WO2020195134A1 - Cathéter d'extension - Google Patents

Cathéter d'extension Download PDF

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Publication number
WO2020195134A1
WO2020195134A1 PCT/JP2020/003217 JP2020003217W WO2020195134A1 WO 2020195134 A1 WO2020195134 A1 WO 2020195134A1 JP 2020003217 W JP2020003217 W JP 2020003217W WO 2020195134 A1 WO2020195134 A1 WO 2020195134A1
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WO
WIPO (PCT)
Prior art keywords
notch
mass
radiation opaque
outer layer
opaque substance
Prior art date
Application number
PCT/JP2020/003217
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English (en)
Japanese (ja)
Inventor
俊哉 木佐
雅之 平田
Original Assignee
株式会社カネカ
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Publication date
Application filed by 株式会社カネカ filed Critical 株式会社カネカ
Priority to JP2021508150A priority Critical patent/JPWO2020195134A1/ja
Publication of WO2020195134A1 publication Critical patent/WO2020195134A1/fr

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    • 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
    • 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
    • A61M25/06—Body-piercing guide needles or the like

Definitions

  • the present invention relates to an extension catheter.
  • ischemic heart disease such as angina and myocardial infarction
  • percutaneous coronary artery formation that dilates the narrowed part of the coronary artery of the heart and increases blood flow using an intravascular treatment device such as a stent or balloon.
  • Art is being performed.
  • the tip of the tubular guiding catheter is inserted into the entrance of the coronary artery and placed, and then the endovascular treatment device is delivered through the guiding catheter to insert the endovascular treatment device into the peripheral side of the coronary artery.
  • I was improving my sex.
  • the backup force is small and the indwelling is unstable, the tip of the guiding catheter may come off from the entrance of the coronary artery. In that case, the backup force was improved by inserting a small-diameter extension catheter into the guiding catheter and projecting it from the distal opening of the guiding catheter.
  • extension catheters for example, a proximal member including an extension portion of Patent Document 1, a collar member attached to the extension portion, and a distal sheath member attached to the collar member.
  • Guide extension catheters with are known.
  • a distal shaft forming the distal end side portion of Patent Document 2 and a proximal shaft forming the proximal end side portion are provided, and the proximal shaft is connected to the proximal end side portion of the distal shaft with a modified polyolefin adhesive.
  • support catheters There are known support catheters.
  • a coaxial guide catheter that can be delivered through the guide catheter by using the guide wire rail segment of Patent Document 3, the tip sheath of Patent Document 4, the proximal shaft, and the distal sheath on the proximal shaft.
  • Guide extension catheters are known that include a coupling member to be immobilized.
  • Patent Document 5 includes a balloon, an inner shaft joined to the tip of the balloon, a buffer film made of resin that covers the outer periphery of the inner shaft, and a metal that covers the outer periphery of the buffer film.
  • a balloon catheter including a metal marker composed of a metal marker and a marker portion composed of the marker portion is disclosed.
  • the position in the body is determined by X-ray fluoroscopy or the like.
  • a radiation opaque substance was used for confirmation.
  • an endovascular treatment device such as a stent or a balloon into an extension catheter in the body
  • the opening on the proximal side of the extension catheter has a notched shape such as a taper shape, the position of the opening is difficult to understand, and it is often difficult to insert an endovascular treatment instrument into the extension catheter.
  • the present invention has been made by paying attention to the above-mentioned problems, and an object of the present invention is to provide an extension catheter in which an endovascular treatment instrument can be easily inserted in the body.
  • the extension catheter according to the present invention that has been able to solve the above problems is as follows.
  • An extension catheter that can be inserted into a tubular catheter and protrudes from the distal opening of the tubular catheter. Equipped with a tubular member
  • the tubular member has a tubular portion having a shape in which the radial cross-sectional shape is continuous in the circumferential direction, and a tubular portion having a radial cross-sectional shape continuous in the circumferential direction on the proximal side of the tubular portion.
  • the tubular portion has a reinforcing portion provided with a reinforcing member and a non-reinforcing portion not provided with the reinforcing member proximal to the reinforcing portion.
  • the non-reinforcing portion is an extension catheter characterized by containing a first radiation opaque substance.
  • the notch has a first notch having a first notch surface having an angle formed by the tubular member with the axial direction of 90 ° or more and less than 175 °, and the first cut.
  • the extension catheter according to [1], wherein the notch contains a second radiation opaque substance.
  • the content (mass%) of the first radiation opaque substance in the outer layer of the non-reinforcing portion is 50% by mass or more and 90% by mass or less according to any one of [3] to [5].
  • Extension catheter. [7] The extension catheter according to [4] or [5], wherein the content (mass%) of the second radiation opaque substance in the outer layer of the first notch is 40% by mass or less.
  • the notch portion further forms a second notch portion having a second notch surface having an angle formed by the tubular member with the axial direction of ⁇ 5 ° or more and 5 ° or less.
  • the extension catheter according to any one of [2] to [8], which is provided proximal to the notch.
  • the extension catheter according to [10] The extension catheter according to [9], wherein the second notch portion contains a third radiation opaque substance.
  • the extension catheter according to any one of [3] to [7], which is 10% by mass or more higher than the content (mass%) of the radiation opaque substance.
  • a region not containing a radiation opaque substance is present in at least one portion selected from the group consisting of the reinforcing portion and the notched portion.
  • the extension catheter described. [16] The extension catheter according to any one of [1] to [15], wherein the first radiation opaque substance is at least one selected from the group consisting of tungsten and barium salt. [17] The extension catheter according to any one of [2] to [14] and [16], wherein the second radiation opaque substance is at least one selected from the group consisting of tungsten and barium salt. [18] The extension catheter according to any one of [10] to [12], wherein the third radiation opaque substance is at least one selected from the group consisting of tungsten and barium salt.
  • the present invention can provide an extension catheter in which an endovascular treatment instrument can be easily inserted in the body.
  • FIG. 1 is a side view of an extension catheter according to an embodiment of the present invention.
  • FIG. 2 is a sectional view taken along line II-II of FIG.
  • FIG. 3 is a sectional view taken along line III-III of FIG.
  • FIG. 4 is a sectional view taken along line IV-IV of FIG.
  • FIG. 5 is a sectional view taken along line VV of FIG.
  • FIG. 6 is an axial cross-sectional view of the R portion of FIG.
  • FIG. 7 is a diagram showing a state when the extension catheter according to the embodiment of the present invention is inserted into the tubular catheter and protrudes from the distal opening of the tubular catheter.
  • the extension catheter of the present invention is an extension catheter that is inserted into a tubular catheter and can protrude from an opening on the distal side of the tubular catheter, and includes a tubular member, and the tubular member is radial.
  • a tubular portion having a shape in which the cross-sectional shape is continuous in the circumferential direction and a notch portion having a shape in which the cross-sectional shape in the radial direction is not continuous in the circumferential direction on the proximal side of the tubular portion.
  • the tubular portion has a reinforcing portion provided with a reinforcing member and a non-reinforcing portion not provided with the reinforcing member proximal to the reinforcing portion, and the non-reinforcing portion is provided.
  • the section contains the first radiation opaque material.
  • the non-reinforcing portion of the tubular portion contains the first radiation opaque substance, the position of the non-reinforcing portion in the body such as under fluoroscopy can be easily confirmed. It is possible to easily grasp the position of the notch portion located on the proximal side of the non-reinforcing portion. As a result, it is possible to easily insert an endovascular treatment instrument such as a stent or a balloon into the extension catheter through the notch in the body.
  • containing the radioactive impermeable substance is not only when the radioactive impermeable substance is mixed and present in the non-reinforcing portion, but also when the radioactive impermeable substance is present independently on the surface of the non-reinforcing portion. Including the case of doing.
  • FIG. 1 is a side view of an extension catheter according to an embodiment of the present invention.
  • FIG. 2 is a sectional view taken along line II-II of FIG.
  • FIG. 3 is a sectional view taken along line III-III of FIG.
  • FIG. 4 is a sectional view taken along line IV-IV of FIG.
  • FIG. 5 is a sectional view taken along line VV of FIG.
  • FIG. 6 is an axial cross-sectional view of the R portion of FIG.
  • FIG. 7 is a diagram showing a state when the extension catheter according to the embodiment of the present invention is inserted into the tubular catheter and protrudes from the distal opening of the tubular catheter.
  • the extension catheter 30 is an extension catheter that can be inserted into a tubular catheter 40 as shown in FIG. 7, and can protrude from an opening a40 on the distal side of the tubular catheter 40, for example. Is.
  • the extension catheter 30 includes a tubular member 10.
  • the tubular member 10 has a tubular portion 4 and a notch portion 3 located proximal to the tubular portion 4.
  • the radial cross-sectional shape of the tubular portion 4 is a shape that is continuous in the circumferential direction as shown in FIGS. 2 and 5, that is, a shape in which at least the inner side surface of the tubular portion 4 is continuous.
  • the cross-sectional shape of the notch portion 3 in the radial direction is a shape that is not continuous in the circumferential direction as shown in FIG.
  • the tubular portion 4 is not provided with the reinforcing portion 6 provided with the reinforcing member 13 and the reinforcing member 13 proximal to the reinforcing portion 6. It has a non-reinforcing portion 5.
  • the non-reinforcing portion 5 of the tubular portion 4 contains a first radiation opaque substance.
  • the cutout portion 3 is a portion that is more difficult to confirm in the body than the tubular portion 4 due to the cutout portion, but the non-reinforcing portion 5 contains the first radiation opaque substance, so that the non-reinforcing portion 5 Since the radiation impermeableness of the non-reinforcing portion 5 becomes high, the non-reinforcing portion 5 can function as a mark. This makes it easier to grasp the position of the notch 3 proximal to the mark, so that an endovascular treatment instrument such as a stent or balloon is inserted into the extension catheter 30 through the notch 3 in the body. It can be made easier.
  • the proximal side means the direction toward the operator's hand side with respect to the extending direction of the extension catheter 30, and the direction opposite to the distal side, that is, the treatment. It means the direction of the target side.
  • the extension catheter 30 is inserted into the tubular catheter 40, for example, through the opening b40 on the proximal side of the tubular catheter 40 shown in FIG. 7.
  • the tubular catheter 40 has a distal end A40 and a proximal end B40, and the distal end A40 and the proximal end B40 are provided with openings a40 and b40, respectively.
  • the tubular catheter 40 may be a guiding catheter.
  • the extension catheter 30 has a distal end A30, and the distal end A30 of the extension catheter 30 is inserted through the proximal opening b40 of the tubular catheter 40. As shown in FIG.
  • the distal portion of the extension catheter 30 can be projected from the opening a40 on the distal side of the tubular catheter 40, or can be pulled back.
  • the extension catheter 30 is inserted into the tubular catheter 40 which is previously arranged in the body cavity, and the device passing through the tubular catheter 40 and the extension catheter 30 is made to reach the distal side in the body cavity. Used.
  • the inner diameter of the tubular catheter 40 is larger than the outer diameter of the extension catheter 30 in order to receive the extension catheter 30 into the lumen.
  • the extension catheter 30 preferably has a shape in which a tubular member 10 including a tubular portion 4 and a notch portion 3 on the distal side and a rod-shaped linear member 20 are connected. As shown in FIG.
  • the linear member 20 of the extension catheter 30 is preferably used without protruding from the opening a40 on the distal side of the tubular catheter 40.
  • the length of the extension catheter 30 can be, for example, 1500 mm, and the length of the tubular member 10 of the extension catheter 30 can be, for example, 350 mm.
  • the diameter of the distal end of the tubular member 10 of the extension catheter 30 can be, for example, 1.5 mm.
  • the device for treatment enters the tubular catheter 40 through the proximal opening b40 of the tubular catheter 40, enters the extension catheter 30 through the proximal opening of the extension catheter 30, and enters the extension catheter 30 distally. It can protrude from the opening a30 of.
  • the reinforcing portion 6 is a portion of the tubular portion 4 where the reinforcing member 13 is provided.
  • the reinforcing member 13 can easily improve the kink resistance of the tubular portion 4, that is, the bending resistance, and as a result, it is possible to easily hold the lumen of the tubular portion 4.
  • the reinforcing member 13 is not limited to the inside of the outer layer 12 of the tubular portion 4 described later, and may be provided in the inner layer 11 or between the inner layer 11 and the outer layer 12. Of these, if the reinforcing member 13 is provided in the outer layer 12, the kink resistance is likely to be improved. Therefore, it is preferable that the reinforcing member 13 is provided in the outer layer 12.
  • Examples of the material constituting the reinforcing member 13 include metal wire and fiber.
  • As the material constituting the metal wire for example, stainless steel, titanium, nickel-titanium alloy, cobalt-chromium alloy and the like, tungsten alloy and the like are preferable. Of these, stainless steel is more preferable.
  • the metal wire may be a single wire or a stranded wire.
  • Examples of the fiber include polyarylate fiber, aramid fiber, ultra-high molecular weight polyethylene fiber, PBO fiber, carbon fiber and the like.
  • the fibers may be monofilaments or multifilaments.
  • the shape of the reinforcing member 13 is not particularly limited, but a spiral shape, a mesh shape, or a braided shape is preferable. Of these, the braided shape tends to improve the kink resistance of the tubular portion 4, so that the shape of the reinforcing member 13 is more preferably braided.
  • the reinforcing member 13 may contain a radiation opaque substance in order to make it easier to confirm the position of the tubular portion 4 under fluoroscopy or the like.
  • a radiation opaque substance the first radiation opaque substance or the like described later can be referred to.
  • the non-reinforcing portion 5 is a portion of the tubular portion 4 located proximal to the reinforcing portion 6 and not provided with the reinforcing member 13.
  • the non-reinforcing portion 5 contains a first radiation opaque substance.
  • the first radiation opaque substance may be inorganic fine particles, as long as the position of the non-reinforcing portion 5 in the body can be easily understood under fluoroscopy or the like.
  • a material for the inorganic fine particles at least one selected from the group consisting of tungsten, barium salt, lead, barium, iodine, gold, platinum, iridium, platinum iridium alloy, stainless steel, titanium, cobalt-chromium alloy, palladium, and tantalum is selected.
  • at least one selected from the group consisting of tungsten, barium salt, lead, and tantalum is more preferable, at least one selected from the group consisting of tungsten and barium salt is further preferable, and tungsten is particularly preferable. ..
  • barium salt at least one selected from the group consisting of barium sulfate, barium carbonate, barium hydroxide, barium chloride, barium nitrate, and barium acetate is preferable. Of these, barium sulfate is more preferable.
  • the first radiation opaque substance preferably contains an element having an atomic number of 20 or more. Since the radiation opacity of a substance tends to increase as the atomic weight increases, the radiation opacity can be improved by containing an element having an atomic number of 20 or more. Therefore, the first radiation impermeable substance more preferably contains an element having an atomic number of 30 or more, and further preferably contains an element having an atomic number of 40 or more. On the other hand, the upper limit of the atomic number of the element contained in the first radiation opaque substance may be, for example, 82 or less, 79 or less, or 74 or less.
  • the average particle size of the first radiation opaque substance is preferably 100 nm or more and 100 ⁇ m or less.
  • the average particle size is more preferably 500 nm or more, still more preferably 1 ⁇ m or more.
  • the average particle size is more preferably 50 ⁇ m or less, still more preferably 20 ⁇ m or less.
  • D50 median size of particle size distribution
  • the non-reinforcing portion 5 preferably includes an inner layer 11 and an outer layer 12 as shown in FIGS. 2 and 6.
  • the first radiation opaque substance is preferably contained in the outer layer 12 of the non-reinforcing portion 5.
  • the position of the non-reinforcing portion 5 under fluoroscopy or the like becomes easy to understand, so that the position of the notch portion 3 located proximal to the non-reinforcing portion 5 can be easily grasped.
  • the inner layer 11 of the non-reinforcing portion 5 may also contain the first radiation opaque substance.
  • Resin can be mentioned as a material constituting the inner layer 11 of the non-reinforcing portion 5.
  • the resin for example, at least one selected from the group consisting of polyamide-based resin, polyester-based resin, polyurethane-based resin, polyolefin-based resin, fluorine-based resin, vinyl chloride-based resin, silicone-based resin, and natural rubber is preferable. Of these, at least one selected from the group consisting of polyester-based resins, polyolefin-based resins, fluororesins, silicone-based resins, and natural rubber is more preferable. Of these, fluororesins are particularly preferable because they are excellent in chemical resistance, non-adhesiveness, and low friction.
  • polyamide resin examples include nylon 12, nylon 12 elastomer, nylon 6, aromatic polyamide and the like.
  • polyester resin examples include polyethylene terephthalate and the like.
  • polyurethane-based resin examples include an aliphatic polyurethane containing an aliphatic isocyanate as a monomer unit and an aromatic polyurethane containing an aromatic isocyanate as a monomer unit.
  • polyolefin resin examples include polyethylene and polypropylene.
  • fluorine-based resin examples include polytetrafluoroethylene, ethylene tetrafluoroethylene, and fluorinated ethylene propylene. High-strength polytetrafluoroethylene is preferable as the polytetrafluoroethylene.
  • Examples of the vinyl chloride resin include polyvinyl chloride and polyvinylidene chloride.
  • Examples of the silicone-based resin include dimethylpolysiloxane, methylphenylpolysiloxane, methylvinylpolysiloxane, fluoroalkylmethylpolysiloxane, and the like.
  • Examples of natural rubber include latex and the like.
  • Resin can be mentioned as a material constituting the outer layer 12 of the non-reinforcing portion 5.
  • the resin for example, at least one selected from the group consisting of polyamide-based resin, polyester-based resin, polyurethane-based resin, polyolefin-based resin, fluorine-based resin, vinyl chloride-based resin, silicone-based resin, and natural rubber is preferable.
  • at least one selected from the group consisting of a polyamide resin, a polyurethane resin, and a polyolefin resin is more preferable, and at least one selected from the group consisting of a polyamide resin and a polyurethane resin is further preferable.
  • Polyurethane-based resins are even more preferred.
  • the outer surface S10 of the outer layer 12 of the non-reinforcing portion 5 is preferably coated with a hydrophilic polymer.
  • a hydrophilic polymer examples include hydrophilic polymers such as maleic anhydride copolymers such as poly2-hydroxyethyl methacrylate, polyacrylamide, polyvinylpyrrolidone, and methyl vinyl ether maleic anhydride copolymers.
  • the inner diameter of the non-reinforcing portion 5 is preferably 1.0 mm or more and 2.2 mm or less. Since the inner diameter of the non-reinforcing portion 5 is 2.2 mm or less, the shape of the non-reinforcing portion 5 is likely to be stable, so that the shape of the adjacent notch portion 3 is also easily stable. It is more preferably 2.0 mm or less, still more preferably 1.8 mm or less. On the other hand, by setting the inner diameter of the non-reinforcing portion 5 to 1.0 mm or more, the endovascular treatment instrument can easily pass through the non-reinforcing portion 5. It is more preferably 1.2 mm or more, still more preferably 1.4 mm or more.
  • the outer diameter of the non-reinforcing portion 5 is preferably 1.2 mm or more and 3 mm or less. When the outer diameter of the non-reinforcing portion 5 is 3 mm or less, the non-reinforcing portion 5 can be easily inserted into the guiding catheter or the blood vessel. It is more preferably 2 mm or less, still more preferably 1.8 mm or less. On the other hand, by setting the outer diameter of the non-reinforcing portion 5 to 1.2 mm or more, it is possible to easily improve the strength of the non-reinforcing portion 5. It is more preferably 1.4 mm or more, still more preferably 1.6 mm or more.
  • the non-reinforcing portion 5 preferably satisfies the following formula (1).
  • D ⁇ L 3 ⁇ 6D ...
  • L 3 indicates the axial length (mm) of the tubular portion 4 from the proximal end B5 to the distal end A5 of the non-reinforcing portion 5.
  • D indicates the outer diameter (mm) of the non-reinforced portion 5 at a position 1 mm away from the proximal end B5 of the non-reinforced portion 5 on the distal side.
  • the axial length L 3 of the cylindrical portion 4 from the proximal end B5 of unreinforced portion 5 to the distal end A5 is distally from the proximal end B5 of unreinforced portion 5
  • the outer diameter D or more of the non-reinforcing portion 5 it is preferable that the outer diameter D or more of the non-reinforcing portion 5 at a position separated by 1 mm.
  • L 3 is preferably 1.5 times or more of D, and more preferably 2 times or more of D.
  • L 3 is 6 times or less of D, it is possible to easily avoid deformation of the non-reinforcing portion 5.
  • L 3 is more preferably 4 times or less of D, and further preferably 3 times or less of D.
  • L 3 is preferably 0.5 mm or more and 8 mm or less, more preferably 2 mm or more and 6 mm or less, and further preferably 3 mm or more and 5 mm or less.
  • the notch portion 3 preferably has a first notch portion 1.
  • the first notched portion 1 has a first notched surface S1 and an outer surface S10.
  • the angle ⁇ 1 formed by the first cutout surface S1 and the axial direction X of the tubular member 10 is 90 ° or more and less than 175 °.
  • ⁇ 1 is more preferably 140 ° or less, still more preferably 130 ° or less, and even more preferably 120 ° or less.
  • ⁇ 1 is more preferably more than 90 °, still more preferably 95 ° or more, even more preferably 100 ° or more, and particularly preferably 110 ° or more.
  • the radial cross-sectional shape of the outer surface S10 of the first notch 1 is from a circular arc with a large central angle as shown in FIG. 3 from the distal side to the proximal side of the first notch 1. It is preferable that the change is continuous in a circular arc with a small central angle as shown in FIG. By continuously changing in this way, it is possible to facilitate insertion of the endovascular treatment instrument from the opening of the first notch portion 1.
  • the first notch portion 1 contains a second radiation opaque substance.
  • the second radiation opaque substance may be inorganic fine particles, as long as the position of the first notch 1 in the body can be easily understood under fluoroscopy or the like.
  • a material for the inorganic fine particles at least one selected from the group consisting of tungsten, barium salt, lead, barium, iodine, gold, platinum, iridium, platinum iridium alloy, stainless steel, titanium, cobalt-chromium alloy, palladium, and tantalum is selected.
  • at least one selected from the group consisting of tungsten, barium salt, lead and tantalum is more preferable, and even more preferably at least one selected from the group consisting of tungsten and barium salt, especially barium salt. preferable.
  • barium salt at least one selected from the group consisting of barium sulfate, barium carbonate, barium hydroxide, barium chloride, barium nitrate, and barium acetate is preferable. Of these, barium sulfate is more preferable as the barium salt.
  • the second radiation opaque substance may contain, for example, an element having an atomic number of 20 or more and an element having an atomic number of 30 or more, an element having an atomic number of 82 or less, an element having an atomic number of 79 or less, and an atomic number. May contain elements of 74 or less.
  • the average particle size of the second radiation opaque substance is preferably 100 nm or more and 100 ⁇ m or less.
  • the average particle size is more preferably 500 nm or more, still more preferably 1 ⁇ m or more.
  • the average particle size is more preferably 50 ⁇ m or less, still more preferably 20 ⁇ m or less.
  • D50 median size of particle size distribution
  • the second radiation opaque substance preferably has lower radiation opacity than the first radiation opaque substance. As a result, it is possible to facilitate the function as a mark for the first notched portion 1 of the non-reinforcing portion 5.
  • the same substance as the first radiation opaque substance may be used. In this case, if the content (mass%) of the first radiation opaque substance in the non-reinforcing portion 5 is made larger than the content (mass%) of the second radiation opaque substance in the first notch portion 1. Good.
  • the first cutout portion 1 includes an inner layer 11 and an outer layer 12 as shown in FIG.
  • the second radiation opaque substance is preferably contained in the outer layer 12 of the first notch portion 1. This makes it easier to understand the shape of the first notch portion 1 under fluoroscopy or the like. Further, the inner layer 11 of the first notch portion 1 may also contain a second radiation opaque substance.
  • the material constituting the inner layer 11 of the first notch portion 1 As the material constituting the inner layer 11 of the first notch portion 1, the material constituting the inner layer 11 of the non-reinforcing portion 5 can be referred to. Further, as the material constituting the outer layer 12 of the first notch portion 1, the material constituting the outer layer 12 of the non-reinforcing portion 5 can be referred to.
  • the first notch portion 1 preferably satisfies the following formula (2). 0.3D ⁇ D 1 ... (2)
  • D indicates the outer diameter (mm) of the non-reinforcing portion 5 at a position 1 mm away from the proximal end B5 of the non-reinforcing portion 5.
  • D 1 indicates the radial length at the proximal end B1 of the first notch 1.
  • the proximal end length D 1 of the radial direction in the B1 of the first cut-out portion 1 shown in FIG. 6, the outer non-reinforced portion 5 in 1mm away distally from the proximal end B5 of unreinforced portion 5 It is preferably 0.3 times or more the diameter D.
  • D 1 is more preferably 0.4 times or more of D.
  • D 1 is preferably 0.8 times or less of D.
  • D 1 is more preferably 0.7 times or less of D, and further preferably 0.6 times or less of D.
  • D 1 is preferably 0.2 mm or more and 2 mm or less, more preferably 0.5 mm or more and 1.5 mm or less, and further preferably 0.8 mm or more and 1.2 mm or less.
  • D is preferably 0.5 mm or more and 4 mm or less, more preferably 1 mm or more and 2 mm or less, and further preferably 1.4 mm or more and 1.8 mm or less.
  • L 1 is preferably 0.5 mm or more and 6 mm or less, more preferably 1 mm or more and 4 mm or less, and further preferably 1.5 mm or more and 3 mm or less.
  • Radial length H 1 between the farthest point F1 closest point N1 to the center axis C of the cylindrical portion 4 of the first notch surface S1 is preferably 0.1mm or more, 1.5 mm or less, more preferably Is 0.2 mm or more and 1 mm or less, more preferably 0.4 mm or more and 0.7 mm or less.
  • the content (mass%) of the first radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 is larger than the content (mass%) of the second radiation opaque substance in the outer layer 12 of the first notch portion 1. It is preferably 10% by mass or more. In this way, by increasing the content of the radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 than in the outer layer 12 of the first notch portion 1, the position of the non-reinforcing portion 5 in the body can be determined under fluoroscopy or the like. It can be easily confirmed. As a result, it is possible to easily exert the function as a mark for the first notched portion 1 of the non-reinforcing portion 5.
  • the content (mass%) of the first radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 is larger than the content (mass%) of the second radiation opaque substance in the outer layer 12 of the first notch portion 1. It is more preferably 20% by mass or more, and further preferably 30% by mass or more.
  • the upper limit of the difference in the content (mass%) is not particularly limited, but may be, for example, 70% by mass or less, 60% by mass or less, or 50% by mass or less.
  • the content (mass%) of the first radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 is preferably 50% by mass or more and 90% by mass or less.
  • the content (mass%) of the first radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 is 50% by mass or more, the position of the non-reinforcing portion 5 in the body can be easily understood under fluoroscopy or the like. be able to. Therefore, it is more preferably 55% by mass or more, further preferably 60% by mass or more, and even more preferably 65% by mass or more.
  • the content (mass%) of the first radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 is 90% by mass or less, the flexibility of the non-reinforcing portion 5 can be easily improved. It is more preferably 85% by mass or less, further preferably 80% by mass or less, and even more preferably 75% by mass or less.
  • the content (mass%) of the second radiation opaque substance in the outer layer 12 of the first notch portion 1 is preferably 40% by mass or less. As a result, it is possible to facilitate the function of the non-reinforcing portion 5 as a mark for the first notched portion 1. It is more preferably 35% by mass or less, still more preferably 30% by mass or less. On the other hand, by setting the content (mass%) of the second radiation opaque substance in the outer layer 12 of the first notch portion 1 to 5% by mass or more, it is easy to confirm the shape of the first notch portion 1. Can be done. It is preferably 5% by mass or more, more preferably 10% by mass or more, and further preferably 15% by mass or more.
  • the mass of the linear member 20 described later shall be excluded.
  • the non-reinforcing portion 5 includes a region having a higher radiation opacity than the first notched portion 1. As a result, it is possible to facilitate the function of the non-reinforcing portion 5 as a mark for the first notched portion 1. Further, it is preferable that the non-reinforcing portion 5 includes a region having a higher radiation opacity than the region on the distal side of the second notch portion 2 described later.
  • the first notch 1 does not contain a radiation opaque substance while the non-reinforcing portion 5 Is a method of containing a first radiation opaque substance
  • the first notch portion 1 contains a second radiation opaque substance
  • the non-reinforcing portion 5 is more radiation than the second radiation opaque substance.
  • Examples thereof include a method of containing a first radiation opaque substance having high opacity.
  • the strength of radiation opacity for example, using an X-ray opaque device (OEC9800 SUP9 MD) manufactured by GE Yokogawa Medical System Co., Ltd., a voltage of 48 kVp, a current amount of 0.64 mA, and a time of 0.
  • the strength of the radiation opacity can be determined by taking an X-ray image of the tubular member 10 under the condition of a dose of 0.25 mGy for 4 minutes and comparing the contrasts of the images.
  • the tubular member 10 has the linear member 20 described later, the region excluding the linear member 20 is measured.
  • the central portion P in the circumferential direction of the contact portion in contact with the first notch portion 1 and the shaft of the non-reinforcing portion 5
  • the non-reinforcing portion 5 is divided into two by the plane Q passing through the axial center O of the non-reinforcing portion 5, which is a plane perpendicular to the straight line connecting the center O, the non-reinforcing portion 5 having no central portion P
  • the content (mass%) of the first radiation opaque substance in the outer layer 12 is higher than the content (mass%) of the first radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 on which the central portion P is present.
  • Is also preferably as high as 10% by mass or more, more preferably as high as 20% by mass or more, and further preferably as high as 30% by mass or more.
  • the radiation opacity on the side where the central portion P does not exist, that is, on the opening side becomes high, so that the orientation of the first notch 1 under fluoroscopy or the like becomes easy to understand, and an endovascular treatment instrument is inserted. It can be made easier.
  • the upper limit of the difference in the content (% by mass) is not particularly limited, but may be, for example, 90% by mass or less, 80% by mass or less, or 60% by mass or less. ..
  • the central portion P in the circumferential direction of the contact portion in contact with the first notch portion 1 and the shaft of the non-reinforcing portion 5
  • the non-reinforcing portion 5 is divided into two by the plane Q passing through the axial center O of the non-reinforcing portion 5, which is a plane perpendicular to the straight line connecting the center O, the non-reinforcing portion 5 on which the central portion P exists
  • the outer layer 12 has a region that does not contain a radiation opaque substance. As a result, the orientation of the first notch portion 1 under fluoroscopy or the like becomes easy to understand, so that the endovascular treatment instrument can be easily inserted.
  • the notch portion 3 preferably has a second notch portion 2 proximal to the first notch portion 1.
  • the second notch portion 2 has a second notch surface S2 and an outer surface S10.
  • the angle ⁇ 2 (not shown) formed by the second cutout surface S2 and the axial direction X of the tubular member 10 is ⁇ 5 ° or more and 5 ° or less.
  • ⁇ 2 is ⁇ 5 ° or more and 5 ° or less.
  • the endovascular treatment instrument is opened along the second notch 2. It can be easily inserted into the portion. It is more preferably -3 ° or more and 3 ° or less, further preferably -2 ° or more and 2 ° or less, and even more preferably -1 ° or more and 1 ° or less.
  • the second notch portion 2 contains a third radiation opaque substance.
  • the third radiation opaque substance may be inorganic fine particles, as long as the position of the second notch 2 in the body can be easily understood under fluoroscopy or the like.
  • a material for the inorganic fine particles at least one selected from the group consisting of tungsten, barium salt, lead, barium, iodine, gold, platinum, iridium, platinum iridium alloy, stainless steel, titanium, cobalt-chromium alloy, palladium, and tantalum is selected.
  • At least one selected from the group consisting of tungsten, barium salt, lead, and tantalum is more preferable, at least one selected from the group consisting of tungsten and barium salt is further preferable, and tungsten is particularly preferable. ..
  • barium salt at least one selected from the group consisting of barium sulfate, barium carbonate, barium hydroxide, barium chloride, barium nitrate, and barium acetate is preferable. Of these, barium sulfate is more preferable as the barium salt.
  • the third radiation impermeable substance may contain, for example, an element having an atomic number of 20 or more and an element having an atomic number of 30 or more, an element having an atomic number of 82 or less, an element having an atomic number of 79 or less, and an atomic number. May contain elements of 74 or less.
  • the average particle size of the third radiation opaque substance is preferably 100 nm or more and 100 ⁇ m or less.
  • the average particle size is more preferably 500 nm or more, still more preferably 1 ⁇ m or more.
  • the average particle size is more preferably 50 ⁇ m or less, still more preferably 20 ⁇ m or less.
  • D50 median size of particle size distribution
  • the same substance as the first radiation opaque substance or the second radiation opaque substance may be used.
  • the strength of the radiation opacity in each part may be controlled by increasing or decreasing the content (mass%) of the radiation opaque substance in each part.
  • the second notch portion 2 preferably includes an inner layer 11 and an outer layer 12 as shown in FIG. It is preferable that the third radiation opaque substance is contained in the outer layer 12 of the second notch portion 2. This makes it easier to understand the position of the second notch portion 2 under fluoroscopy or the like. Further, the inner layer 11 of the second notch portion 2 may also contain a third radiation opaque substance.
  • the material constituting the inner layer 11 of the second notch portion 2 the material constituting the inner layer 11 of the non-reinforcing portion 5 can be referred to. Further, as the material constituting the outer layer 12 of the second notch portion 2, the material constituting the outer layer 12 of the non-reinforcing portion 5 can be referred to.
  • the second notch 2 (hereinafter, may be referred to as a proximal region of the second notch 2) from the proximal end B2 of the second notch 2 to a position 3 mm away from the distal side.
  • the content (mass%) of the third radiation opaque substance in the outer layer 12 of) is the second notch 2 (hereinafter referred to as the second) from a position 3 mm away to the distal end A2 of the second notch 2. 2 It is preferable that the content is 10% by mass or more higher than the content (mass%) of the third radiation opaque substance in the outer layer 12 of the notch 2 (sometimes referred to as the distal region). Since the second notch 2 is notched, it is difficult to confirm it in the body.
  • the second notch 2 is formed. 2 It is possible to easily confirm the position of the proximal end B2 of the notch portion 2. As a result, the endovascular treatment instrument can be easily inserted into the opening along the second notch 2. Therefore, the content (mass%) of the third radiation opaque substance in the outer layer 12 of the proximal region of the second notch 2 is the third in the outer layer 12 of the distal region of the second notch 2. It is more preferably 20% by mass or more higher than the content (mass%) of the radiation opaque substance, and further preferably 30% by mass or more. On the other hand, the upper limit of the difference in the content (mass%) is not particularly limited, but may be, for example, 90% by mass or less, 80% by mass or less, or 60% by mass or less. Good.
  • the content (mass%) of the third radiation opaque substance in the outer layer 12 of the proximal region of the second notch 2 is preferably 50% by mass or more and 90% by mass or less.
  • the content (mass%) of the third radiation opaque substance in the outer layer 12 in the proximal region of the second notch 2 is 50% by mass or more, the proximal end B2 of the second notch 2 It is possible to easily confirm the position of. Therefore, it is more preferably 55% by mass or more, further preferably 60% by mass or more, and even more preferably 65% by mass or more.
  • the upper limit of the content (mass%) of the third radiation opaque substance in the outer layer 12 in the proximal region of the second notch 2 is not particularly limited, but may be, for example, 90% by mass or less. It may be 85% by mass or less, 80% by mass or less, or 75% by mass or less.
  • the content (mass%) of the third radiation opaque substance in the outer layer 12 of the distal region of the second notch 2 is preferably 40% by mass or less.
  • the proximal region of the second notch 2 Can be facilitated to function as a marker for the proximal end B2. It is more preferably 35% by mass or less, still more preferably 30% by mass or less.
  • the shape of the second notch 2 can be changed. It can be easily confirmed. It is preferably 5% by mass or more, more preferably 10% by mass or more, and further preferably 15% by mass or more.
  • the content (% by mass) of the first radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 is the content of the third radiation opaque substance in the outer layer 12 of the distal region of the second notch portion 2. It is preferably 10% by mass or more higher than (% by mass). In this way, by increasing the content of the radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 than in the outer layer 12 of the distal region of the second notch portion 2, the function as a mark of the non-reinforcing portion 5 is provided. It can be easily exerted.
  • the content (% by mass) of the first radiation opaque substance in the outer layer 12 of the non-reinforcing portion 5 is the content of the third radiation opaque substance in the outer layer 12 of the distal region of the second notch portion 2. It is more preferably 20% by mass or more higher than (% by mass), and even more preferably 30% by mass or more.
  • the upper limit of the difference in the content (mass%) is not particularly limited, but may be, for example, 70% by mass or less, 60% by mass or less, or 50% by mass or less.
  • the second notch portion 2 preferably satisfies the following formula (3). 10D ⁇ L 2 ⁇ 200D ... (3)
  • D indicates the outer diameter (mm) of the non-reinforcing portion 5 at a position 1 mm away from the proximal end B5 of the non-reinforcing portion 5.
  • L 2 indicates the length (mm) of the tubular member 10 in the axial direction X from the distal end A2 of the second notch 2 to the proximal end B2 of the second notch 2.
  • the length L 2 in the axial direction X of the tubular member 10 from the distal end A2 of the second cut-out portion 2 to the proximal end B2 of the second cut-out section 2, the proximal end B5 of unreinforced portion 5 It is preferably 10 times or more the outer diameter D of the non-reinforcing portion 5 at a position 1 mm away from the distal side.
  • L 2 is more preferably 30 times or more the outer diameter D, and further preferably 60 times or more the outer diameter D.
  • L 2 is preferably 200 times or less the outer diameter D. Thereby, the flexibility of the linear member 20 can be improved.
  • L 2 is more preferably 120 times or less of the outer diameter D, and further preferably 90 times or less of the outer diameter D.
  • L 2 is preferably 5 cm or more and 20 cm or less, more preferably 10 cm or more and 18 cm or less, and further preferably 12 cm or more and 15 cm or less.
  • first notch portion 1 and the second notch portion 2 are adjacent to each other.
  • a third notch (not shown) may be provided between the first notch 1 and the second notch 2.
  • the third notched portion has a third notched surface and an outer surface. In this case, it is preferable that the first notch portion 1 and the third notch portion are adjacent to each other, and it is preferable that the third notch portion and the second notch portion 2 are adjacent to each other.
  • the angle ⁇ 3 (not shown) formed by the third cutout surface and the axial direction X is preferably 120 ° or more. As a result, it is possible to easily increase the opening area of the opening for inserting the endovascular treatment instrument. Therefore, ⁇ 3 is more preferably 130 ° or more, still more preferably 140 ° or more, and even more preferably 150 ° or more. On the other hand, the upper limit of ⁇ 3 may be, for example, 175 °, 170 °, or 168 °.
  • the axial length from the point farthest to the point closest to the central axis C of the tubular portion 4 of the third notched surface is preferably 0.5 mm or more, 6 mm or less, and more preferably 1 mm. It is 4 mm or less, more preferably 1.5 mm or more and 3 mm or less.
  • the radial length of the point closest to the central axis C and the point farthest from the central axis C of the tubular portion 4 of the third cutout surface is preferably 0.1 mm or more, 1.5 mm or less, more preferably. Is 0.2 mm or more and 1 mm or less, more preferably 0.4 mm or more and 0.7 mm or less.
  • At least one portion selected from the group consisting of the reinforcing portion 6 and the notched portion 3 has a region that does not contain a radiation opaque substance.
  • the reinforcing portion 6, the notch portion 3, the reinforcing portion 6 and the notch portion 3, the first notch portion 1, the second notch portion 2, the first notch portion 1 and the first 2 Radiation opaque to the notch 2, the reinforcing part 6 and the first notch 1, the reinforcing part 6 and the second notch 2, or the reinforcing part 6 and the first notch 1 and the second notch 2.
  • a region containing no substance can be mentioned.
  • the non-reinforcing portion 5 may also have a region that does not contain a radiation opaque substance.
  • the axial length from the distal end (not shown) to the proximal end (not shown) of the tubular portion 4 is preferably 10 cm or more and 50 cm or less, more preferably 20 cm or more and 40 cm or less, still more preferably. Is 25 cm or more and 35 cm or less.
  • a radiation opaque marker made of a radiation opaque substance may be provided near the distal end, the proximal end, or the like of the reinforcing member 13.
  • the length of the tubular member 10 of the radiation opaque marker in the axial direction X is preferably about 0.5 mm or more and 2 mm or less.
  • the shape of the radiation opaque marker is not particularly limited, and examples thereof include a band shape and a spiral shape.
  • the extension catheter 30 preferably includes a linear member 20 fixed to the tubular member 10 as shown in FIG.
  • the linear member 20 is a long wire rod.
  • the linear member 20 pushes the tubular member 10 to project the tubular member 10 from the opening of the tubular catheter (not shown).
  • the linear member 20 is preferably fixed to the outer layer 12 of the non-reinforcing portion 5 and the outer layer 12 of the notch portion 3.
  • the linear member 20 can be easily fixed firmly to the tubular member 10 having the tubular portion 4 and the notch portion 3. It is more preferable that the linear member 20 is fixed to the outer layer 12 of the reinforcing portion 6, the outer layer 12 of the non-reinforcing portion 5, and the outer layer 12 of the notch portion 3.
  • the linear member 20 is preferably made of metal.
  • the material constituting the linear member 20 for example, stainless steel, titanium, nickel-titanium alloy, cobalt-chromium alloy and the like, tungsten alloy and the like are preferable. Of these, stainless steel is more preferable.
  • the cross-sectional shape of the linear member 20 in the thickness direction is not limited to the shape shown in FIG. 2, and may be, for example, a square, a rectangle, a trapezoid, a circle, or the like. Of these, a rectangle is preferable.
  • the gripping member 21 is provided on the proximal side of the linear member 20.
  • the gripping member 21 is attached to the proximal end of the linear member 20 and is shaped so that the practitioner can grip it with a finger.
  • the material constituting the gripping member 21 include resins, and examples of the resin include polyolefin resins such as polyethylene and polypropylene.
  • a method for manufacturing the extension catheter 30 will be described.
  • a manufacturing method including a step of shrinking the heat-shrinkable tube to fix the linear member 20 to the tubular body and a step of forming a notched surface in the tubular body can be mentioned.
  • a resin tube may be put on the linear member 20, or the resin may be attached in a molten state by heating.
  • the linear member 20 By enclosing the linear member 20 and the tubular body with a heat-shrinkable tube and heating to shrink the heat-shrinkable tube to fix the linear member 20 to the tubular body, the linear member 20 can be easily fixed in the outer layer 12. can do.
  • a heat-shrinkable tube it is preferable to insert a metal core material into the cylinder, surround it with a heat-shrinkable tube, and heat it to shrink the heat-shrinkable tube.
  • the step of forming the notched surface on the cylinder includes the step of forming the first notched surface S1.
  • the first notched surface S1 for example, it may be formed so as to satisfy the angle ⁇ 1 formed by the axial direction X of the tubular member 10. Further, by forming the first cutout surface S1, it is possible to easily control the angle ⁇ 2 formed by the second cutout surface S2 with the axial direction X of the tubular member 10.
  • the step of forming the notched surface on the cylinder preferably includes a step of forming the second notched surface S2.
  • the tubular member 10 may be formed so as to satisfy the angle ⁇ 2 formed by the axial direction X.
  • a notch is made from the proximal side to the distal side of the first notch surface S1 to form the second notch surface S2, thereby forming a flat surface.
  • the second cutout surface S2 can be easily formed.
  • a notch may be made from the distal end of the first notch surface S1 toward the proximal side.
  • the first cutout surface S1 and the second cutout surface S2 can be formed by continuously making cuts.
  • a notch surface other than the first notch surface S1 and the second notch surface S2 may be formed. In forming these notched surfaces, a cutting tool such as a cutter may be used.
  • An extension catheter 30 including a tubular member 10 composed of a tubular portion 4 and a notch portion 3 and a linear member 20 fixed to the tubular member 10 by a step of forming a notched surface in the tubular body. Is obtained. Since it is easier to fix the linear member 20 to the cylinder before forming the notched surface, the step of forming the notched surface on the cylinder is after the step of fixing the linear member 20 to the cylinder. Is preferable.
  • the tubular body which is the basis of the tubular member 10
  • extrusion molding can be mentioned.
  • the tubular body may be manufactured by coextrusion molding in which the respective materials constituting the inner layer 11 and the outer layer 12 are extruded at the same time.
  • the outer layer cylinders corresponding to the respective parts of the outer layer 12 are sequentially covered on the surface of the inner layer 11 and then heated and cooled to provide the outer layer 12 to manufacture the cylinder. You may.
  • the method for manufacturing the tubular body include a manufacturing method including the following steps (i) to (v).
  • the inner layer is extruded using the resin for the inner layer.
  • a reinforcing member is put on the surface of the inner layer.
  • a predetermined amount of a predetermined radiation opaque substance is mixed with the resin for the outer layer to prepare resin pellets corresponding to each part of the outer layer. Using the obtained resin pellets for each part, each is extruded into a tubular shape.
  • the outer layer cylinders for each of the obtained parts are cut to a predetermined length, and are arranged so as to cover the inner layer and the surface of the reinforcing member in order.
  • V Cover the surface of the outer layer cylinder with a heat-shrinkable tube. Next, the heat-shrinkable tube is heat-shrinked while melting the outer layer cylinder by heating, and the outer layer is formed by cooling.

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

Abstract

La présente invention consiste à fournir un cathéter d'extension permettant d'insérer facilement un instrument thérapeutique endovasculaire dans un corps. Le cathéter d'extension peut être inséré dans un cathéter cylindrique et projeté à partir d'une ouverture distale du cathéter cylindrique, le cathéter d'extension comprenant : un élément cylindrique comprenant une partie cylindrique qui présente une forme de section transversale radiale continue en circonférence et une partie d'encoche située sur le côté proximal de la partie cylindrique et présentant une forme de section transversale radiale non continue en circonférence ; la partie cylindrique comprend une partie renforcée qui est constituée d'un élément de renforcement et une partie non renforcée qui se trouve sur le côté proximal de la partie renforcée et qui ne comprend pas d'élément de renforcement ; et la partie non renforcée contient un premier matériau imperméable aux rayonnements.
PCT/JP2020/003217 2019-03-26 2020-01-29 Cathéter d'extension WO2020195134A1 (fr)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022158417A1 (fr) * 2021-01-20 2022-07-28 テルモ株式会社 Cathéter

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2003038656A (ja) * 2001-07-31 2003-02-12 Hideji Suzuki 右冠状動脈用ガイドカテーテル
JP2007202979A (ja) * 2006-02-06 2007-08-16 Kaneka Corp 医療用ガイディングカテーテルチューブ
WO2011086758A1 (fr) * 2010-01-14 2011-07-21 株式会社グッドマン Ensemble cathéter
JP2016517320A (ja) * 2013-03-15 2016-06-16 キューエックスメディカル リミテッド ライアビリティ カンパニー ブースティングカテーテルおよび関連するシステムおよび方法

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2003038656A (ja) * 2001-07-31 2003-02-12 Hideji Suzuki 右冠状動脈用ガイドカテーテル
JP2007202979A (ja) * 2006-02-06 2007-08-16 Kaneka Corp 医療用ガイディングカテーテルチューブ
WO2011086758A1 (fr) * 2010-01-14 2011-07-21 株式会社グッドマン Ensemble cathéter
JP2016517320A (ja) * 2013-03-15 2016-06-16 キューエックスメディカル リミテッド ライアビリティ カンパニー ブースティングカテーテルおよび関連するシステムおよび方法

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022158417A1 (fr) * 2021-01-20 2022-07-28 テルモ株式会社 Cathéter

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