WO2021044923A1 - Cathéter - Google Patents

Cathéter Download PDF

Info

Publication number
WO2021044923A1
WO2021044923A1 PCT/JP2020/032186 JP2020032186W WO2021044923A1 WO 2021044923 A1 WO2021044923 A1 WO 2021044923A1 JP 2020032186 W JP2020032186 W JP 2020032186W WO 2021044923 A1 WO2021044923 A1 WO 2021044923A1
Authority
WO
WIPO (PCT)
Prior art keywords
curved
catheter
shaft
tip
artery
Prior art date
Application number
PCT/JP2020/032186
Other languages
English (en)
Japanese (ja)
Inventor
東　洋
雄一 日置
彩花 西出
佳之 齊藤
徹也 福岡
Original Assignee
テルモ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Priority to JP2021543717A priority Critical patent/JPWO2021044923A1/ja
Publication of WO2021044923A1 publication Critical patent/WO2021044923A1/fr

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • 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 a catheter inserted into a living lumen.
  • Catheters used in blood vessels with many branches and bends are provided with a highly lubricated surface coated with a hydrophilic polymer or the like on the outer surface of the catheter in order to reduce the frictional resistance between the outer surface of the catheter and the lumen of the living body.
  • Patent Document 1 describes a catheter in which a low-lubricating surface having low lubricity is provided on the inside of the curvature of a curved catheter and a high-lubricating surface is provided on the outside of the curvature.
  • a catheter provided with a low lubrication portion having a larger frictional resistance than the above is disclosed.
  • Patent Document 3 discloses a guiding catheter having a small outer diameter that engages with the coronary artery and subsequently reaches the periphery of the coronary artery.
  • Guiding catheters and angiographic catheters have a tip-shaped portion, and usually engage the cutting-edge portion of the tip-shaped portion with the coronary artery ostium.
  • the tip-shaped part is inserted into the coronary artery and the tip opening of the catheter is placed in front of the coronary artery lesion.
  • a high lubrication part is provided only on the inside of the curvature of the tip shape part so that it will not easily come off when the guiding catheter engages with the coronary artery ostium, even if the tip shape part is straightened to some extent with a guide wire, the coronary artery
  • the outer curved portion or the side surface is mainly in contact with the inner wall, and the effect of the highly lubricated surface inside the curved portion is not sufficiently exerted, and the frictional resistance between the inner wall of the coronary artery and the catheter increases.
  • An object of the present invention is to provide a catheter that can be engaged with the coronary artery ostium and that can shorten the procedure time by reducing the frictional resistance in the coronary artery and easily delivering it to the lesion.
  • a catheter having a tip and a proximal end, a shaft having a lumen that communicates from the distal end to the proximal end, and a hand portion, and the shaft has a distal end portion, an intermediate portion, and a base portion.
  • the shaft has a high lubrication surface and a low lubrication surface
  • the hand portion is connected to the base portion
  • the intermediate portion has at least one curved portion curved in one direction
  • the curved portion is the curved portion. It has a curved inner outer surface near the center of the curve, a curved outer outer surface far from the center of the curve, and a boundary region outer surface between the curved inner outer surface and the curved outer outer surface.
  • the catheter is characterized by having the high lubrication surface on at least a part of the catheter and having the low lubrication surface on at least a part of the curved inner outer surface or the curved outer outer surface.
  • the catheter according to the present invention has a highly lubricated surface on at least a part of the outer surface of the boundary region between the curved outer outer surface and the curved inner outer surface of the curved portion of the shaft of the catheter with respect to the central axis of the aorta. It has a large backup force for the blood vessel when it engages with the coronary artery that branches so as to be almost orthogonal to each other. Reduces frictional resistance with the tip shape of the catheter. Further, the difference in frictional resistance between the catheter and the inner surface of the blood vessel in contact with the catheter when moving forward and backward is reduced. This facilitates the operation of the catheter and shortens the procedure time.
  • FIG. 1A is a plan view of the catheter according to the first embodiment of the present invention.
  • FIG. 2A is a partial cross-sectional view of a perspective view of the shaft of FIG. 1
  • FIG. 2B is a cross-sectional view taken along the line AB of the curved portion.
  • FIG. 3 (A) is a schematic cross-sectional view in which the guiding catheter is engaged with the coronary artery ostium of the first embodiment of the present invention, and (B) shows the tip of the guiding catheter inside the coronary artery and the left anterior descending artery (left anterior descending artery).
  • FIG. 4 is a plan view of the catheter assembly according to the second embodiment of the present invention.
  • FIG. 5 is a plan view of a guiding catheter assembly using the catheter according to the second embodiment of the present invention as an inner catheter.
  • FIG. 6A is a schematic perspective partial cross-sectional view of the catheter shaft of FIG. 4, and
  • FIG. 6B is a cross-sectional view taken along the line AB of the curved portion.
  • FIG. 7 is a schematic cross-sectional view of the catheter assembly of the second embodiment of the present invention reaching the aorta.
  • FIG. 8 is a schematic cross-sectional view in which the catheter assembly of the second embodiment of the present invention is arranged in front of the lesion L.
  • 9 (A) is a plan view of a catheter according to a third embodiment of the present invention, and (B) is a DD'cross-sectional view of a kink-resistant protector and a shaft base.
  • FIG. 10A is a partial cross-sectional view of a perspective view of the shaft of FIG. 9, and FIG. 10B is a cross-sectional view taken along the line AB of the curved portion.
  • FIG. 11 (A) is a schematic cross-sectional view in which an angiographic catheter is advanced into the aorta of the third embodiment of the present invention and (B) is engaged with the celiac artery.
  • “advance” means advancing the catheter from the blood vessel insertion port to the target site
  • “backward” means returning the catheter to the blood vessel insertion port, that is, the hand side
  • “indwelling” means inserting the catheter into the blood vessel. It means to fix it as it is.
  • “Place on the outer surface at different positions on the circumference” means to place the two elements on the circumference without overlapping on the outer surface of the circular cross section of the catheter or hand.
  • the guiding catheter 100 of the present embodiment shown in FIG. 1 is configured as, for example, a guiding catheter that sends a balloon catheter or a stent delivery catheter for treating a stenosis or occlusion of a coronary artery to a lesion.
  • the guiding catheter 100 has a shaft 20 and a hand portion 10, and the shaft 20 is provided between a tip portion 4, a base portion 6, a tip portion 4 and a base portion 6, and is composed of an intermediate portion 5 having a curved portion 3. .. Further, the base portion 6 is connected to the hand portion 10, and the hand portion 10 specifically includes a hub 7 communicating with the lumen 24 of the shaft 20 and a kink-resistant protector 12 connected to the hub 7.
  • the shaft 20 has a highly lubricated surface 1 on at least a part of the boundary region outer surface 9 of the outer surface.
  • the curved portion 3 refers to a curved portion as shown in FIG. 2, which may be curved in one direction, and a plurality of curved portions having different bending radii are combined as a tip-shaped portion. Those having a straight portion in the middle, those having a plurality of curved portions curved in opposite directions, and those having a three-dimensional shape, and those in which most of the tip portion 4, the intermediate portion 5 and the base portion 6 are curved. Good.
  • the curved portion 3 of the guiding catheter 100 When the curved portion 3 of the guiding catheter 100 is placed horizontally on a flat XY reference surface 40 orthogonal to the vertical direction Z in a natural state, the curved portion 3 is in the same plane and the outer diameter is constant.
  • the plane 41 formed by the central axis CC'line of the lumen 24 of the curved portion 3 is located at a distance equal to the outer diameter of the curved portion 3 from the XY reference surface 40.
  • the center of curvature on the plane 41 is defined as the curvature center point A.
  • the curved portion 3 has a curved radius R which is a distance between the curved center point A and the central axis C when the curved portion 3 is left standing on a flat surface in a natural state.
  • R is 3 mm to 2000 mm, more preferably 10 mm to 300 mm, and may not be constant between the tip end and the base end of the curved portion 4, and may have a straight portion in a part thereof.
  • the shaft 20 has a straight base 6 like a normal guiding catheter, and the total length of the intermediate portion 5 including the curved portion 3 and the tip portion 4 is shorter than that of the base 6, but conversely.
  • the intermediate portion 5 including the curved portion 3 may be longer than the base portion 6, and the tip portion 4, the intermediate portion 5 and the base portion 6 may be curved in one direction.
  • the AC line drawn to the curved center point A and the arbitrary central axis C, and the curve radius R from the central axis C on the extension line of the AC line. Defines a curved outer reference point B separated by an equal distance.
  • the curved inner outer surface 7 refers to a region on the center side surrounded by two tangents drawn from the curved center point A to the circular cross section with respect to the circular cross section formed by the lines AB.
  • the curved outer outer surface 8 refers to a region outside the curved portion surrounded by two tangents drawn in a circular cross section from the curved outer reference point B.
  • the boundary region outer surface 9 refers to one or both of the regions between the curved inner outer surface 7 and the curved outer outer surface 8.
  • the shaft 20 is made of a flexible tubular body, and a cavity 24 is formed in the center of the shaft 20 over the entire length of the shaft 20.
  • the lumen 24 is open at the opening at the tip of the tip 4.
  • the tip portion 4 may be a soft chip 13 obtained by kneading a contrast medium and a resin, or may be a combination of a ring-shaped or coil-shaped marker at the tip portion and a tip flexible portion.
  • the high-lubricating surface 1 is a surface having a small frictional resistance to the inner surface of the blood vessel, and is coated with a hydrophilic or hydrophobic lubricating resin provided on the outer surface of the shaft 20, or is processed by embossing or the like on the outer surface. It means the one that has been given. More specifically, it refers to an uncoated portion near the base end of the catheter or a shaft 20 having a smaller frictional resistance to blood vessels than the outer surface of the unprocessed shaft 20.
  • the high lubrication surface 1 is formed in a planar shape along the long axis of the shaft 20.
  • the shape of the highly lubricated surface 1 is not limited to a planar shape, and if the frictional resistance to the blood vessel is small, the lubricating resin or the embossed surface is separated and arranged in a plurality of linear lines, or a dotted line. , Or a collection of dots.
  • the highly lubricated surface 1 is outside the outer surface at a different position on the long axis if at least one of the two boundary region outer surfaces 9 between the circumferential curved inner outer surface 7 and the curved outer outer surface 8 of the shaft 20.
  • a plurality may be arranged on the surface.
  • the high lubrication surface 1 may be provided on the curved inner outer surface 7 or the curved outer outer surface 8, but the height may be higher.
  • the low lubrication surface 2 is provided only on the boundary region outer surface 9 having two lubrication surfaces 1 and the low lubrication surface 2 is provided on the curved inner outer surface 7 and the curved outer outer surface 8.
  • the high lubrication surface 1 is provided on one of the curved medial outer surface 7 and the curved outer outer surface 8, when the catheter is advanced or retracted in the curved coronary artery, a difference in frictional resistance occurs between the advance and the retract.
  • the curved outer outer surface 8 mainly contacts the curved outer inner surface of the curved coronary artery, and when the catheter is retracted, the curved inner outer surface 7 is mainly formed. This is because it comes into contact with the curved medial inner surface of the curved coronary artery.
  • a balloon catheter or stent delivery catheter is projected from the most advanced opening of the guiding catheter engaged with the opening of the coronary artery, and in the coronary artery, the balloon or stent is advanced to the lesion while being exposed to reach the lesion. ..
  • DCB drug-coated balloons
  • DEB drug-reluting balloons
  • DES drug-eluting stents
  • the drug is released until the lesion reaches the lesion. It is preferable to project from the guiding catheter at the coronary artery lesion so that it is not unnecessarily released outside the lesion.
  • the lesion can be penetrated with a penetrating catheter or dilated with an atelectomy device such as a rotor blaster, and then the tip of the guiding catheter.
  • an atelectomy device such as a rotor blaster
  • the drug release part is placed in the lesion part by passing through the lesion part, and then the guiding catheter 100 is retracted to expose the drug release part, and balloon dilation or balloon expansion or The drug may be released into the lesion by stent placement.
  • the guiding catheter engaged with the coronary artery ostium is advanced into the flexed coronary artery as it is, in order to prevent intravascular dissection, the guiding catheter is repeatedly advanced and retracted along the GW, as shown in FIG. 3B. As shown, bring it to the front of the coronary artery lesion.
  • the coronary arteries are curved so as to spread toward the outside of the heart because they spread on the surface of the heart, which has a rounded three-dimensional shape.
  • the guiding catheter 100 when the guiding catheter 100 is advanced in the LAD, it is in contact with the curved outer surface of the LAD, and when the guiding catheter 100 is retracted, it is in contact with the curved inner surface of the LAD. If the high lubrication surface 1 is arranged only on one of the eights, the frictional resistance of the catheter when it is advanced and when it is retracted is different.
  • the highly lubricated surface 1 is made of a material that absorbs moisture and exhibits lubricity, and the thickness of the lubricating layer can be appropriately set within a range in which sufficient lubricity can be obtained. It can be in the range of 0.0001 mm to 0.02 mm.
  • the hydrophilic polymer constituting the highly lubricated surface 1 include polyvinylpyrrolidone, polyvinyl alcohol, polyethylene oxide polymer, cellulosic polymer, acrylamide polymer, hyaluronic acid, polyacrylic acid, maleic anhydride polymer, and water-soluble polymer. Sexual nylon and derivatives thereof can be mentioned.
  • these hydrophilic polymers are preferably crosslinked by adding an appropriate amount of a cross-linking agent or introducing an appropriate reactive functional group in order to firmly immobilize the outer layer 22 on the surface.
  • the low lubrication surface 2 refers to a surface having a large frictional resistance to the inner surface of the blood vessel, and includes an uncoated portion or an unprocessed outer surface of the catheter.
  • a polymer having a photocurable functional group is applied to the entire outer surface of the shaft 20, and a part is crosslinked, then a part is masked and the non-masking part is further irradiated with light to crosslink. May be formed to form a low lubrication surface 2 having a larger frictional resistance to the inner surface of the blood vessel than the masked portion.
  • the masking portion after removing the masking may be a high lubrication surface 1 having a small frictional resistance.
  • the shape of the low-lubricated surface 2 is not limited to a planar shape, and friction against the inner surface of the blood vessel rather than the high-lubricated surface 1 such as those arranged in a plurality of linear lines at intervals, dotted lines, or aggregates of dots. As long as the resistance is large, a plurality of them may be provided at different positions on the circumference.
  • the tip portion 4 of the shaft 20 is provided with a high lubrication surface 1 on the two boundary region outer surfaces 9 and a low lubrication surface 2 on the curved inner outer surface 7 and the curved outer outer surface 8. There is.
  • the length of the tip portion provided with the high lubrication surface 1 on at least the outer surface 9 of the boundary region is more than 0 mm and 500 mm or less, more preferably 10 mm or more and 300 mm or less, and more preferably 100 mm or more and 250 mm or less.
  • a portion that is more than 0 and 500 mm or less, preferably 50 or more and 250 mm or less in the direction from the base end of the shaft 20 to the tip end, and is composed of only the low lubrication surface 2 without providing the high lubrication surface 1 is included. There is. As a result, when the operator grips the shaft 20, it is easy to operate the shaft 20 without slipping.
  • the shaft 20 may be a single-layer resin tube having a cavity 24, but as shown in FIG. 2 (B), the shaft 20 has an inner layer 21 and an outer layer 22 in part, and a coil is wound or a blade structure is formed between the outer layers 22. It may have a reinforcing wire 23.
  • the ratio of the lengths L11 and L12 of the high lubrication surface 1 on the circumference of FIG. 2B and the lengths L21 and L22 of the low lubrication surface is arbitrary when expressed as (100 ⁇ (L11 + L12 / L11 + L12 + L21 + L22)%). However, it is 5 to 90%, more preferably 10 to 75%, still more preferably 20 to 45% with respect to the circumference (L11 + L12 + L21 + L22).
  • the sum may be L11 + L12, or when the width of the low lubrication surface 2 is small, it may be the distance between both ends of the high lubrication surface 1.
  • the guiding catheter 100 operates as shown in FIG. 3 below.
  • This guiding catheter 100 is used as a guiding catheter that punctures a leg artery, for example, the femoral artery, inserts it from an alternative artery, passes through the aorta, and is placed in the coronary artery.
  • it may be used as a guiding catheter that is pierced into an artery of the arm, for example, the radial artery, inserted from the radial artery, passed through the brachial artery, and placed from the aorta to the coronary artery.
  • the guiding catheter 100 may be used as a child catheter to be inserted into a parent catheter into which the guiding catheter 100 can be inserted, in addition to a catheter for delivering a balloon catheter or a stent delivery catheter to a lesion portion, and communicates from the tip to the proximal end. It may be a guiding catheter having a shaft having a lumen, or a rapid exchange type guiding catheter having an opening in the middle of the shaft.
  • an angiography catheter used as a parent catheter that supports a microcatheter penetrating a stenosis may be used.
  • the guiding catheter 100 may be a guiding catheter, a guiding sheath having a detachable hemostatic valve attached to a hub, a long sheath, an introducer sheath, a microcatheter, or a guide wire support catheter.
  • the catheter may be a balloon catheter, a stent delivery catheter, an atherectomy catheter, or a diagnostic imaging catheter.
  • a Judkinsleft-shaped guiding catheter having a curved portion 3 is inserted along a guide wire, and the catheter is engaged with the coronary artery ostium 32.
  • the hub 7 of the guiding catheter 100 is pushed in, and the curved portion 3 is extended along the guide wire 50 into the coronary artery ostium 32. invade.
  • the catheter 100 easily passes through the inner surface 33 of the coronary artery.
  • the tip of the guiding catheter 100 is placed in front of the lesion 34.
  • the coronary arteries are curved so as to spread toward the outside of the heart because they spread on the surface of the heart, which has a rounded three-dimensional shape.
  • FIG. 3C shows a state in which the guiding catheter 100 is in contact with the curved outer surface of the LAD when the guiding catheter 100 is advanced in the LAD, and the outer surface of one of the boundary regions and the inner wall of the coronary artery are in contact with each other.
  • a catheter having no shape at the tip can change the direction of the catheter tip by turning a hub at hand and applying torque, but the guiding catheter 100 having a tip shape is as thin as an inner diameter of about 2-4 mm. It is difficult to rotate the tip shape within the coronary artery.
  • the guiding catheter 100 When the guiding catheter 100 is retracted, it comes into contact with the curved inner surface of the LAD. Therefore, if the high lubrication surface 1 is arranged only on the outer surface 9 of the boundary region of the guiding catheter 100, the difference in frictional resistance between when the catheter is advanced and when the catheter is retracted becomes large. It becomes smaller.
  • the balloon catheter is delivered to the lesion through the lumen of the indwelling guiding catheter 100. Friction resistance occurs in the balloon when passing through a lesion such as a stenosis, and a reaction occurs when the balloon catheter is further advanced.
  • the low lubrication surface 2 of the curved outer outer surface 8 of the guiding catheter 100 supports the guiding catheter 100 at the aortic wall to prevent the guiding catheter 100 from being disengaged due to a backup force.
  • the hub 7 or the kink-resistant protector 12 is provided with a marker indicating the position or range of the boundary region outer surface 9, the position of the curved inner outer surface 7, that is, the highly lubricated surface 1 can be easily recognized, so that the procedure time is shortened. It is particularly preferable.
  • the ratio of the length of the highly lubricated surface of the shaft 20 (L11 + L12 / L11 + L12 + L21 + L22) and the ratio of the length of the marker (L11'+ L12'/ L11'+ L12'+ L21' + L22') in the kink protector 12 are the same.
  • the position and range of the high lubrication surface 1 are easy to understand.
  • the length of the marker may be the same as the length of the low lubrication surface 2 instead of the high lubrication surface 1, and as shown in FIG. 1, the marker 15 is the low lubrication surface 2 and the marker 15'is the high lubrication surface 1.
  • the low lubrication surface 2 may be composed of a region in which the lubrication performance is deteriorated by forming the film thickness of the high lubrication surface 1 thinner than the others. Further, the low lubrication surface 2 may be covered with a material having a higher coefficient of friction with respect to the inner surface of the blood vessel than the material constituting the high lubrication surface 1.
  • Examples of the biological lumen to be treated include digestive tract, lymphatic vessel, blood vessel, etc., but it is preferably a blood vessel and more preferably an artery.
  • Examples of arteries include head, arm, heart, aorta, various organs, and blood vessels of lower limbs.
  • the guiding catheter 100'of the present embodiment shown in FIG. 4 is configured as, for example, a guiding catheter that sends a balloon catheter or a stent delivery catheter for treating a stenosis or an occlusion of a lower limb artery to a lesion L.
  • the guiding catheter assembly 100 ′′ has an outer catheter used as a guiding catheter 100 ′ and a catheter 100 used as an inner catheter inserted into the lumen of the guiding catheter 100 ′.
  • the catheter 100 has a shaft 20 and a hand portion 10, and the shaft 20 is provided between a tip portion 4, a base portion 6, a tip portion 4 and a base portion 6, and is composed of an intermediate portion 5 having a curved portion 3. Further, the base portion 6 is connected to the hand portion 10, and the hand portion 10 specifically has a hub 7 communicating with the lumen 24 of the shaft 20.
  • the hub 7 is provided with a marker 13 to indicate the position of the high lubrication surface 1.
  • the guiding catheter 100' has a shaft 20'and a hand portion 10', the shaft 20'is connected to the base portion 6'to the hand portion 10', and the hand portion 10'is specifically the lumen of the shaft 20'. It has a hub 7'communicating with the hub 7'and an outer catheter 100' equipped with a kink-resistant protector 12'connected to the hub 7'.
  • the shaft 20 of the catheter 100 has a highly lubricated surface 1 on at least a part of the curved outer outer surface 8 of the intermediate portion 5 having the curved portion 3 on the outer surface.
  • the curved portion 3 refers to a curved portion as shown in FIG. 4, which may be curved in one direction, and a plurality of curved portions having different bending radii are combined as a tip-shaped portion. Those having a straight portion in the middle, those having a plurality of curved portions curved in opposite directions, and those having a three-dimensional shape, and those in which most of the tip portion 4, the intermediate portion 5 and the base portion 6 are curved. Good.
  • the curved portion 3 of the catheter 100 When the curved portion 3 of the catheter 100 is placed horizontally on a flat XY reference surface 40 orthogonal to the vertical direction Z in a natural state, the curved portion 3 is in the same plane and the outer diameter is constant.
  • the plane 41 formed by the central axis CC'line of the lumen 24 of the portion 3 is located at a distance equal to the outer diameter of the curved portion 3 from the XY reference surface 40.
  • the center of curvature on the plane 41 is defined as the curvature center point A.
  • the curved portion 3 has a curved radius R which is a distance between the curved center point A and the central axis C when the curved portion 3 is left standing on a flat surface in a natural state.
  • R is 3 mm to 2000 mm, more preferably 10 mm to 300 mm, and may not be constant between the tip end and the base end of the curved portion 4, and may have a straight portion in a part thereof.
  • the shaft 20 has a straight base 6 like a normal inner catheter, and the total length of the intermediate portion 5 including the curved portion 3 and the tip portion 4 is shorter than that of the base 6, but is curved on the contrary.
  • the intermediate portion 5 including the portion 3 may be longer than the base portion 6, and the tip portion 4, the intermediate portion 5 and the base portion 6 may be curved in one direction.
  • the AC line drawn to the curved center point A and the arbitrary central axis C, and the curve radius R from the central axis C on the extension line of the AC line. Defines a curved outer reference point B separated by an equal distance.
  • the curved inner outer surface 7 refers to a region on the center side surrounded by two tangents drawn from the curved center point A to the circular cross section with respect to the circular cross section formed by the lines AB.
  • the curved outer outer surface 8 refers to a region outside the curved portion surrounded by two tangents drawn in a circular cross section from the curved outer reference point B.
  • the boundary region outer surface 9 refers to one or both of the regions between the curved inner outer surface 7 and the curved outer outer surface 8.
  • the shaft 20 is made of a flexible tubular body, and a cavity 24 is formed in the center of the shaft 20 over the entire length of the shaft 20.
  • the lumen 24 is open at the opening at the tip of the tip 4.
  • the tip portion 4 may be a soft chip obtained by kneading a contrast medium and a resin, or may be a combination of a ring-shaped or coil-shaped X-ray contrast marker and a tip flexible portion at the tip portion.
  • the high-lubricating surface 1 is a surface having a small frictional resistance to the inner surface of the blood vessel, and is coated with a hydrophilic or hydrophobic lubricating resin provided on the outer surface of the shaft 20, or is processed by embossing or the like on the outer surface. It means the one that has been given. More specifically, it refers to an uncoated portion near the base end of the catheter or a shaft 20 having a smaller frictional resistance to blood vessels than the outer surface of the unprocessed shaft 20.
  • the high lubrication surface 1 is formed in a planar shape along the long axis of the shaft 20.
  • the shape of the highly lubricated surface 1 is not limited to a planar shape, and if the frictional resistance to the blood vessel is small, the lubricating resin or the embossed surface is separated and arranged in a plurality of linear lines, or a dotted line. , Or a collection of dots.
  • a plurality of high lubrication surfaces 1 may be arranged on the outer surface at different positions on the long axis as long as it is at least a part of the curved outer outer surface 8 on the circumference of the shaft 20.
  • the high lubrication surface 1 may be provided on the curved inner outer surface 7 or the boundary region outer surface 9, but it is high. It is more preferable that the lubrication surface 1 is provided only on the curved outer outer surface 8 and the low lubrication surface 2 is provided on the curved inner outer surface 7 and the boundary region outer surface 9.
  • the highly lubricated surface 1 is made of a material that absorbs moisture and exhibits lubricity, and the thickness of the lubricating layer can be appropriately set within a range in which sufficient lubricity can be obtained. It can be in the range of 0.0001 mm to 0.02 mm.
  • the hydrophilic polymer constituting the highly lubricated surface 1 include polyvinylpyrrolidone, polyvinyl alcohol, polyethylene oxide polymer, cellulosic polymer, acrylamide polymer, hyaluronic acid, polyacrylic acid, maleic anhydride polymer, and water-soluble polymer. Sexual nylon and derivatives thereof can be mentioned.
  • these hydrophilic polymers are preferably crosslinked by adding an appropriate amount of a cross-linking agent or introducing an appropriate reactive functional group in order to firmly immobilize the outer layer 22 on the surface.
  • the low lubrication surface 2 refers to a surface having a large frictional resistance to the inner surface of the blood vessel, and includes an uncoated portion or an unprocessed outer surface of the catheter.
  • a polymer having a photocurable functional group is applied to the entire outer surface of the shaft 20, and a part is crosslinked, then a part is masked and the non-masking part is further irradiated with light to crosslink. May be formed to form a low lubrication surface 2 having a larger frictional resistance to the inner surface of the blood vessel than the masked portion.
  • the masking portion after removing the masking may be a high lubrication surface 1 having a small frictional resistance.
  • the shape of the low-lubricated surface 2 is not limited to a planar shape, and friction against the inner surface of the blood vessel rather than the high-lubricated surface 1 such as a plurality of linearly arranged lines, dotted lines, or an aggregate of dots. As long as the resistance is large, a plurality of them may be provided at different positions on the circumference.
  • the tip portion 4 of the shaft 20 is provided with a high lubrication surface 1 on the curved outer outer surface 8 and a low lubrication surface 2 on the curved inner outer surface 7 and the boundary region outer surface 9.
  • the length of the tip portion provided with the highly lubricated surface 1 on at least the curved outer outer surface 8 is more than 0 mm and 500 mm or less, more preferably 10 mm or more and 300 mm or less, and more preferably 20 mm or more and 100 mm or less.
  • a portion that is more than 0 and 500 mm or less, preferably 50 mm or more and 250 mm or less in the direction from the base end of the shaft 20 to the tip end, and is composed of only the low lubrication surface 2 without providing the high lubrication surface 1 is included. There is. As a result, when the operator grips the shaft 20, it is easy to operate the shaft 20 without slipping.
  • the shaft 20 may be a single-layer resin tube having a cavity 24, but as shown in FIG. 6A, the shaft 20 has an inner layer 21 and an outer layer 22 in part, and is coiled or has a blade structure between the outer layers 22. It may have a reinforcing wire 23.
  • the ratio of the length L1 of the high lubrication surface 1 and the length L2 of the low lubrication surface on the circumference of FIG. 6B is optional when expressed as (100 ⁇ (L1 / L1 + L2)%). It is good, but it is 10 to 90%, more preferably 20 to 75%, still more preferably 30 to 45% with respect to the circumference (L1 + L2).
  • the low lubrication surface 2 is arranged between the high lubrication surfaces 1 and is high. If there are a plurality of lubrication surfaces 1 on the circumference, the sum may be L1, or if the width of the low lubrication surface 2 is small, the distance between both ends of the high lubrication surface 1 may be set.
  • the catheter 100 according to the second embodiment of the present invention operates as shown in FIGS. 7 and 8 below.
  • the catheter 100 pierces, for example, an arm artery, for example, the radial artery, is inserted through the radial artery, passes through the humerus artery, and is placed inside the guiding catheter assembly 100'' placed from the aorta to the lower extremity artery lesion. It may be used as a catheter.
  • the catheter 100 may be used as a child catheter to be inserted into a parent catheter into which the guiding catheter 100 can be inserted, in addition to a catheter for delivering a balloon catheter or a stent delivery catheter to the lesion L, and a lumen communicating from the tip to the base. It may be a guiding catheter having a shaft having a shaft, or a rapid exchange type guiding catheter having an opening in the middle of the shaft.
  • an angiography catheter used as a parent catheter that supports a microcatheter penetrating a stenosis may be used.
  • the guiding catheter 100 may be a guiding catheter, a guiding sheath having a detachable hemostatic valve attached to a hub, a long sheath, an introducer sheath, a microcatheter, or a guide wire support catheter.
  • the catheter may be a balloon catheter, a stent delivery catheter, an atherectomy catheter, or a diagnostic imaging catheter.
  • the tip opening of the catheter 100 inserted from the left radial artery 32 and curved along the guide wire 50 is directed toward the descending aorta 33, and the guide wire 50 advances to the descending aorta 33.
  • the guide wire 50 reaches the lower limb artery 34, and the guiding catheter assembly 100 ′′ reaches the left lower limb artery along the guide wire 50.
  • the guiding catheter assembly 100'' has a high lubrication surface 1 on the entire circumference due to frictional resistance when traveling in the blood vessel. It is almost the same as when the provided inner catheter is used.
  • the tip of the guiding catheter assembly 100 ′′ is easily placed in front of the lesion L.
  • the catheter 100 which is an inner catheter, is removed, and the balloon catheter is delivered to the lesion L through the lumen of the indwelling guiding catheter 100'. Friction resistance occurs in the balloon as it passes through the stenosis, and reaction occurs when the balloon catheter is further advanced.
  • the reaction causes unnecessary retreat of the guiding catheter 100'or a kickback phenomenon of coming out of the target blood vessel.
  • the hub 7 is provided with a marker 13 indicating the position or range of the curved outer outer surface 8, the position of the curved outer outer surface 8, that is, the highly lubricated surface 1 can be easily recognized, which shortens the procedure time and is particularly preferable. ..
  • the guiding catheter is used as an outer catheter, and an inner catheter having a curved portion is inserted into the lumen of the guiding catheter to obtain the inner catheter.
  • a guiding catheter assembly may be used in which the tip protrudes from the tip opening of the lateral catheter.
  • the medial catheter is removed and replaced with a therapeutic catheter such as a balloon catheter.
  • the removed medial catheter is not reinserted into the guiding catheter for use unless the guiding catheter is further advanced to treat another lesion. Therefore, if a high lubrication surface is provided on the entire circumference and the entire length of the inner catheter having a curved portion used in this way, the cost increases.
  • the catheter 100 is located between the curved outer outer surface 8, the curved inner outer surface 7, the curved outer outer surface 8 and the curved inner outer surface 7 of the shaft curved portion 3.
  • the boundary region outer surface 9 at least a part of the curved outer outer surface 8 has a high lubrication surface 1, and at least a part of the boundary region outer surface 8 and the curved inner outer surface 7 has a low lubrication surface 2.
  • a highly lubricated surface is provided on the curved outer outer surface of the tip of the curved inner catheter 100 mainly used when advancing, and the amount of the lubricating polymer used for forming the highly lubricated surface can be reduced to reduce the cost. it can.
  • the low lubrication surface 2 may be composed of a region in which the lubrication performance is deteriorated by forming the film thickness of the high lubrication surface 1 thinner than the others. Further, the low lubrication surface 2 may be covered with a material having a higher coefficient of friction with respect to the inner surface of the blood vessel than the material constituting the high lubrication surface 1.
  • Examples of the biological lumen to be treated include digestive tract, lymphatic vessel, blood vessel, etc., but it is preferably a blood vessel and more preferably an artery.
  • Examples of arteries include head, arm, heart, aorta, various organs, and blood vessels of lower limbs.
  • the angiography catheter 100 of the present embodiment shown in FIG. 9 is configured as, for example, an angiography catheter that injects a contrast medium or an embolic material into an artery of the liver.
  • the angiography catheter 100 has a shaft 20 and a hand portion 10, and the shaft 20 is provided between a tip portion 4, a base portion 6, a tip portion 4 and a base portion 6, and is composed of an intermediate portion 5 having a curved portion 3. .. Further, the base portion 6 is connected to the hand portion 10, and the hand portion 10 specifically includes a hub 7 communicating with the lumen 24 of the shaft 20 and a kink-resistant protector 12 connected to the hub 7.
  • the shaft 20 has a high lubrication surface 1 and a low lubrication surface 2 on at least a part of the outer surface.
  • the curved portion 3 means a curved portion as shown in FIG. 10, and may be curved in one direction.
  • the curved portion 3 of the angiographic catheter 100 When the curved portion 3 of the angiographic catheter 100 is placed horizontally on a flat XY reference plane 40 orthogonal to the vertical direction Z in a natural state, the curved portion 3 is in the same plane and the outer diameter is constant.
  • the plane 41 formed by the central axis CC'line of the lumen 24 of the curved portion 3 is located at a position equal to the outer diameter of the curved portion 3 from the XY reference surface 40.
  • the center of curvature on the plane 41 is defined as the curvature center point A.
  • the curved portion 3 has a curved radius R which is a distance between the curved center point A and the central axis C when the curved portion 3 is left standing on a flat surface in a natural state.
  • R is 3 mm to 2000 mm, more preferably 10 mm to 300 mm, and may not be constant between the tip end and the base end of the curved portion 4, and may have a straight portion in a part thereof.
  • the shaft 20 has a straight base 6 like a normal angiographic catheter, and the total length of the intermediate portion 5 including the curved portion 3 and the tip portion 4 is shorter than that of the base 6, but conversely.
  • the intermediate portion 5 including the curved portion 3 may be longer than the base portion 6.
  • the AC line drawn to the curved center point A and the arbitrary central axis C, and the curve radius R from the central axis C on the extension line of the AC line. Defines a curved outer reference point B separated by an equal distance.
  • the curved inner outer surface 7 refers to a region on the center side surrounded by two tangents drawn from the curved center point A to the circular cross section with respect to the circular cross section formed by the lines AB.
  • the curved outer outer surface 8 refers to a region outside the curved portion surrounded by two tangents drawn in a circular cross section from the curved outer reference point B.
  • the boundary region outer surface 9 refers to any of the regions between the curved inner outer surface 7 and the curved outer outer surface 8.
  • the shaft 20 is made of a flexible tubular body, and a cavity 24 is formed in the center of the shaft 20 over the entire length of the shaft 20.
  • the lumen 24 is open at the opening at the tip of the tip 4.
  • the tip portion 4 may be a soft chip 13 obtained by kneading a contrast medium and a resin, or may be a combination of a ring-shaped or coil-shaped marker at the tip portion and a tip flexible portion.
  • the high-lubricating surface 1 is a surface having a small frictional resistance with respect to the inner surface of the blood vessel, and is coated with a hydrophilic or hydrophobic lubricating resin provided on the outer surface of the shaft 20, or is processed by embossing or the like on the outer surface. The one that has been applied. More specifically, the frictional resistance to the blood vessel is smaller than that of the uncoated portion near the base end of the catheter or the outer surface of the unprocessed shaft 20.
  • the high lubrication surface 1 is formed in a planar shape along the long axis of the shaft 20.
  • the shape of the highly lubricated surface 1 is not limited to a planar shape, and if the frictional resistance to the blood vessel is small, the lubricating resin or the embossed surface is separated and arranged in a plurality of linear lines, or a dotted line. , Or a collection of dots.
  • a plurality of high lubrication surfaces 1 may be arranged on outer surfaces at different positions as long as they are curved inner outer surfaces 7 on the circumference of the shaft 20.
  • the high lubrication surface 1 may be provided on the boundary region outer surface 9 or the curved outer outer surface 8 at the tip.
  • a high lubrication surface 1 may be provided on the entire circumference, but the high lubrication surface 1 is provided only on the curved inner outer surface 7, and the low lubrication surface 2 is provided on the curved outer outer surface 8 or the boundary region outer surface 9. Is more preferable.
  • the reason is to prevent the catheter from being displaced due to unnecessary contact between the curved outer outer surface 8 or the boundary region outer surface 9 and the inner surface of the blood vessel.
  • the highly lubricated surface 1 is made of a material that absorbs moisture and exhibits lubricity, and the thickness of the lubricating layer can be appropriately set within a range in which sufficient lubricity can be obtained. It can be in the range of 0.0001 mm to 0.02 mm.
  • the hydrophilic polymer constituting the highly lubricated surface 1 include polyvinylpyrrolidone, polyvinyl alcohol, polyethylene oxide polymer, cellulosic polymer, acrylamide polymer, hyaluronic acid, polyacrylic acid, maleic anhydride polymer, and water-soluble polymer. Sexual nylon and derivatives thereof can be mentioned.
  • these hydrophilic polymers are preferably crosslinked by adding an appropriate amount of a cross-linking agent or introducing an appropriate reactive functional group in order to firmly immobilize the outer layer 22 on the surface.
  • the low lubrication surface 2 refers to a surface having a large frictional resistance to the inner surface of the blood vessel, and includes an uncoated portion or an unprocessed outer surface of the catheter.
  • a polymer having a photocurable functional group is applied to the entire outer surface of the shaft 20, and a part is crosslinked, then a part is masked and the non-masking part is further irradiated with light to crosslink. May be formed to form a low lubrication surface 2 having a larger frictional resistance to the inner surface of the blood vessel than the masked portion.
  • the masking portion after removing the masking may be a high lubrication surface 1 having a small frictional resistance.
  • the shape of the low-lubricated surface 2 is not limited to a planar shape, and friction against the inner surface of the blood vessel rather than the high-lubricated surface 1 such as a plurality of linearly arranged lines, dotted lines, or an aggregate of dots.
  • a plurality of shafts 20 may be provided at different positions on the circumference as long as they have a large resistance.
  • the tip portion 4 of the shaft 20 is not provided with the low lubrication surface 2 and is provided only with the high lubrication surface 1. Is provided all around the outer surface. This makes it easier for the angiographic catheter 100 to move through the bent blood vessel.
  • the length of the tip portion in which the low lubrication surface 2 is not provided and only the high lubrication surface 1 is provided on the entire outer circumference is more than 0 mm and 500 mm or less, more preferably 10 mm or more and 300 mm or less.
  • the elliptical curved portion 3 inverted by 180 degrees is provided with a highly lubricated surface 1 on at least a part of the curved inner outer surface 7, and when it comes into contact with the blood vessel bifurcation portion 33, The frictional resistance with the inner surface of the blood vessel is small, and it easily enters the celiac artery 32 from the aorta 31.
  • a portion that is more than 0 and 500 mm or less, preferably 50 or more and 250 mm or less in the direction from the base end of the shaft 20 to the tip end, and is composed of only the low lubrication surface 2 without providing the high lubrication surface 1 is included. There is. As a result, when the operator grips the shaft 20, it is easy to operate the shaft 20 without slipping.
  • the shaft 20 may be a single-layer resin tube having a cavity 24, but as shown in FIG. 10B, the shaft 20 has an inner layer 21 and an outer layer 22 in part, and is coiled or has a blade structure between the outer layers 22. It may have a reinforcing wire 23.
  • the ratio of the length L1 of the high lubrication surface 1 and the length L2 of the low lubrication surface on the circumference of FIG. 10B is arbitrary when expressed as (100 ⁇ (L1 / L1 + L2)%). It is good, but it is 10 to 90%, more preferably 20 to 75%, still more preferably 30 to 45% with respect to the circumference (L1 + L2).
  • the low lubrication surface 2 is arranged between the high lubrication surfaces 1 and is high. If there are a plurality of lubrication surfaces 1 on the circumference, the sum may be L1, or if the width of the low lubrication surface 2 is small, the distance between both ends of the high lubrication surface 1 may be set.
  • the angiographic catheter 100 according to the third embodiment of the present invention operates as shown in FIG. 11 below.
  • This angiographic catheter 100 is used as an angiographic catheter that pierces a leg artery, for example, the femoral artery, inserts it from the femoral artery, passes through the aorta, and is placed in the abdominal artery or the hepatic artery.
  • the angiography catheter is used as a parent catheter that supports a microcatheter that injects an embolic material or the like into the tumor part of the hepatic artery in addition to injecting a contrast medium for X-ray angiography.
  • the angiographic catheter 100 may be a guiding catheter, a guiding sheath having a detachable hemostatic valve attached to a hub, a long sheath, an introducer sheath, a microcatheter, or a guide wire support catheter.
  • it may be a balloon catheter, a stent delivery catheter, an atherectomy catheter, or a diagnostic imaging catheter.
  • an angiographic catheter having an elliptical curved portion 3 is inserted along the guide wire and placed in the vicinity of the celiac artery 32.
  • the hub 7 of the angiographic catheter 100 is pushed in, the curved portion 3 is extended along the guide wire 50, and the tip portion 4 and the curved portion 5 are connected to the celiac artery. Invade inside 32.
  • the reaction causes unnecessary retraction of the catheter or kickback phenomenon of coming out of the target blood vessel.
  • the curved outer outer surface 8 of the angiographic catheter 100 and the low-lubricating surface 2 of the boundary region outer surface 9 support the angiographic catheter 100 on the inner surface of the blood vessel, and the angiographic catheter 100 comes out of the peritoneal artery 32 due to the kickback phenomenon. To prevent.
  • the hub 7 or the kink-resistant protector 12 is provided with a marker indicating the position or range of the curved inner outer surface 7, the position of the curved inner outer surface 7, that is, the highly lubricated surface 1 can be easily recognized, so that the procedure time is shortened. It is particularly preferable.
  • the length of the marker may be the same as the length of the low lubrication surface 2 instead of the high lubrication surface 1.
  • the celiac artery 32 branches sharply with respect to the aorta 31, but an angiographic agent may be injected for liver cancer examination.
  • an angiographic catheter is inserted from the femoral artery of the foot, and an angiographic catheter having a shape at the tip is placed in the celiac artery 32.
  • the shape portion is inverted near the celiac artery 32, or the shape portion of the angiography catheter is once advanced to the heart side and then pulled back to the hand side to engage with the celiac artery 32. Therefore, the angiographic catheter is caught in the blood vessel and many operations are performed, so that the procedure time becomes long.
  • a highly lubricated surface coated with a lubricating polymer can be provided on the outer surface of the catheter to reduce frictional resistance and shorten the procedure time.
  • the angiographic catheter is pushed back by the reaction when the contrast medium is injected, and the position of the shape portion changes.
  • a highly lubricated surface is provided from the tip to the proximal end of the catheter, a kickback phenomenon may occur in which the catheter comes out of the celiac artery. When the kickback phenomenon occurs, it is necessary to return the position and engage the shape portion with the celiac artery again, which increases the procedure time.
  • the angiographic catheter 100 has a highly lubricated surface 1 on at least a part of the curved inner outer surface 7 inside the curved portion 3 of the shaft 20 of the catheter 100. Therefore, the frictional resistance between the inner surface of the blood vessel and the curved inner outer surface 7 is reduced when advancing through the celiac artery 32 extending at a sharp angle from the aorta 31. Further, the frictional resistance with the inner surface of the blood vessel that comes into contact with the catheter 100 when it retracts is reduced. This facilitates the operation of the catheter 100 and shortens the procedure time.
  • the low lubrication surface 2 may be composed of a region in which the lubrication performance is deteriorated by forming the film thickness of the high lubrication surface 1 thinner than the others. Further, the low lubrication surface 2 may be covered with a material having a higher coefficient of friction with respect to the inner surface of the blood vessel than the material constituting the high lubrication surface 1.
  • Examples of the biological lumen to be treated include digestive tract, lymphatic vessel, blood vessel, etc., but it is preferably a blood vessel and more preferably an artery.
  • Examples of arteries include head, arm, heart, aorta, various organs, and blood vessels of lower limbs.
  • a high lubrication surface 1 may be provided on the curved inner outer surface of a guiding catheter having a tip shape that engages with a coronary artery, and a low lubrication surface 2 may be provided on the entire circumference of the tip portion 4.
  • the catheter is introduced into the ulnar artery or the radial artery among the arteries of the arm, the radial artery is more preferable, and the radial artery is the conventional radial artery near the wrist as well as the more peripheral side. It may be the distal radial artery of the or the radial artery in the snuff box.

Landscapes

  • 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

Le problème décrit par la présente invention est de proposer un cathéter qui peut être positionné de manière appropriée de façon à faciliter son avancement, sa rétraction et sa mise en place dans un vaisseau sanguin incurvé et en empêchant un déplacement dû à un recul provoqué pendant le fonctionnement d'un dispositif de traitement. Selon l'invention, la solution porte sur un tube de cathéter 20 qui présente au moins partiellement une section incurvée. Une surface de lubrification élevée 1 et une surface de lubrification faible 2 ayant une plus grande résistance de frottement sur la surface interne d'un vaisseau sanguin que la surface de lubrification élevée 1 sont disposées sur la surface externe à la même position dans la direction d'axe long et dans des positions circonférentielles différentes. Ce cathéter est facilement introduit dans un vaisseau sanguin se ramifiant selon un angle aigu, empêche le déplacement d'une sonde-guide dû à un recul provoqué par l'injection d'un agent de contraste, et réduit le temps de manipulation.
PCT/JP2020/032186 2019-09-02 2020-08-26 Cathéter WO2021044923A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2021543717A JPWO2021044923A1 (fr) 2019-09-02 2020-08-26

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
JP2019-159835 2019-09-02
JP2019159835 2019-09-02
JP2020004108 2020-01-15
JP2020-004108 2020-01-15
JP2020-030234 2020-02-26
JP2020030234 2020-02-26

Publications (1)

Publication Number Publication Date
WO2021044923A1 true WO2021044923A1 (fr) 2021-03-11

Family

ID=74852471

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2020/032186 WO2021044923A1 (fr) 2019-09-02 2020-08-26 Cathéter

Country Status (2)

Country Link
JP (1) JPWO2021044923A1 (fr)
WO (1) WO2021044923A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024070960A1 (fr) * 2022-09-30 2024-04-04 テルモ株式会社 Cathéter et méthode de traitement l'utilisant

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6605049B1 (en) * 2000-12-21 2003-08-12 Advanced Cardiovascular Systems, Inc. Marking system and method for medical devices
JP2014124408A (ja) * 2012-12-27 2014-07-07 Asahi Intecc Co Ltd ガイドワイヤ
JP2015507964A (ja) * 2012-02-10 2015-03-16 ドラー テクノロジーズ， エル．エル．シー． 患者の鼻腔内治療を促進するためのシステムおよび装置
WO2015046148A1 (fr) * 2013-09-30 2015-04-02 テルモ株式会社 Cathéter
JP2015066331A (ja) * 2013-09-30 2015-04-13 テルモ株式会社 カテーテル
WO2017057389A1 (fr) * 2015-09-29 2017-04-06 テルモ株式会社 Élément allongé médical
US9782569B2 (en) * 2007-12-21 2017-10-10 Innovatech, Llc Marked precoated medical device and method of manufacturing same

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6605049B1 (en) * 2000-12-21 2003-08-12 Advanced Cardiovascular Systems, Inc. Marking system and method for medical devices
US9782569B2 (en) * 2007-12-21 2017-10-10 Innovatech, Llc Marked precoated medical device and method of manufacturing same
JP2015507964A (ja) * 2012-02-10 2015-03-16 ドラー テクノロジーズ， エル．エル．シー． 患者の鼻腔内治療を促進するためのシステムおよび装置
JP2014124408A (ja) * 2012-12-27 2014-07-07 Asahi Intecc Co Ltd ガイドワイヤ
WO2015046148A1 (fr) * 2013-09-30 2015-04-02 テルモ株式会社 Cathéter
JP2015066331A (ja) * 2013-09-30 2015-04-13 テルモ株式会社 カテーテル
WO2017057389A1 (fr) * 2015-09-29 2017-04-06 テルモ株式会社 Élément allongé médical

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024070960A1 (fr) * 2022-09-30 2024-04-04 テルモ株式会社 Cathéter et méthode de traitement l'utilisant

Also Published As

Publication number Publication date
JPWO2021044923A1 (fr) 2021-03-11

Similar Documents

Publication Publication Date Title
JP6920355B2 (ja) 溝付きプッシュ部材セグメントを備えるガイドエクステンションカテーテル
JP2019076526A (ja) 治療方法
JP2020114421A (ja) 経頸動脈アクセスのための方法およびデバイス
EP0702535B1 (fr) Dispositif d'application d'une prothese comportant une pointe de dilatation
US20210038869A1 (en) Cutting balloon and balloon catheter
US6080140A (en) Integral cerebro-vascular access system
JP2017209532A (ja) 複数の並行ガイドワイヤを有する医療用ガイドワイヤシステム
JP6537200B2 (ja) 血管内閉塞をバイパスするための変動可撓性を有する閉塞バイパス装置及び方法
JP2019076527A (ja) 治療方法
CN113993570B (zh) 导管
CA2675209A1 (fr) Tige de catheter a ballonnet a echange rapide et procede correspondant
US20160287845A1 (en) Catheter and treatment methods for lower leg ischemia
JP2019080750A (ja) 治療方法
JP2014230710A (ja) 治療方法
US8366664B2 (en) Agent delivery catheter having articulating arms
CN217661083U (zh) 一种切割球囊导管
WO2021044923A1 (fr) Cathéter
US20220062599A1 (en) Balloon Occlusion Catheter
WO2021246030A1 (fr) Cathéter et méthode de traitement
WO2020194907A1 (fr) Cathéter et méthode de traitement
WO2024070960A1 (fr) Cathéter et méthode de traitement l'utilisant
US20170080185A1 (en) System and procedure for placing a medical device proximate an ostial lesion using a catheter assembly
JP7312556B2 (ja) カテーテル
WO2022158417A1 (fr) Cathéter
WO2023157440A1 (fr) Dilatateur, ensemble cathéter et procédé d'actionnement d'ensemble cathéter

Legal Events

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

Ref document number: 20860156

Country of ref document: EP

Kind code of ref document: A1

ENP Entry into the national phase

Ref document number: 2021543717

Country of ref document: JP

Kind code of ref document: A

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 20860156

Country of ref document: EP

Kind code of ref document: A1