separated by a predetermined distance so that the tip of the imaging unit 141 can be held in an inclined state with respect to the axis of the inner tube 122.
  • the arrangement interval and the number of the protrusions 131 to 134 are not limited to the above, and for example, four positions may be provided every 90 degrees.
  • the outer tube 121 and the inner tube 122 are provided with observation windows 123, 124, and 125, and the protrusions 131 to 134 are formed on the inner surface of the inner tube 122, so that the imaging unit 141 is inclined. Is held in a state where As a result, if the imaging unit 141 is held in an inclined state by the protrusions 131 and 132 at the positions of the observation windows 123 and 124 (see the solid line-shaped imaging unit in FIG. 3), the imaging unit 141 is a balloon in the inner tube 122.
  • the outer surface of the balloon 110 located outside the inner tube 122 and the outer tube 121 can be observed from the base end portion 126 of 110. Therefore, if the narrowed natural mouth is located in the vicinity of the balloon 110, the positional relationship between the balloon 110 and the constricted portion can be confirmed and the position can be adjusted.
  • the imaging unit 141 may be the balloon 110 in the inner tube 122.
  • the state of contact between the balloon 110 and the narrowed natural mouth can be observed from the insertion portion 127 of the lens. Therefore, it can be confirmed that the balloon 110 is arranged so that the natural mouth can be expanded, and that the natural mouth is surely expanded by the balloon 110.
  • the shape of the protrusions 131 to 134 is desirably formed so as to match the side shape of the imaging unit 141.
  • the outer surface of the camera catheter 140 to which the imaging unit 141 is attached is formed in a cylindrical shape so that it can be easily inserted into the inner tube 122 or the like.
  • the protrusions 131 to 134 may form a concave curved surface at the part of the camera catheter 140 that contacts the imaging unit 141.
  • the imaging unit 141 can be directed in a desired direction while being stably held by the protrusions 131 to 134.
  • the imaging unit 141 is also disposed at the tip 130 of the balloon 110 as shown in FIG. Therefore, when the camera catheter 140 is pushed from the longitudinal direction proximal end side to the distal end side or from the distal end side to the proximal end side with a force of a certain level or more, the protrusions 131 to 134 are deformed so as to be crushed radially outward. The hardness of the protrusions 131 to 134 is adjusted so that 140 can move in the longitudinal direction.
  • a hub 161 is connected to the base end of the main body 120.
  • a holder 163 is attached to the hub 161, and an elastic member 162 is disposed between the hub 161 and the holder 163.
  • the hub 161 has a lumen 164, a recess 165, and a male screw 166.
  • the holder 163 has a female screw 167 and a protrusion 168.
  • the lumen 164 communicates with the outer tube 121 on the distal end side, and communicates with the pressure supply means 200 on the proximal end side.
  • the liquid or gas that expands the balloon 110 passes through the lumen 164 and the outer tube 121 and is supplied to the balloon 110, and passes through the outer tube 121 and the lumen 164 from the balloon 110 and is discharged to the pressure supply means 200.
  • Base ends of the outer tube 121 and the inner tube 122 are sealed with the hub 161 in a liquid-tight or air-tight manner.
  • the recess 165 is formed on the proximal end side of the hub 161.
  • the elastic member 162 is formed in an annular shape and is inserted into the recess 165 of the hub 161.
  • a camera catheter 140 or the like disposed inside the inner tube 122 can be inserted into the elastic member 162.
  • the female screw 167 provided on the holder 163 is tightened by the male screw 166 provided on the hub 161. Thereby, the protrusion 168 presses the elastic member 162 disposed between the hub 161 and the holder 163 in the longitudinal direction.
  • the male screw 166 and the female screw 167 are operated so as to loosen the tightening of the hub 161 and the holder 163, the amount of expansion of the elastic member 162 in the radial direction is reduced by the amount of the pressure on the elastic member 162 by the protrusion 168 weakening. Decrease (shrink). Therefore, the holding force of the camera catheter 140 by the elastic member 162 is weakened, and the fixation of the camera catheter 140 is released.
  • the hub 161 and the holder 163 are made of a thermoplastic resin such as polycarbonate, polyamide, polysulfone, polyarylate, methacrylate-butylene-styrene copolymer.
  • the elastic member 162 is made of, for example, silicone rubber or latex rubber.
  • the camera catheter 140 is disposed inside the inner tube 122 through the hub 161, the elastic member 162, and the holder 163.
  • the camera catheter 140 has an imaging unit 141 attached to the tip.
  • the imaging unit 141 includes an irradiation unit 142, a lens 144, an imaging device 145, a cable 146, and an optical fiber 143.
  • the irradiation unit 142 supplies light supplied from the light source 300 through the optical fiber 143 toward the imaging target.
  • the image sensor 145 detects visible light from the lens 144 and acquires an image.
  • the image sensor 145 is, for example, a CCD image sensor or a CMOS image sensor, but is not limited thereto.
  • the cable 146 transmits the image information or video information acquired by the imaging unit 141 to the display unit 400.
  • image information acquired at the distal end may be imaged by a CCD image sensor or a CMOS image sensor on the proximal end side using an image fiber.
  • FIG. 5A to 5D are views showing a state where a balloon is observed from the observation window
  • FIG. 6 is a view showing a state where the catheter according to the first embodiment enters the nasal cavity
  • 7 is a view showing a state in which the catheter is aligned with a narrowed natural mouth in the nasal cavity
  • FIG. 8 is a view showing a state in which the narrowed natural mouth in the nasal cavity is expanded by the catheter
  • FIG. It is a figure which shows the state which extracted from the nasal cavity.
  • contraction process which shrink
  • recovery process which collect
  • the imaging unit 141 is disposed at the distal end portion 130 of the balloon 110 in the inner tube 122 at the time of starting the procedure, and the position in the longitudinal direction is fixed by the hub 161, the elastic member 162, and the holder 163.
  • the operator advances the catheter 100 inserted into the nasal cavity N into the natural mouth E as shown in FIG.
  • the state of the imaging range can be visually recognized.
  • the video or image acquired by the imaging unit 141 is displayed on the display unit 400.
  • the surgeon advances the catheter 100 to the natural mouth E while confirming the image and the like, and inserts and arranges the balloon 110 into the natural mouth E as shown in FIG.
  • the visual recognition process is performed at a stage where the catheter 100 can be approached to the vicinity of the narrowed natural mouth E.
  • the operator loosens the tightening by the hub 161 and the holder 163 in the visual recognition process, and makes the camera catheter 140 movable in the longitudinal direction.
  • the surgeon pulls the imaging unit 141 toward the proximal end while checking the display unit 400 and moves it to the observation windows 123 and 124 or the observation window 125.
  • the imaging unit 141 passes through the projections 131 and 132 or the projections 133 and 134, the surgeon uses resistance on the hand side that the imaging unit 141 deforms the projections 131 and 132 or the projections 133 and 134. Therefore, the position of the imaging unit 141 can be recognized tactilely.
  • the operator may recognize the position of the imaging unit 141 by providing a scale on the proximal end side of the camera catheter 140.
  • the imaging unit 141 When the camera catheter 140 is moved and the imaging unit 141 is positioned at the protrusions 131 and 132, the imaging unit 141 is disposed at the proximal end 126 of the balloon 110 in the inner tube 122. In addition, when the imaging unit 141 is positioned at the protrusions 133 and 134, the imaging unit 141 is disposed in the insertion portion 127 of the balloon 110 in the inner tube 122.
  • the imaging unit 141 is rotated in the circumferential direction so that the imaging unit 141 is aligned with the observation windows 123 and 124 or the observation window 125. If the imaging unit 141 is directed toward the observation windows 123 and 124, as shown in FIG. 5A, a video or an image from the proximal end side to the distal end side of the balloon 110 can be acquired. The position of the balloon 110 and the natural mouth E can be adjusted.
  • the imaging unit 141 is directed to the observation window 125, it is possible to acquire a video or image directed radially outward from the inner tube 122, and whether the balloon 110 is arranged so that the narrowed natural mouth E can be expanded. Can be confirmed.
  • the observation window 125 is formed in the center in the longitudinal direction in the insertion portion 127 of the balloon 110, the center of the balloon 110 cannot be disposed in the vicinity of the narrowed natural mouth E as shown in FIG.
  • the position of the balloon 110 is adjusted while confirming the positional relationship between the balloon 110 and the narrowed natural mouth E by the display means 400.
  • the balloon 110 is expanded by the pressure supply means 200 in the expansion process.
  • the narrowed natural mouth E is expanded so that the pus accumulated on the back side of the natural mouth E can be removed.
  • the balloon 110 is deflated in the contraction process as shown in FIG. 5C, the catheter 100 is removed from the nasal cavity N as shown in FIG. 9 in the recovery process, and a separate suction tube is connected to the sinus cavity.
  • Recovery may be performed by inserting the camera catheter 140 into the inside, or the camera catheter 140 may be removed from the inner tube 122 of the balloon 110 and used as a suction lumen.
  • a suction pump or the like (not shown) is connected to the proximal end portion of the inner tube, and suction is performed.
  • a medical instrument equipped with an imaging unit In the expansion of a narrowed natural mouth, which is performed in the treatment of sinusitis, a medical instrument equipped with an imaging unit is inserted into a living body, and the natural mouth is expanded by a balloon or the like.
  • a medical instrument When a medical instrument is advanced to a natural mouth, it is necessary to attach an imaging unit to the tip of the medical instrument and grasp the medical instrument entry position.
  • the imaging unit captures the front of the medical instrument, the natural mouth cannot be accurately expanded by the balloon unless the positional relationship between the balloon and the natural mouth can be grasped.
  • the catheter 100 has a distal end portion that extends from the proximal end portion 126 of the balloon 110 beyond the balloon 110 along the longitudinal direction of the main body portion 120 inside the inner tube 122 constituting the main body portion 120.
  • An imaging unit 141 that can move forward and backward up to 130 is arranged.
  • the outer tube 121 and the inner tube 122 constituting the main body 120 have observation windows 123 and 124 for observing the direction in which the imaging unit 141 is directed.
  • the imaging unit 141 is disposed at the distal end portion 130 of the balloon 110 in the inner tube 122 that constitutes the main body unit 120, the front of the catheter 100 in the entry direction can be grasped.
  • the imaging unit 141 is disposed at the proximal end 126 of the balloon 110 in the inner tube 122 constituting the main body 120, the outer surface of the balloon 110 can be observed from the position through the observation windows 123 and 124. The positional relationship with the natural mouth E can be grasped. Therefore, since both the positional relationship between the balloon 110 and the natural mouth E and the forward direction in which the catheter 100 is advanced can be grasped, a procedure for expanding the natural mouth E can be performed accurately and quickly.
  • the catheter 100 includes the expandable balloon 110, the long and hollow main body 120 to which the balloon 110 is attached at the tip, and the main body 120 within the main body 120.
  • an imaging unit 141 arranged to be movable back and forth from the proximal end 126 of the balloon 110 to the distal end 130 beyond the balloon 110 along the longitudinal direction, and an outer tube 121 and an inner tube constituting the main body 120
  • Reference numeral 122 has observation windows 123 and 124 for observing the direction in which the imaging unit 141 is directed.
  • the imaging unit 141 forward and backward from the proximal end portion 126 of the balloon 110 to the distal end portion 130 beyond the balloon 110, the positional relationship between the balloon 110 and the natural mouth E is changed at the proximal end portion 126 through the observation windows 123 and 124.
  • the distal end portion 130 can observe the state in front of the approach direction in which the catheter 100 is advanced, and a procedure such as expanding the natural mouth E can be quickly performed.
  • the inner tube 122 constituting the main body 120 has protrusions 131 and 132 that hold the imaging unit 141 tilted toward the observation windows 123 and 124 at the proximal end 126 that is proximal to the balloon 110.
  • the observation windows 123 and 124 are provided in the proximal end portion 126 which is the proximal end side of the balloon 110 in the inner tube 122 constituting the main body portion 120.
  • the imaging unit 141 tilted toward the observation windows 123 and 124 by the projections 131 and 132, even on a camera with a relatively narrow viewing angle, the surface of the balloon 110 can be seen from the base end side of the balloon 110. The state can be confirmed, and the position of the balloon 110 and the natural mouth E can be adjusted.
  • the balloon 110 is transparent, and the inner tube 122 constituting the main body 120 has an insertion portion 127 through which the balloon 110 is inserted, and an observation window 125 for observing the direction in which the imaging unit 141 is directed at the insertion portion 127. ,have. Furthermore, the inner tube 122 has projections 133 and 134 that hold the imaging unit 141 tilted toward the observation window 125 in the insertion portion 127.
  • the imaging unit 141 tilted toward the observation window 125 by the projections 133 and 134, the situation of the living body located outside the balloon 110 can be visually recognized even with a camera with a narrow viewing angle. it can. Therefore, if the natural mouth E is located in the vicinity of the balloon 110, it can be confirmed whether the balloon 110 is disposed at a position where the narrowed natural mouth E can be expanded.
  • the protrusions 131 and 132 or the protrusions 133 and 134 are provided in pairs inside the inner tube 122 and are spaced apart in the longitudinal direction. Therefore, when the imaging unit 141 is tilted from the longitudinal direction, the imaging unit 141 can be pressed from two directions as well as from one direction to be held more firmly. Therefore, even when the distance between the imaging unit 141 and the inner wall of the inner tube 122 is relatively large, imaging can be performed while the imaging unit 141 is tilted in a desired direction and held more firmly.
  • the projecting parts 131 and 132 and the projecting parts 133 and 134 are formed in a concave curved surface at the contact portion with the imaging unit 141 in the camera catheter 140.
  • the camera catheter 140 to which the imaging unit 141 is attached is often formed with a cylindrical outer surface so that it can be easily inserted into the inner tube 122 or the like. Therefore, by forming the contact portions of the projections 131 to 134 with the imaging unit 141 into a concave curved surface, the projection unit 131 can be oriented in a desired direction while holding the imaging unit 141 more stably.
  • FIG. 10 is an enlarged cross-sectional view showing the vicinity of the balloon of the catheter according to the second embodiment.
  • the protrusions 131 to 134 are provided on the inner surface of the inner tube 122 constituting the main body 120, and the imaging unit 141 is held in an inclined state.
  • the imaging unit 141 is oriented as follows. May be.
  • symbol is attached
  • the protrusions 131 to 134 are provided on the inner surface of the inner tube 122 constituting the main body 120, but also the protrusions 131 and 133 on the outer surface of the distal end portion of the camera catheter 140 to which the imaging unit 141 is attached.
  • An engaging portion 147 is provided for engaging with.
  • the engaging portion 147 is provided at a part of the outer periphery of the side surface at the distal end portion of the camera catheter 140.
  • the engaging portion 147 is a protrusion.
  • 131 or the protrusion 133 is provided at a position to be engaged.
  • the engaging portion 147 may be provided with one or a plurality of protrusions having a fan-shaped cross section on the outer periphery of the distal end portion of the camera catheter 140 so as to contact the protrusions 131 and 133 on the outer periphery of the distal end portion of the camera catheter 140.
  • one or a plurality of protrusions having a polygonal cross section may be provided in the same part.
  • the engaging portion 147 on the outer periphery of the distal end portion of the camera catheter 140 to which the imaging unit 141 is attached, the protruding portion 131 or the protruding portion 133 and the engaging portion 147 are engaged in the longitudinal direction.
  • the holding position is difficult to shift in the longitudinal direction. Therefore, it is possible to more accurately grasp the positional relationship between the balloon 110 and the narrowed natural mouth E from the observation windows 123 and 124 or the observation window 125 by holding the imaging unit 141 more accurately at a desired position.
  • the catheter 100a according to the second embodiment is engaged with the protrusion 131 or the protrusion 133 of the inner tube 122 constituting the main body 120 at the distal end portion of the camera catheter 140 to which the imaging unit 141 is attached.
  • a portion 147 is provided. Therefore, the engaging portion 147 makes the holding position of the imaging unit 141 by the protrusions 131 and 132 or the protrusions 133 and 134 more difficult to shift in the longitudinal direction. Therefore, the positional relationship between the balloon 110 and the narrowed natural mouth E can be better understood from the observation windows 123 and 124 or the observation window 125.
  • Embodiment 1 the embodiment has been described in which the protrusions 131 to 134 are provided as a pair and spaced apart in the longitudinal direction, but the present invention is not limited to this. If the imaging unit 141 can be fixed, as shown in FIG. 11, the projection 132 is not provided, the projection 131 is provided at the proximal end 126 of the balloon 110 in the inner tube 122, the projection 134 is not provided, and the projection 133 is provided. You may make it provide in the insertion part 127 of the balloon 110. FIG.
  • protrusions are provided at the two locations of the proximal end portion 126 of the balloon and the insertion portion 127 of the balloon in the inner tube 122, any one may be provided.
  • a protruding portion 148 that protrudes radially outward due to the tilted reaction may be formed in a portion closer to the proximal end than the imaging unit 141, as shown in FIG. .
  • the imaging unit 141 is disposed on the protrusions 131 and 132, and in the vicinity of the protruding portion 148 when tilted toward the observation window 128, a protruding hole is provided. 135 may be provided.
  • the main body may be a single tube 137 instead of a double tube, and a tube 138 for expanding the balloon 110 may be connected to the balloon 110 separately from the main body 120.
  • the balloon 110 and the like can be imaged from the observation window 128 by tilting the imaging unit 141 disposed inside the single tube 137 while ensuring expansion of the balloon 110.
  • the projecting hole is formed inside the balloon 110 in the longitudinal direction of the single tube 137, a portion of the projecting hole is prevented so that the fluid filled in the balloon 110 does not leak from the projecting hole to the inner lumen of the inner tube 122.
  • a film-like soft member such as polyethylene, the airtightness of the balloon 110 can be secured, and the movable range of the protruding portion 148 of the imaging unit 141 can be expanded.
  • the imaging unit 141 is inclined even when the imaging unit 141 is substantially parallel to the axis of the main body 120. Can be imaged.
  • observation windows 123 to 125 are provided in the main body 120, and the projections may not be provided.
  • the observation is not performed directly from the observation windows 123 and 124 by the imaging unit 141, but is shown in FIG.
  • the image may be observed indirectly through an optical element 139 such as a lens, a mirror, or a prism.
  • an optical element 149 such as a mirror is attached to the imaging unit 141, and the balloon 110 is interposed via the optical element 149 in a state where the imaging unit 141 is disposed at the distal end portion 130 of the balloon 110 in the inner tube 122 as shown in FIG. May be observed.
  • the engaging unit 147 is a protrusion on the outer periphery of the distal end when the imaging unit 141 is tilted toward the observation windows 123 and 124 or the observation window 125.
  • the embodiment provided at the position where it abuts on 131 or the protrusion 133 has been described.
  • the protrusion is formed on the entire inner surface of the inner end 122 of the balloon 110 and the insertion portion 127 in the inner tube 122.
  • the joint portion may be provided all around the distal end portion of the imaging unit 141.
  • the embodiment has been described in which the protrusions 131 to 134 are formed in a concave curved surface as shown in FIG. 4 so that the contact portion with the imaging unit 141 is formed so as to match the outer surface of the imaging unit 141.
  • the shape may not match the shape of the outer surface of the imaging unit 141, for example, as a convex shape.
  • mucus such as runny nose from the living body may adhere to the observation window 123 of the outer tube 121. Therefore, water is supplied to the observation window 123 separately from the catheter 100, or a brush or the like is attached to the distal end portion. Thus, a catheter having a function of cleaning the observation window 123 may be disposed to clean the observation window 123.
  • the object to be imaged by the imaging unit 141 is not limited to the vicinity of the sinuses.
  • the inner wall or branching portion of a blood vessel, an artificial blood vessel, or a trachea may be observed, or plaque formed on the blood vessel wall may be observed to determine whether the color is stable or unstable.
  • CTO chronic total occlusion
  • the position of the microchannel, the position of the stent strut, the state of the heart valve, the insertion state of the coil into the aneurysm the drug when the drug is applied to the balloon surface It is also possible to observe a situation where the action acts on the in vivo tissue.
  • the balloon 110 has a function of expanding the stenosis, but various characteristics other than the above can be imparted.
  • the surface of the balloon may be subjected to a process of cutting a stenotic tissue (calcified lesions such as calcified lesions, plaques, blood clots, etc.).
  • the ablation treatment may be performed by using the balloon 110 as a hot balloon. In this case, it is possible to confirm the treatment unit that has performed the ablation treatment by the imaging unit 141.
  • non-compliant balloons and semi-compliant balloons are used for the balloon material, or a plurality of balloons are used, for example, as a guide for blood flow disruption or instrument insertion.
  • a stent / filter or the like disposed in the stenosis portion by expansion may be adhered to the balloon surface, and the balloon may be deflated and recovered.

Landscapes

  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Optics & Photonics (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Astronomy & Astrophysics (AREA)
  • General Physics & Mathematics (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Endoscopes (AREA)
  • Instruments For Viewing The Inside Of Hollow Bodies (AREA)

Abstract

La présente invention concerne un cathéter dont le positionnement puisse être effectué au niveau d'une sténose pendant l'observation d'un ballon, et de nature à permettre que la formation d'un champ de vision dans le sens antérieur de l'entrée du cathéter puisse être effectuée d'une manière claire. Le cathéter comporte : un corps dilatable (110) qui peut se dilater ; un corps principal (120) creux, allongé à la pointe duquel est fixé le corps dilatable ; et une unité d'imagerie (141) disposée de façon à pouvoir avancer et reculer dans le sens de la longueur du corps principal à l'intérieur du corps principal. L'unité d'imagerie peut avancer et reculer au moins à partir du côté d'extrémité de base (126) du corps dilatable vers le côté d'extrémité de pointe (130) au-delà du corps dilatable, et le corps principal comporte des fenêtres d'observation (123, 124) pour observer le sens dans lequel l'unité d'imagerie est orientée.
PCT/JP2013/079270 2012-11-08 2013-10-29 Cathéter WO2014073420A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2012246489A JP2016010419A (ja) 2012-11-08 2012-11-08 カテーテル
JP2012-246489 2012-11-08

Publications (1)

Publication Number Publication Date
WO2014073420A1 true WO2014073420A1 (fr) 2014-05-15

Family

ID=50684529

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2013/079270 WO2014073420A1 (fr) 2012-11-08 2013-10-29 Cathéter

Country Status (2)

Country Link
JP (1) JP2016010419A (fr)
WO (1) WO2014073420A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112138266A (zh) * 2020-09-03 2020-12-29 威海世创医疗科技有限公司 一种具有可视控制功能的宫颈球囊扩张导管

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH01135901U (fr) * 1988-03-11 1989-09-18
JP2008142346A (ja) * 2006-12-11 2008-06-26 Olympus Corp 蛍光内視鏡

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH01135901U (fr) * 1988-03-11 1989-09-18
JP2008142346A (ja) * 2006-12-11 2008-06-26 Olympus Corp 蛍光内視鏡

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112138266A (zh) * 2020-09-03 2020-12-29 威海世创医疗科技有限公司 一种具有可视控制功能的宫颈球囊扩张导管

Also Published As

Publication number Publication date
JP2016010419A (ja) 2016-01-21

Similar Documents

Publication Publication Date Title
US20130217964A1 (en) Expansion catheter
US10549076B2 (en) Uncinate process support for ethmoid infundibulum illumination
JP5932770B2 (ja) 耳鼻咽喉用治療装置
EP0402467A1 (fr) Tube de catheter et endoscope
US20120253123A1 (en) Otorhinolaryngological treatment device and method
WO1989000829A1 (fr) Tube de catheter
JP2018517451A (ja) ナビゲーションセンサを伴うガイドワイヤ
JP2758349B2 (ja) カテーテルチューブおよび内視鏡
WO2012132114A1 (fr) Dispositif de traitement oto-rhino-laryngologique
US20160045098A1 (en) Heart inner wall checking tool and device for checking heart inner wall
JP5347425B2 (ja) 血栓吸引カテーテル組立体
EP3048999A1 (fr) Éléments améliorés de préhension pour systèmes de traitement des sinus nasaux et paranasaux
US20150011827A1 (en) Medical treatment instrument
CN112790836A (zh) 一种球囊通道装置及手术通道搭建的方法
US9808603B2 (en) Medical instrument
WO2014073420A1 (fr) Cathéter
WO1989001755A1 (fr) Tube de catheter
WO2016040820A1 (fr) Support destiné à l'apophyse unciforme aux fins d'éclairage du canal naso-frontal
JP7463246B2 (ja) 内視鏡及び医療機器
WO2013089247A1 (fr) Cathéter d'expansion
US20080172010A1 (en) Disposable Endoscope Connector
WO2021075229A1 (fr) Bronchoscope et son procédé d'utilisation
CN115025373A (zh) 导管系统
JPH04261635A (ja) カテーテルチューブ
CN114176500A (zh) 球囊导管

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 13852888

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 13852888

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: JP