WO2019220612A1

WO2019220612A1 - Catheter

Info

Publication number: WO2019220612A1
Application number: PCT/JP2018/019242
Authority: WO
Inventors: 武治桂田
Original assignee: 朝日インテック株式会社
Priority date: 2018-05-18
Filing date: 2018-05-18
Publication date: 2019-11-21

Abstract

The purpose of the present invention is to provide a catheter capable of reducing the time for manipulation. In this catheter, a first tube part 13, a second tube part 14, and a third tube part 15 are configured such that when the first tube part 13 and the third tube part 15 are expanded in the radial direction, the first tuber part 13 is extended to at least the distal side in the axial direction and the third tube part 15 is extended to at least the proximal side in the axial direction. Accordingly, the second tube part 14 is contracted in the axial direction to cause an intermediate part 72 of a receiving member 70 to expand in the radial direction.

Description

catheter

The present invention relates to a catheter.

The following procedure is known as a technique for improving blood flow by removing a blockage that blocks a blood vessel, such as chronic total occlusion (CTO). First, an ante-side guide wire is inserted by an antegrade approach (an approach from the ante side) to form a gap in the CTO or a false cavity below the intima of the blood vessel. Next, a retro-side guide wire is inserted from the opposite side (peripheral side) of the CTO by a retrograde approach (approach from the retro side) and pushed into the formed CTO gap or into the pseudointima below the intima. As a result, the ante-side guide wire and the retro-side guide wire are brought into traffic.

On the other hand, a medical device having a triangular pyramid funnel at the tip is known as a medical device for easily transporting the ante side guide wire and the retro side guide wire. If this medical device is inserted from the ante side, the retro-side guide wire can be easily received by this funnel. (For example, refer to Patent Document 1).

US Patent Application Publication No. 2014/0025086

When using the above medical device for the above procedure, there are two steps consisting of a step of expanding the false lumen with a balloon catheter or the like, and a step of removing the balloon catheter or the like and then inserting the medical device into the expanded false lumen. A process is necessary, and the procedure time becomes long.

An object of the present invention is to provide a catheter that can shorten the procedure time.

The catheter of the present invention includes a first inner shaft, an outer shaft disposed on the outer periphery of the first inner shaft, and a cylindrical receiving member provided on the outer shaft. The outer shaft includes a shaft portion, a first tube portion whose base end is connected to a tip end of the shaft portion, and is configured to expand and contract in a radial direction, and a base end at the tip end of the first tube portion. A second tube portion connected and configured to contract in the axial direction; and a third tube portion configured to expand and contract in the radial direction with a proximal end connected to a distal end of the second tube portion. Have. The receiving member has a distal end portion, an intermediate portion, and a proximal end portion, the distal end portion is fixed to the distal end portion of the second tube portion, and the proximal end portion is a proximal end of the second tube portion. The intermediate part is configured to expand in the radial direction. An opening that communicates the inside and the outside of the second tube portion is formed in a portion of the second tube portion that faces the intermediate portion of the receiving member. A tip end of the first inner shaft is connected to the opening. The first tube portion, the second tube portion, and the third tube portion are configured such that when the first tube portion and the third tube portion expand in a radial direction, the first tube portion is at least an axial tip. The third tube portion extends at least toward the proximal end side in the axial direction, whereby the second tube portion contracts in the axial direction, and the intermediate portion of the receiving member has a diameter. It is configured to expand in the direction.

The receiving member may be a mesh member or a coil body.

The catheter may further include a second inner shaft and a distal tip connected to a distal end of the third tube portion of the outer shaft. The distal end of the second inner shaft may be connected to the proximal end of the distal tip or the distal end of the outer shaft.

The present invention can provide a catheter that can shorten the procedure time.

It is a general view of the catheter which concerns on 1st Embodiment, Comprising: The state which the 1st tube part and the 3rd tube part contracted is shown. It is sectional drawing of the front-end | tip part vicinity of the catheter which concerns on 1st Embodiment, Comprising: The state which the 1st tube part and the 3rd tube part expanded is shown. It is a partial cross section figure near the front-end | tip part of the catheter which concerns on 2nd Embodiment, Comprising: The 1st tube part and the 3rd tube part show the state which contracted. FIG. 4 shows a cross-sectional view of the catheter shown in FIG. 3 taken along line IV-IV. It is sectional drawing of the front-end | tip part vicinity of the catheter which concerns on 2nd Embodiment, Comprising: The state which the 1st tube part and the 3rd tube part expanded is shown. It is an external view near the front-end | tip part of the catheter which concerns on 3rd Embodiment, Comprising: The 1st tube part and the 3rd tube part show the state which contracted. It is an external view near the front-end | tip part of the catheter which concerns on 3rd Embodiment, Comprising: The 1st tube part and the 3rd tube part show the state expanded.

Hereinafter, the catheter according to the present embodiment will be described with reference to the drawings. The present embodiment is not limited to the form shown in the drawings.

In the present specification, the “ante-side guide wire” means a guide wire that is pushed forward to an operation site such as an occlusion site in a blood vessel prior to the catheter among the guide wires, and “retro-side guide wire”. The term “guide wire” means, for example, a guide wire that comes in the blood vessel from the distal end side of the catheter.

Further, in this specification, the “tip side (distal side)” refers to the side where the tip 30 is located in the longitudinal direction of the catheter 1. The “proximal side (proximal side)” refers to a side opposite to the tip side in the longitudinal direction. The “distal end” refers to the end portion on the distal end side in each member constituting the catheter 1, and the “proximal end” refers to the end portion on the proximal end side in each member constituting the catheter 1.

[First Embodiment]
A catheter 1 according to a first embodiment will be described with reference to the drawings.

FIG. 1 is an overall view of the catheter 1 according to the first embodiment, and shows a state in which the first tube portion 13 and the third tube portion 15 are contracted. FIG. 2 is a cross-sectional view of the vicinity of the distal end portion of the catheter 1 and shows a state where the first tube portion 13 and the third tube portion 15 are expanded.

As shown in FIG. 1, the catheter 1 includes an outer shaft 10, a hub 20, a distal tip 30, a first inner shaft 40, a second inner shaft 50, a reinforcing body 60, and a receiving member 70. Prepare.

The outer shaft 10 is a tubular member that defines an expansion lumen 10a through which a liquid such as a contrast medium or physiological saline flows. The outer shaft 10 includes a first shaft portion 11, a second shaft portion 12, a first tube portion 13, a second tube portion 14, and a third tube portion 15 that are arranged in order from the proximal end side.

The first shaft portion 11 is a metal tubular member called a hypotube, and defines a part of the expansion lumen 10a. A hub 20 is attached to the rear end of the first shaft portion 11. Although the material which comprises the 1st shaft part 11 is not specifically limited, Superelastic alloys, such as stainless steel (SUS304) and a Ni-Ti alloy, can be used.

The hub 20 is attached with an indeflator (not shown). A liquid such as a contrast medium and physiological saline is supplied from the indeflator (not shown) through the hub 20 to the expansion lumen 10a.

The second shaft portion 12 is a tubular member made of a resin material such as polyamide, polyamide elastomer, polyolefin, polyester, or polyester elastomer, and defines a part of the expansion lumen 10a. The distal end portion of the first shaft portion 11 is inserted and fixed (welded) to the proximal end portion of the second shaft portion 12. The base end portion of the second shaft portion 12 and the tip end portion of the first shaft portion 11 form a first opening portion 10b that opens toward the base end side. A second opening 12a is formed at an intermediate portion of the second shaft portion 12 between the distal end portion and the proximal end portion.

The first tube portion 13, the second tube portion 14, and the third tube portion 15 are tubular members made of a stretchable flexible resin material such as polyurethane or polyurethane elastomer, and a part of the expansion lumen 10a is used. Define. In this embodiment, the 1st tube part 13, the 2nd tube part 14, and the 3rd tube part 15 are comprised integrally.

The proximal end of the first tube portion 13 is fixed (welded) to the distal end of the second shaft portion 12. The first tube portion 13 is configured to expand and contract in the radial direction.

The 2nd tube part 14 is located in the front end side of the 1st tube part 13, and is comprised so that it may shrink | contract in the axial direction. A third opening portion 14 a is formed at an intermediate portion between the distal end portion and the proximal end portion of the second tube portion 14.

As will be described later, the retro side guide wire W2 is inserted into the retro lumen 41 of the first inner shaft 40 from the third opening 14a via the expanded receiving member 70 (see FIG. 2). That is, the third opening portion 14 a functions as an entrance of the retro lumen 41. Therefore, the third opening 14a is configured as wide as possible so that the retro-side guide wire W2 can be easily inserted. Specifically, the third opening portion 14 a is configured to extend over about a half circumference along the circumferential direction of the second tube portion 14.

In the present embodiment, only one third opening 14a is provided, but in addition to the third opening 14a, an intermediate portion between the distal end portion and the proximal end portion of the second tube portion 14 is provided. A configuration in which a plurality of other openings are provided may be employed. In this case, it is preferable that at least one of the plurality of other openings is arranged at a position facing the third opening 14a (an opposite position). Further, the expansion lumen 10 a is provided with a shaft for communicating a plurality of other openings with the retro lumen 41 of the first inner shaft 40.

The 3rd tube part 15 is located in the front end side of the 2nd tube part 14, and is comprised so that it may expand and contract in the radial direction. The first tube portion 13 and the third tube portion 15 are configured to be thinner than the second tube portion 14 so as to easily expand and contract in the radial direction.

In addition, the 1st tube part 13 and the 3rd tube part 15 expand in radial direction so that it may mention later (refer FIG. 2). At this time, the first tube portion 13 extends at least toward the distal end side (second tube portion 14 side) in the axial direction, and the third tube portion 15 extends at least on the proximal end side (second tube portion 14 in the axial direction). Side). As a result, the second tube portion 14 contracts in the axial direction, and the distal end portion 71 and the proximal end portion 73 of the receiving member 70 approach each other, whereby the intermediate portion 72 of the receiving member 70 expands in the radial direction. Therefore, in this embodiment, although the 1st tube part 13, the 2nd tube part 14, and the 3rd tube part 15 are comprised integrally, the 2nd tube part 14 is constituted with the 1st tube part 13 and the 2nd tube. The material may be different from that of the portion 14, for example, a material that is flexible enough to absorb the elongation by being compressed and deformed by the expansion of the first tube portion 13 and the second tube portion 14.

The distal tip 30 is a tubular member made of a flexible resin such as polyurethane or polyurethane elastomer, and is fixed (welded) to the distal end of the third tube portion 15. The tip 30 is sharpened toward the tip side. The distal end of the third tube portion 15 is fixed to the inner periphery of the proximal end of the distal tip 30.

The first inner shaft 40 is a tubular member made of a resin such as polyethylene, polyurethane, polyamide, polyamide elastomer, polyolefin, polyester, or polyester elastomer, and has a retro lumen 41 for inserting the retro-side guide wire W2 therein. Define. The tip of the first inner shaft 40 is joined to the third opening 14 a of the second tube portion 14. The tip of the first inner shaft 40 has a shape corresponding to the third opening 14 a of the second tube portion 14. If there are a plurality of third openings 14a, a plurality of first inner shafts 40 are provided corresponding to the plurality of third openings 14a. The proximal end of the first inner shaft 40 is joined to the first opening 10 b formed by the proximal end portion of the second shaft portion 12 and the distal end portion of the first shaft portion 11. The first inner shaft 40 extends from the second tube portion 14 to the proximal end portion of the second shaft portion 12 (the distal end portion of the first shaft portion 11) in the expansion lumen 10a.

The second inner shaft 50 is a tubular member made of a resin such as polyethylene, polyurethane, polyamide, polyamide elastomer, polyolefin, polyester, or polyester elastomer, and has an anthermen 51 for inserting the antenna guide wire W1 therein. Define. The distal end of the second inner shaft 50 is joined to the proximal end of the distal tip 30. A base end of the second inner shaft 50 is joined to a second opening 12 a formed in the second shaft portion 12. The second inner shaft 50 extends from the proximal end of the distal tip 30 to the middle portion of the second shaft portion 12 in the expansion lumen 10a.

Markers

52, 53, and 54 are attached to the second inner shaft 50 near the distal end portion of the second shaft portion 12, and on the outer periphery at positions corresponding to the insides of the first tube portion 13 and the third tube portion 15. . The

markers

52, 53, 54 are made of a radiopaque material. For the

markers

52, 53, 54, when using a resin material, for example, a polyamide resin, a polyolefin resin, a polyester resin, a polyurethane resin, a silicone resin, a fluorine resin, etc., a radiopaque material such as bismuth trioxide, tungsten, barium sulfate, etc. In the case of using a metal material, for example, it may be formed of a radiopaque material such as gold, platinum, tungsten, or an alloy containing these elements (for example, a platinum nickel alloy). preferable.

The reinforcing body 60 is attached to the inner peripheral surface of the distal end portion of the first shaft portion 11 and extends toward the distal end. The reinforcing body 60 is a tapered metallic wire rod having a circular cross section and having a diameter reduced toward the tip. The material of the reinforcing body 60 is, for example, a superelastic alloy such as stainless steel (SUS304) or a Ni—Ti alloy.

The heel reinforcement 60 passes through the second shaft portion 12 and extends to the first tube portion 13. In FIG. 1, the tip of the reinforcing body 60 is not fixed to the outer shaft 10, the first inner shaft 40, or the second inner shaft 50, but is not limited thereto. For example, the end of the reinforcing body 60 may be fixed so as to be sandwiched between the outer shaft 10 and the first inner shaft 40 or the second inner shaft 50 or between the first inner shaft 40 and the second inner shaft 50. .

The receiving member 70 is a coil body made of a metal material (for example, stainless steel) and is wound around the outer periphery of the second tube portion 14. The receiving member 70 has a distal end portion 71, an intermediate portion 72, and a proximal end portion 73. The distal end portion 71 is fixed (welded) to the distal end portion of the second tube portion 14. The base end portion 73 is fixed (welded) to the base end portion of the second tube portion 14. The intermediate portion 72 is not fixed to the outer periphery of the second tube portion 14 and is configured to be expandable in the radial direction. The receiving member 70 may be made of a radiopaque material from the viewpoint of improving visibility. Examples of the radiopaque material include gold, platinum, tungsten, or an alloy containing these elements (for example, platinum nickel alloy). The radiopaque material may be a combination of the radiopaque material and a material other than this material, such as a material coated on the surface of a material that is not radiopaque.

Next, how the catheter 1 is used will be described.

First, the ante-side guide wire W1 is inserted into a blood vessel, for example, and pushed along the blood vessel to a site where an obstruction exists (hereinafter also referred to as “occlusion site”). After the distal end of the ante-side guide wire W1 reaches the occluded site, the proximal end of the ante-side guide wire W1 is inserted through the second inner shaft 50 via the distal tip 30, and the catheter 1 with the ante-side guide wire W1 as a guide. Push the tip of the tube to the occlusion site in the blood vessel.

After the distal end of the catheter 1 reaches the occluded site, a liquid such as a contrast medium or physiological saline is supplied to the expansion lumen 10a from the indeflator (not shown) via the hub 20. When the liquid is supplied, as shown in FIG. 2, the first tube portion 13 and the third tube portion 15 expand in the radial direction, and the outer peripheral surfaces of the first tube portion 13 and the third tube portion 15 are in the vicinity of the occlusion site. Squeeze out radially. At this time, the first tube portion 13 extends at least toward the distal end side (second tube portion 14 side) in the axial direction, and the third tube portion 15 extends at least on the proximal end side (second tube portion 14 in the axial direction). Side). Thereby, the 2nd tube part 14 shrinks to an axial direction, and when the front-end | tip part 71 and the base end part 73 of the receiving member 70 mutually approach, the intermediate part 72 of the receiving member 70 expands to radial direction.

Next, the retro-side guide wire W2 coming from the distal end side is received by the catheter 1. As a path to which the retro-side guide wire W2 is directed, for example, a false cavity in a blood vessel wall surrounding the occlusion site, a through-hole penetrating the occlusion site, and the like are assumed. W2 may be sufficient. The retro-side guide wire W2 is guided to the third opening 14a of the second tube portion 14 by the expanded intermediate portion 72, inserted through the first inner shaft 40, and delivered to the outside of the catheter 1 from the first opening 10b. Is done. Next, the retro-side guide wire W2 delivered from the first opening 10b passes through the blood vessel, and then the end is delivered out of the body. Thereby, it is possible to create a state in which the retro side guide wire W2 penetrates the occluded portion and both end portions of the retro side guide wire W2 are exposed to the outside of the body.

As described above, according to the catheter 1 described above, when the first tube portion 13 and the third tube portion 15 are expanded in the radial direction to spread the obstruction site, the second tube portion 14 contracts in the axial direction. The intermediate portion 72 of the receiving member 70 can be expanded in the radial direction. The retro-side guide wire W2 is guided from the third opening 14a to the first inner shaft 40 by receiving the retro-side guide wire W2 with the receiving member 70 in a state where the intermediate portion 72 of the receiving member 70 is radially expanded. be able to. Therefore, two steps consisting of a step of expanding the occlusion site with a balloon catheter or the like and a step of inserting the medical member for receiving the retro side guide wire W2 to the occlusion site after removing the balloon catheter or the like are combined into one step. Since it can be a process, the procedure time can be shortened.

Since the receiving member 70 is a coil body, it is possible to provide a member that receives the retro-side guide wire W2 with a simple configuration.

Since the distal end of the second inner shaft 50 is connected to the proximal end of the distal tip 30, the retro-side guide wire W2 received by the receiving member 70 in a state where the antenna-side guide wire W1 is passed through the second inner shaft 50. Can be passed through the first inner shaft 40. Therefore, it is possible to prevent the antenna side guide wire W1 and the retro side guide wire W2 from being entangled. Therefore, since the procedure can be performed efficiently, the procedure time can be shortened.

[Second Embodiment]
A catheter 101 according to a second embodiment will be described with reference to the drawings.

FIG. 3 is a partial cross-sectional view of the vicinity of the distal end portion of the catheter 101 according to the second embodiment, showing a state in which the first tube portion 113 and the third tube portion 115 are contracted. 4 shows a cross-sectional view of the catheter 101 shown in FIG. 3 taken along the line IV-IV. FIG. 5 is a cross-sectional view of the vicinity of the distal end portion of the catheter 101 and shows a state where the first tube portion 113 and the third tube portion 115 are expanded.

The catheter 101 includes an outer shaft 110, a hub 20 (not shown), a distal tip 30, a first inner shaft 40, a second inner shaft 50, a reinforcing body 60, and a receiving member 70. In the present embodiment, the configuration of the outer shaft 110 is different from the configuration of the outer shaft 10 of the first embodiment. The configuration of the hub 20 (not shown), the tip tip 30, the first inner shaft 40, the second inner shaft 50, the reinforcing body 60, and the receiving member 70 is the same as that of the first embodiment. The same reference numerals are given and the description is omitted.

The outer shaft 110 is a tubular member that defines an expansion lumen 110a through which a liquid such as a contrast medium or physiological saline flows. The outer shaft 110 has a first shaft portion 11 (not shown), a second shaft portion 12, a first tube portion 113, a second tube portion 114, and a third tube portion 115 arranged in order from the proximal end side. Have. Since the 1st shaft part 11 (not shown) and the 2nd shaft part 12 are the same structures as the thing of a 1st embodiment, the same numerals are attached and explanation is omitted.

The first tube portion 113 and the second tube portion 114 are tubular members made of a flexible resin material having elasticity such as polyurethane and polyurethane elastomer, respectively, and define a part of the expansion lumen 110a. Note that the second tube portion 114 may be made of a resin material that is more flexible than the first tube portion 113. The third tube portion 115 is a tubular member made of a resin material such as polyamide, polyamide elastomer, polyolefin, polyester, or polyester elastomer, and defines a part of the expansion lumen 110a. In this embodiment, the 1st tube part 113, the 2nd tube part 114, and the 3rd tube part 115 are comprised separately from each other.

The proximal end of the first tube portion 113 is fixed (welded) to the outer periphery of the distal end of the second shaft portion 12. The first tube portion 113 is configured to expand and contract in the radial direction.

The 2nd tube part 114 is located in the front end side of the 1st tube part 113, and is comprised so that it may shrink | contract in the axial direction. The proximal end of the second tube portion 114 is fixed (welded) to the outer periphery of the distal end of the first tube portion 113. A third opening 114 a is formed at an intermediate portion between the distal end portion and the proximal end portion of the second tube portion 114.

The 3rd tube part 115 is located in the front end side of the 2nd tube part 114, and is comprised so that it may expand and contract in the radial direction. The proximal end of the third tube portion 115 is fixed (welded) to the outer periphery of the distal end of the second tube portion 114. In FIG. 3, the external appearance of the third tube portion 115 is shown.

As shown in FIGS. 3 and 4, the third tube portion 115 is configured to be folded in a contracted state. The third tube portion 115 includes a cylindrical tube main body portion 116 and two wing portions 117. The two wing parts 117 are connected to the tube body part 116 at positions facing each other in the radial direction. As shown in FIG. 4, when the third tube portion 115 is contracted, the two wing portions 117 are folded along the outer periphery of the tube main body portion 116. When the liquid is supplied to the expansion lumen 110a, the wing portion 117 expands, and the third tube portion 115 expands so that the cross-sectional shape becomes an annular shape as a whole.

In the usage mode of the catheter 101 of the present embodiment, when the liquid is supplied to the expansion lumen 110a after the catheter 101 has advanced to the occlusion site via the ante side guide wire W1, as shown in FIG. The tube portion 113 and the third tube portion 115 expand in the radial direction, and the outer peripheral surfaces of the first tube portion 113 and the third tube portion 115 push the vicinity of the blocked site in the radial direction. At this time, the first tube portion 113 extends at least toward the distal end side in the axial direction (second tube portion 114 side), and the third tube portion 115 extends at least in the proximal end side in the axial direction (second tube portion 114). Side). As a result, the second tube portion 114 contracts in the axial direction, and the distal end portion 71 and the proximal end portion 73 of the receiving member 70 approach each other, whereby the intermediate portion 72 of the receiving member 70 expands in the radial direction.

The retro-side guide wire W2 is guided to the third opening 114a of the second tube portion 114 by the expanded intermediate portion 72, inserted through the first inner shaft 40, and delivered to the outside of the catheter 101 from the first opening 10b. Is done.

As described above, in this embodiment as well, in the same manner as the catheter 1 of the first embodiment, the step of expanding the occluded portion with a balloon catheter or the like and the removal of the balloon catheter or the like and then receiving the retro side guide wire W2 Since the two steps including the step of inserting the medical member up to the occlusion site can be made into one step, the procedure time can be shortened.

[Third Embodiment]
Next, a catheter 201 according to a third embodiment will be described with reference to the drawings.

FIG. 6 is an external view of the vicinity of the distal end portion of the catheter 201 according to the third embodiment, and shows a state in which the first tube portion 213 and the third tube portion 215 are contracted. FIG. 7 is an external view of the vicinity of the distal end portion of the catheter 201 according to the third embodiment, and shows a state where the first tube portion 213 and the third tube portion 215 are expanded.

The catheter 201 includes an outer shaft 210, a hub 20 (not shown), a tip 30, a first inner shaft 40, a second inner shaft 50, a reinforcing body 60 (not shown), a receiving member 270, Is provided. In the present embodiment, the configurations of the outer shaft 210 and the receiving member 270 are different from the configurations of the outer shaft 10 and the receiving member 70 of the first embodiment. The configuration of the hub 20 (not shown), the tip tip 30, the first inner shaft 40, the second inner shaft 50, and the reinforcing body 60 (not shown) is the same as that of the first embodiment. The same reference numerals are given and the description is omitted.

The outer shaft 210 is a tubular member that defines an expansion lumen 210a through which a liquid such as a contrast medium or physiological saline flows. The outer shaft 210 has a first shaft portion 11 (not shown), a second shaft portion 12, a first tube portion 213, a second tube portion 214, and a third tube portion 215 arranged in order from the base end side. Have. Since the 1st shaft part 11 (not shown) and the 2nd shaft part 12 are the same structures as the thing of a 1st embodiment, the same numerals are attached and explanation is omitted.

The first tube portion 213, the second tube portion 214, and the third tube portion 215 are tubular members made of a stretchable flexible resin material such as polyurethane and polyurethane elastomer, and a part of the expansion lumen 210a is formed. Define. In the present embodiment, the first tube portion 213, the second tube portion 214, and the third tube portion 215 are configured separately from each other.

The proximal end of the first tube portion 213 is fixed (welded) to the outer periphery of the distal end of the second shaft portion 12. The first tube portion 213 is configured to expand and contract in the radial direction.

The 2nd tube part 214 is located in the front end side of the 1st tube part 213, and is comprised so that it may shrink | contract in the axial direction. The proximal end of the second tube portion 214 is fixed (welded) to the outer periphery of the distal end of the first tube portion 213. A third opening 214a is formed at an intermediate portion of the second tube portion 214 between the distal end portion and the proximal end portion.

The third tube portion 215 is located on the distal end side of the second tube portion 214 and is configured to expand and contract in the radial direction. The proximal end of the third tube portion 215 is fixed (welded) to the outer periphery of the distal end of the second tube portion 214. The distal end of the third tube portion 215 is fixed (welded) to the outer periphery of the proximal end of the distal tip 30. The first tube portion 213 and the third tube portion 215 are configured to be thinner than the second tube portion 214 so as to easily expand and contract in the radial direction. The second tube portion 214 may be made of a resin material that is more flexible than the first tube portion 213 and the third tube portion 215.

The receiving member 270 is a mesh member in which a plurality of strands are knitted into a lattice shape to form a tube shape as a whole, and is disposed on the outer periphery of the second shaft portion 214. The receiving member 270 has a distal end portion 271, an intermediate portion 272, and a proximal end portion 273. The distal end portion 271 is fixed (welded) to the distal end portion of the second tube portion 214. The proximal end portion 273 is fixed (welded) to the proximal end portion of the second tube portion 214. The distal end of the distal end portion 271 is covered with the proximal end of the third tube portion 215. The proximal end of the proximal end portion 273 is covered with the distal end of the first tube portion 213. The intermediate portion 272 is not fixed to the outer periphery of the second tube portion 214 and is configured to be expandable in the radial direction.

Each wire of the receiving member 270 may be a single wire or a stranded wire obtained by twisting a plurality of strands. As a material constituting each element wire of the receiving member 270, a metal material or a resin material can be employed. Examples of the metal material include stainless steel such as SUS304, nickel titanium alloy, cobalt chrome alloy, and the like. Examples of the resin material include polyamide, polyester, polyacrylate, polyether ether ketone, and the like.

From the viewpoint of improving the visibility of the receiving member 270, the material constituting each strand of the receiving member 270 may be a radiopaque material. Examples of the radiopaque material include gold, platinum, tungsten, or an alloy containing these elements (for example, platinum nickel alloy). The radiopaque material may be a combination of the radiopaque material and a material other than this material, such as a material coated on the surface of a material that is not radiopaque.

The receiving member 270 is provided with a guide film 274. The distal end of the guide film 274 is located at a position facing the third opening 214 a of the intermediate portion 272 of the receiving member 270 or on the base end portion 273 side from the position. The guide film 274 smoothly guides the retro-side guide wire W2 received through the opening of the receiving member 270 toward the third opening 214a.

Examples of the material constituting the induction film 274 include polyethylene, polyurethane, polyamide, polyamide elastomer, polyolefin, polyester, polyester elastomer, and the like. The method of forming the guide film 274 is not particularly limited. For example, a dipping method is used for the guide film disposed on the receiving member 270, and a method of fusing the leading end of the film to the receiving member 270 is used for the film-like guide film. be able to.

In the usage mode of the catheter 201 of the present embodiment, when the liquid is supplied to the expansion lumen 210a after the catheter 201 has traveled to the occlusion site via the ante side guide wire W1, as shown in FIG. The tube portion 213 and the third tube portion 215 expand in the radial direction, and the outer peripheral surfaces of the first tube portion 213 and the third tube portion 215 push the vicinity of the closed site in the radial direction. At this time, the first tube portion 213 extends at least toward the distal end side (second tube portion 214 side) in the axial direction, and the third tube portion 215 extends at least on the proximal end side (second tube portion 214 in the axial direction). Side). Accordingly, the second tube portion 214 contracts in the axial direction, and the distal end portion 271 and the proximal end portion 273 of the receiving member 270 approach each other, whereby the intermediate portion 272 of the receiving member 270 expands in the radial direction. Thereby, the induction film 274 expands into a funnel shape.

The retro-side guide wire W2 is guided to the third opening 214a of the second tube portion 214 by the expanded intermediate portion 272 and the guide membrane 274, inserted through the first inner shaft 40, and from the first opening 10b to the catheter 201. Sent to outside.

In addition, this invention is not limited to the structure of embodiment mentioned above, is shown by the claim, and intends that all the changes within the meaning and range equivalent to a claim are included. Is done. A part of the configuration of the above-described embodiment may be deleted or replaced with another configuration, or another configuration may be added to the configuration of the above-described embodiment.

For example, the receiving member 70 that is the coil body of the first and second embodiments may be used in place of the receiving member 270 in the third embodiment. The receiving member 270 that is the mesh member of the third embodiment may be used in place of the receiving member 70 in the first and second embodiments. The third tube portion 115 of the second embodiment may be used in place of the third tube portion 215 in the third embodiment.

In the third embodiment, the guide film 274 is provided on the receiving member 270, but the guide film 274 may not be provided. A guide film may be provided on the receiving member 70 in the first and second embodiments.

1, 101, 201

Catheter

10, 110, 210 Outer shaft 11 First shaft portion
12 2nd shaft part 13,113,213 1st tube part 14,114,214

2nd tube part

14a, 214a Opening part 15,115,215 3rd tube part 40 1st inner shaft 50 2nd inner shaft 70,270 Receiving

members

71, 271

distal end

72, 272 intermediate 73, 273 proximal end

Claims

A first inner shaft;
An outer shaft disposed on an outer periphery of the first inner shaft;
A cylindrical receiving member provided on the outer shaft,
The outer shaft is
A shaft portion;
A first tube portion having a proximal end connected to a distal end of the shaft portion and configured to expand and contract in a radial direction;
A second tube portion configured to be proximally connected to a distal end of the first tube portion and contract in the axial direction;
A proximal end connected to the distal end of the second tube portion, and a third tube portion configured to expand and contract in the radial direction, and
The receiving member has a distal end portion, an intermediate portion, and a proximal end portion, the distal end portion is fixed to the distal end portion of the second tube portion, and the proximal end portion is a proximal end of the second tube portion. The intermediate portion is configured to expand in a radial direction,
An opening that communicates the inside and the outside of the second tube portion is formed in a portion of the second tube portion that faces the intermediate portion of the receiving member,
A tip of the first inner shaft is connected to the opening,
The first tube portion, the second tube portion, and the third tube portion are configured such that when the first tube portion and the third tube portion expand in a radial direction, the first tube portion is at least an axial tip. The third tube portion extends at least toward the proximal end side in the axial direction, whereby the second tube portion contracts in the axial direction, and the intermediate portion of the receiving member has a diameter. A catheter configured to expand in a direction.
The catheter according to claim 1, wherein the receiving member is a mesh member or a coil body.
A second inner shaft, and a tip connected to the tip of the third tube portion of the outer shaft;
The catheter according to claim 1 or 2, wherein a distal end of the second inner shaft is connected to a proximal end of the distal tip or a distal end of the outer shaft.