WO2021064825A1 - Catheter - Google Patents

Catheter Download PDF

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Publication number
WO2021064825A1
WO2021064825A1 PCT/JP2019/038625 JP2019038625W WO2021064825A1 WO 2021064825 A1 WO2021064825 A1 WO 2021064825A1 JP 2019038625 W JP2019038625 W JP 2019038625W WO 2021064825 A1 WO2021064825 A1 WO 2021064825A1
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WO
WIPO (PCT)
Prior art keywords
tip
mesh member
catheter
hollow shaft
wire
Prior art date
Application number
PCT/JP2019/038625
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French (fr)
Japanese (ja)
Inventor
啓介 川口
Original Assignee
朝日インテック株式会社
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 朝日インテック株式会社 filed Critical 朝日インテック株式会社
Priority to PCT/JP2019/038625 priority Critical patent/WO2021064825A1/en
Priority to JP2021550778A priority patent/JPWO2021064825A1/ja
Publication of WO2021064825A1 publication Critical patent/WO2021064825A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes

Definitions

  • the present invention relates to a catheter.
  • CTO chronic complete occlusion
  • a catheter that captures a retrograde guide wire via a mesh member is known.
  • the catheter is transported to the occlusion site by, for example, inserting an anterograde guide wire previously inserted into a blood vessel through the guide tube of the catheter, and then retrograde after the anterograde guide wire is removed from the catheter. Accept sex guide wires.
  • the mesh member In order to accept the retrograde guide wire, it is necessary to expand the mesh member appropriately. However, for example, when the mesh member is located at the bent portion of the blood vessel, the mesh member may not be able to expand properly and the retrograde guide wire may not be properly received.
  • the present invention has been made based on the above circumstances, and an object of the present invention is to enable the mesh member to be appropriately expanded.
  • the catheter according to the first aspect includes a tubular mesh member that can be expanded and contracted in the radial direction, a hollow shaft connected to the base end portion of the mesh member, and a tip of the mesh member.
  • a hollow tip tip connected to the portion and a plurality of core wires having the tip portion connected to the tip portion of the mesh member and / or the tip end and extending through the inside of the mesh member and the hollow shaft.
  • the plurality of core wires are connected at positions where the tip portion is off-center in the tip portion of the mesh member and / or the tip end side view.
  • Each of the plurality of core wires may extend so that the proximal end is located closer to the proximal end side than the proximal end of the first hollow shaft.
  • the plurality of core wires may be connected to a common wire having the same proximal end, and the common wire may extend so as to be located closer to the proximal end side than the proximal end of the hollow shaft.
  • three or more core wires are provided, and the tip portions of the three or more core wires are on the circumference centered on the tip portion of the mesh member and / or the center in the tip side view of the tip tip. May be connected at positions where the distance between the tips thereof is even.
  • two core wires are provided, and the two core wires are positioned so that their respective tips are not on the same straight line passing through the tip of the mesh member and / or the center of the tip in the tip side view. It may be connected.
  • the mesh member can be appropriately expanded.
  • the catheter according to the embodiment will be described with reference to the drawings, but the present invention is not limited to the embodiments described in the drawings. Further, the dimensions of the catheter shown in each drawing are the dimensions shown for facilitating the understanding of the implementation contents, and do not correspond to the actual dimensions.
  • forward guide wire means a guide wire used to guide a catheter to a surgical part in a body cavity such as a blood vessel, and “retrograde guide”.
  • Wire means a guide wire that comes into the body cavity from the distal end side of the catheter.
  • the "tip side” means a direction along the longitudinal direction of the catheter (a direction along the axial direction of the hollow shaft) and a direction in which the mesh member is located with respect to the hollow shaft. ..
  • the “base end side” means a direction along the longitudinal direction of the catheter and a direction opposite to the distal end side.
  • the “tip” refers to the end portion on the distal end side of any member or portion, and the “base end” indicates the end portion on the proximal end side of any member or portion.
  • tip side view means viewing from the tip side of the catheter.
  • FIG. 1 is a schematic cross-sectional view of the catheter according to the first embodiment.
  • the catheter 1 roughly includes a hollow shaft 11, a mesh member 21, an induction membrane 31, a tip tip 41, a plurality of core wires 51, and a connector 61.
  • the hollow shaft 11 is a hollow shaft, and its tip is connected to the base end portion of the mesh member 21.
  • the hollow shaft 11 has, for example, a hollow tip side shaft 111 and a hollow base end side shaft 112.
  • the tip end side shaft 111 is connected to the base end portion of the mesh member 21.
  • the tip-side shaft 111 has a lumen 111a penetrating from the tip to the base end, and for example, an antegrade guide wire, a retrograde guide wire W (see FIG. 3), a core wire 51, and the like (not shown) are included. It is inserted.
  • the proximal end side shaft 112 is connected to the proximal end of the distal end side shaft 111 and has a lumen 112a penetrating from the distal end to the proximal end, and for example, a core wire 51 or the like is inserted therethrough.
  • a communication hole 113 that opens toward the proximal end side is formed at the connection portion between the distal end side shaft 111 and the hollow proximal end side shaft 112.
  • the communication hole 113 is used, for example, as a guide wire port for sending the retrograde guide wire W received in the cavity 111a of the distal shaft 111 of the hollow shaft 11 to the outside of the catheter 1.
  • the distal end side shaft 111 and the proximal end side shaft 112 are integrally formed.
  • the hollow shaft 11 since the hollow shaft 11 is inserted into a body cavity such as a blood vessel, it is preferable that the hollow shaft 11 has antithrombotic property, flexibility and biocompatibility, and is preferably a resin material or a metal.
  • the material can be adopted. From the viewpoint of improving flexibility and the like, it is preferable to use a resin material such as a polyamide resin, a polyolefin resin, a polyester resin, a polyurethane resin, a silicone resin, or a fluororesin as the tip side shaft 111. From the viewpoint of improving pushability and the like, it is preferable to use a metal material such as stainless steel (SUS304 or the like) for the base end side shaft 112. As the proximal end side shaft 112, a hypotube (metal tube) can be preferably used.
  • the mesh member 21 is a tubular member that can be expanded and contracted in the radial direction.
  • the mesh member 21 is joined (fixed) to, for example, the tip of the hollow shaft 11.
  • a method of joining the mesh member 21 and the hollow shaft 11 for example, a method of embedding the base end portion of the mesh member 21 in the tip end portion of the hollow shaft 11 by welding or the like can be adopted.
  • the mesh member 21 is made of, for example, a wire rod 21a braided into a mesh shape, and is easily deformed (expanded / contracted).
  • the mesh member 21 is made of, for example, a wire rod 21a braided in a mesh shape, is easily deformed (expanded / contracted), and can receive the retrograde guide wire W through the opening 21b.
  • the base end of the mesh member 21 is joined (fixed) to the tip of the hollow shaft 11. Therefore, when the core wire 51 described later is pulled toward the base end side, the mesh member 21 bulges (diameters) outward in diameter, and the retrograde guide wire W is taken into the mesh member 21 through the widened opening 21b. be able to.
  • the base end portion of the core wire 51 is pushed into the hollow shaft 11 toward the tip end side, the diameter of the mesh member 21 is reduced, the mesh member 21 becomes compact, and the catheter 1 can be easily moved in the body cavity. it can.
  • the material of the wire rod 21a constituting the mesh member 21 examples include metal materials such as stainless steel (for example, SUS304), nickel-titanium alloys, and cobalt-chromium alloys; resins such as polyamide, polyester, polyacrylate, and polyetheretherketone. Materials and the like can be mentioned. Among these, from the viewpoint of improving the strength and flexibility and improving the visibility of the confirmation image used during the procedure, the material of the wire rod 21a is preferably a metal material. .. When the mesh member 21 is composed of a plurality of wire rods, these wire rods may be formed of the same material or may be formed of different materials.
  • the induction film 31 is a film-like member whose base end is located at the base end of the mesh member 21 and covers a part of the mesh member 21. According to the guide film 31, for example, the retrograde guide wire W received through the opening 21b of the mesh member 21 can be smoothly guided toward the opening 11b of the hollow shaft 11. Specifically, for example, the tip of the inductive film 31 is located between the base end of the tip tip 41 and the tip end of the hollow shaft 11, and the base end is located at the tip end of the hollow shaft 11.
  • Examples of the material constituting the induction film 31 include polyethylene, polyurethane, polyamide, polyamide elastomer, polyolefin, polyester, polyester elastomer and the like.
  • polyurethane is preferable as the material from the viewpoint of improving the sliding property of the surface.
  • a part of the inductive membrane 31 may be joined to the mesh member 21, for example, the tip end portion (for example, the outer periphery of the tip end end of the inductive membrane 31), the proximal end portion and / or the central portion of the inductive membrane 31 are joined. can do.
  • the material forming the induction film 31 is heated and melted, the mesh member 21 is immersed in the melted material, and the wire rods 21a are crosslinked (opening 21b).
  • a method of welding the open end of the funnel-shaped film to the mesh member 21, and the like can be adopted.
  • the tip is located at a substantially central portion in the axial direction of the mesh member 21, the base end is located at the tip of the hollow shaft 11, and the wire rods 21a of the mesh member 21 are crosslinked (the opening 21b is closed).
  • the induction film 31 and the mesh member 21 are joined so as to be used.
  • the tip tip 41 is a hollow member connected to the tip of the mesh member 21.
  • the tip tip 41 can, for example, reduce the resistance of the catheter 1 to move forward in the body cavity and allow the catheter 1 to advance smoothly.
  • the tip tip 41 is provided with a cavity 41a for inserting a guide wire (for example, an antegrade guide wire (not shown)), and the tip portion is rounded toward the tip side. It can be formed so as to have a substantially sharp shape.
  • the base end portion of the tip tip 41 is joined (fixed) to the tip end portion of the mesh member 21 or the like.
  • the material constituting the tip tip 41 is preferably flexible so as to reduce the impact on the body cavity and the like.
  • Examples of such a material include resin materials such as polyurethane and polyurethane elastomer.
  • a method of joining the tip tip 41 and the mesh member 21 for example, a method of burying the tip of each wire rod 21a constituting the mesh member 21 in the base end of the tip tip 41 by welding or the like can be adopted. it can.
  • the core wire 51 has a tip end portion bonded (fixed) to the tip tip 41, and has a space inside the mesh member 21, a cavity 111a of the tip side shaft 111 of the hollow shaft 11, and a connector 61 described later. It can be arranged so that the proximal end is exposed to the outside through the lumen 61a.
  • the material constituting the core wire 51 preferably has sufficient rigidity and tensile strength from the viewpoint of reliably expanding and contracting the mesh member 21 and preventing the core wire 51 itself from being cut.
  • Examples of such a material include metal materials such as stainless steel (SUS304 and the like), nickel titanium alloys, and cobalt-chromium alloys.
  • a method of joining the core wire 51 and the tip tip 41 and / or the mesh member 21 for example, a method of burying the tip of the core wire 51 in the base end of the tip tip 41 by welding or the like, and / or the tip of the core wire 51.
  • a method of welding the portion and the tip portion of the mesh member 21 or the like can be adopted.
  • the connector 61 is a member for which the operator grips the catheter 1.
  • the connector 61 is connected to the base end portion of the hollow shaft 11.
  • the connector 61 is formed with a cavity 61a communicating with the cavity 111a of the hollow shaft 11 and an opening 61b formed at the base end of the cavity 61a so that the core wire 51 is exposed to the outside.
  • the form of the connector 61 is not particularly limited as long as the effect of the present invention is not impaired.
  • FIG. 2 is a diagram showing a connection state of the core wire according to the first embodiment.
  • FIG. 2 shows a connection state between the tip tip 41 and the plurality of core wires 51 when viewed from the tip side.
  • the tip tip 41 is a cylindrical hollow member.
  • a plurality of (two in the example of FIG. 2) core wires 51 are connected to the base end side of the tip tip 41 at a position deviated from the center O in the tip side view of the tip tip 41.
  • the core wires 51A and 51B are connected to positions on the circumference centered on the center O.
  • the core wire 51A and the core wire 51B are connected at positions where they are not on the same straight line passing through the center O. That is, the core wire 51B is connected at a position deviated from the straight line connecting the core wire 51A and the center O.
  • the force at the time of pulling can be dispersed, so that the diameter of the core wires can be reduced as compared with the case where a single core wire is provided.
  • the mounting portion of the tip tip 41 can be made smaller.
  • the diameter of the core wire can be reduced, it is possible to reduce the occurrence of obstacles due to the core wire (for example, obstacles that cannot avoid the core wire) when guiding the retrograde guide wire W to the hollow shaft 11. it can.
  • the usage mode of the catheter 1 will be described.
  • a procedure for passing the retrograde guide wire W through a site where an obstruction exists in a blood vessel (hereinafter, also referred to as an “occlusal site”) will be described.
  • an antegrade guide wire (not shown) is inserted into the blood vessel, and then the antegrade guide wire is pushed along the blood vessel to the occluded site.
  • the balloon catheter is pushed to the occluded site using the antegrade guide wire as a guide.
  • the balloon provided in the balloon catheter is expanded and contracted to form a cavity in the obstructed site, and then the balloon catheter is pulled out of the body.
  • an antegrade guide wire is inserted into the lumen 41a of the tip tip 41 from its base end, and the tip of the catheter 1 is pushed into the blood vessel to the cavity formed at the occlusion site using the antegrade guide wire as a guide.
  • the catheter 1 is inserted into the blood vessel with the mesh member 21 reduced in diameter, and the tip of the catheter 1 reaches the cavity of the occlusion site while the mesh member 21 is maintained in the reduced diameter state. Be done.
  • the antegrade guide wire is pulled from the catheter 1 by pulling the antegrade guide wire toward the proximal end side with respect to the catheter 1.
  • the end portion of the core wire 51 exposed to the outside from the opening 61b of the connector 61 is pulled toward the base end side.
  • the ends of the plurality of core wires 51 may be pulled at the same time, or the ends of any part of the core wires 51 may be pulled.
  • the mesh member 21 bulges (expands) toward the outside of the diameter.
  • the opening 21b of the mesh member 21 is also expanded as the diameter of the mesh member 21 is expanded, it becomes easy to accept the retrograde guide wire W coming from the tip side.
  • the tip of the guide film 31 since the tip of the guide film 31 is joined to the substantially central portion in the axial direction of the mesh member 21, the tip of the guide film 31 is also expanded in diameter following the expansion of the mesh member 21.
  • the induction film 31 develops in a funnel shape as a whole.
  • the retrograde guide wire W coming from the distal end side is received in the catheter 1.
  • a false cavity in the blood vessel wall surrounding the obstruction site, a through hole penetrating the obstruction site, or the like is assumed, and the retrograde guide wire from any of the routes is assumed. It may be W.
  • the retrograde guide wire W is received in the space inside the mesh member 21 through the opening 21b of the enlarged mesh member 21, and then is received in the cavity 111a of the tip side shaft 111 through the opening 11b at the tip of the hollow shaft 11. It is delivered to the outside of the catheter 1 through the communication hole 113.
  • the retrograde guide wire W can be received by the mesh member 21 and appropriately guided to the cavity 111a of the hollow shaft 11.
  • FIG. 4 is a diagram showing an example of the state of the catheter according to the first embodiment at the bent portion of the blood vessel.
  • the tip tip 41 and the mesh member 21 are in contact with the bent outer side (upper side in the figure) of the bent portion of the blood vessel 200. It will be in a bent state.
  • FIG. 5 is a diagram showing an example of expansion of a mesh member at a bending portion of a blood vessel of a catheter according to a comparative example.
  • the same portion as the catheter 1 according to the present embodiment will be described with reference to the same reference numerals.
  • the catheter 100 is provided with one core wire 51, and the core wire 51 is connected to the proximal end side of the distal end tip 41 at a position off-center in the distal end side view. In the state shown in FIG. 5, the core wire 51 is connected to the tip tip 41 at a position close to the bent outer side of the bent portion of the blood vessel 200.
  • FIG. 6 is a diagram showing an example of expansion of a mesh member at a bent portion of a blood vessel of the catheter according to the first embodiment.
  • one core wire 51 is connected to a position close to the outside of the bend of the bent portion of the blood vessel of the tip tip 41, while the other core wire 51 is connected to the bent portion of the blood vessel 200 of the tip tip 41. It is connected to a position far from the outside of the bend (inside the bend).
  • the orientation of the mesh member 21 and the like can be adjusted, and the mesh member 21 can be expanded. It can be done more effectively.
  • the mesh member 21 can accept the retrograde guide wire W and appropriately guide it to the cavity 111a of the hollow shaft 11.
  • the two core wires are connected at positions where they are not on the same straight line passing through the center O of the tip side view of the tip tip 41.
  • the two core wires have the same positional relationship with respect to the bending direction, specifically, for example, the core wire 51 is equidistant from the outside of the bending. Can be prevented.
  • the mesh member 21 can be adjusted to a state in which it is easier to expand.
  • FIG. 7 is a schematic cross-sectional view of the catheter according to the second embodiment.
  • the same parts as those of the catheter according to the first embodiment are designated by the same reference numerals.
  • the catheter 1A includes a plurality of core wires 52 instead of the plurality of core wires 51.
  • the method of connecting the core wire 52 and the tip tip 41 may be the same as the method of connecting the core wire 51 and the tip tip 41.
  • the material constituting the core wire 52 may be the same as the material constituting the core wire 51.
  • the core wire 52 has a length up to the middle portion of the tip side shaft 111 of the hollow shaft 11.
  • the plurality of core wires 52 are connected via a connecting member 53.
  • the connecting member 53 is connected to one common wire 54.
  • the common wire 54 is configured to have a length such that the base end is exposed to the outside through the cavity 111a of the tip end side shaft 111 of the hollow shaft 11 and the cavity 61a of the connector 61.
  • the same effect as that of the first embodiment can be obtained. Further, according to the catheter according to the present embodiment, the operator only needs to operate the common wire 54, so that the complexity of the procedure can be reduced.
  • FIG. 8 is a schematic cross-sectional view of the catheter according to the third embodiment.
  • the same parts as those of the catheter according to the first embodiment are designated by the same reference numerals.
  • Catheter 1B includes a plurality of core wires 55 instead of the plurality of core wires 51.
  • the method of connecting the core wire 55 and the tip tip 41 may be the same as the method of connecting the core wire 51 and the tip tip 41.
  • the material constituting the core wire 55 may be the same as the material constituting the core wire 51.
  • the core wire 55 has a length up to the middle portion of the tip side shaft 111 of the hollow shaft 11.
  • the plurality of core wires 55 are connected to one common wire 56.
  • the common wire 56 is configured to have a length such that the base end is exposed to the outside through the cavity 111a of the tip end side shaft 111 of the hollow shaft 11 and the cavity 61a of the connector 61.
  • the core wire 55 may be configured by branching the common wire 56.
  • the same effect as that of the first embodiment can be obtained. Further, according to the catheter according to the present embodiment, the operator only needs to operate the common wire 56, so that the complexity of the procedure can be reduced.
  • FIG. 9 is a diagram showing a connection state of the core wire according to the modified example.
  • catheters 1, 1A and 1B provided with two core wires 51 (52, 55) have been described as specific examples, but the present invention is not limited to this, and three or more core wires are provided. May be good.
  • each core wire 51 (52, 55) is located on the circumference centered on the center O of the tip tip 41 as shown in FIG. It suffices to connect three core wires 51 to.
  • the positions where the core wires 51 (52, 55) are connected are evenly spaced, in other words, the positions where the core wires 51 are connected are the positions of the vertices of an equilateral triangle whose center of gravity is the center O. You may.
  • the position where each core wire 51 (52, 55) is connected corresponds to the number of core wires 51 (52, 55) with the center O as the center of gravity. It may be the position of the apex of the regular polygon.
  • the position where the tip tip 41 is pulled, the pulling force, and the pulling length can be adjusted by the core wire 51 (52, 55), and the tip tip 41 is pulled by applying an even force. It is also possible to appropriately expand the mesh member 21.
  • the catheter 1 in which the hollow shaft 11 includes the distal end side shaft 111, the proximal end side shaft 112, and the communication hole 113 has been described, but the catheter does not have a communication hole and is from the distal end. It may be a catheter (over-the-wire type (OTW) catheter) with a hollow shaft having a single lumen extending over the proximal end.
  • OGW over-the-wire type

Abstract

[Problem] To enable a mesh member to be appropriately expanded. [Solution] A catheter 1 is provided with: a tube-like mesh member 21 expandable in the radial direction; a hollow shaft 11 connected to a proximal end portion of the mesh member 21; a hollow distal tip 41 connected to a distal end portion of the mesh member 21; and a plurality of core wires 51, each of which has a distal end portion 41 connected to the distal end portion of the mesh member 21 and/or the distal tip 41 and extends through the inside of the mesh member 21 and the hollow shaft 11. The distal end portion of each of the plurality of core wires 51 is connected at a position away from the center of the distal end portion of the mesh member 21 and/or the distal tip 41 in a view from the distal end.

Description

カテーテルcatheter
 本発明は、カテーテルに関する。 The present invention relates to a catheter.
 慢性完全閉塞(CTO:Choronic total occlusion)のような血管を閉塞する閉塞物を除去して血流を改善する医療器具として、例えば、順行性ガイドワイヤを用いて偽腔拡張を行った後、この偽腔に逆行性ガイドワイヤを通す技術が開示されている(例えば、特許文献1、非特許文献1参照)。 As a medical device for improving blood flow by removing obstructions that occlude blood vessels such as chronic complete occlusion (CTO), for example, after performing pseudoluminal dilation using an anterograde guide wire, A technique for passing a retrograde guide wire through this false cavity is disclosed (see, for example, Patent Document 1 and Non-Patent Document 1).
 このような技術に用いられるカテーテルとしては、例えば、メッシュ部材を介して逆行性ガイドワイヤを捕獲するカテーテルが知られている。このカテーテルは、例えば、先行して血管内に挿入された順行性ガイドワイヤにカテーテルの案内チューブに挿通することで閉塞部位まで搬送され、次いで順行性ガイドワイヤがカテーテルから抜去された後に逆行性ガイドワイヤを受け入れる。 As a catheter used in such a technique, for example, a catheter that captures a retrograde guide wire via a mesh member is known. The catheter is transported to the occlusion site by, for example, inserting an anterograde guide wire previously inserted into a blood vessel through the guide tube of the catheter, and then retrograde after the anterograde guide wire is removed from the catheter. Accept sex guide wires.
特開2019-072301号公報Japanese Unexamined Patent Publication No. 2019-072301
 逆行性ガイドワイヤを受け入れるためには、メッシュ部材を適切に拡張させる必要がある。しかしながら、例えば、メッシュ部材が血管の屈曲している部分に位置している場合には、メッシュ部材が適切に拡張できず、逆行性ガイドワイヤを適切に受け入れることができない虞がある。 In order to accept the retrograde guide wire, it is necessary to expand the mesh member appropriately. However, for example, when the mesh member is located at the bent portion of the blood vessel, the mesh member may not be able to expand properly and the retrograde guide wire may not be properly received.
 本発明は、以上のような事情に基づいてなされたものであり、その目的は、メッシュ部材を適切に拡張できるようにすることにある。 The present invention has been made based on the above circumstances, and an object of the present invention is to enable the mesh member to be appropriately expanded.
 かかる目的を達成するために、第1の観点に係るカテーテルは、径方向に拡縮可能なチューブ状のメッシュ部材と、前記メッシュ部材の基端部に接続された中空シャフトと、前記メッシュ部材の先端部に接続された中空の先端チップと、先端部が前記メッシュ部材の先端部および/または前記先端チップに接続され、前記メッシュ部材および前記中空シャフトの内部を通って延びる複数のコアワイヤと、を備え、複数の前記コアワイヤは、先端部が前記メッシュ部材の先端部および/または前記先端チップの先端側視における中心から外れた位置に接続されている。 In order to achieve such an object, the catheter according to the first aspect includes a tubular mesh member that can be expanded and contracted in the radial direction, a hollow shaft connected to the base end portion of the mesh member, and a tip of the mesh member. A hollow tip tip connected to the portion and a plurality of core wires having the tip portion connected to the tip portion of the mesh member and / or the tip end and extending through the inside of the mesh member and the hollow shaft. , The plurality of core wires are connected at positions where the tip portion is off-center in the tip portion of the mesh member and / or the tip end side view.
 複数の前記コアワイヤのそれぞれは、基端が前記第中空シャフトの基端よりも基端側に位置するように延びていてもよい。 Each of the plurality of core wires may extend so that the proximal end is located closer to the proximal end side than the proximal end of the first hollow shaft.
 また、複数の前記コアワイヤは、基端が同一の共通ワイヤに接続され、前記共通ワイヤは、前記中空シャフトの基端よりも基端側に位置するように延びていてもよい。 Further, the plurality of core wires may be connected to a common wire having the same proximal end, and the common wire may extend so as to be located closer to the proximal end side than the proximal end of the hollow shaft.
 上記カテーテルにおいて、前記コアワイヤを3以上備え、3以上の前記コアワイヤは、それぞれの先端部が、前記メッシュ部材の先端部および/または前記先端チップの先端側視における中心をその中心とする円周上における、それぞれの前記先端部の間隔が均等となる位置に接続されていてもよい。 In the catheter, three or more core wires are provided, and the tip portions of the three or more core wires are on the circumference centered on the tip portion of the mesh member and / or the center in the tip side view of the tip tip. May be connected at positions where the distance between the tips thereof is even.
 上記カテーテルにおいて、前記コアワイヤを2つ備え、2つの前記コアワイヤは、それぞれの先端部が、前記メッシュ部材の先端部および/または前記先端チップの先端側視における中心を通る同一直線上とならない位置に接続されていてもよい。 In the catheter, two core wires are provided, and the two core wires are positioned so that their respective tips are not on the same straight line passing through the tip of the mesh member and / or the center of the tip in the tip side view. It may be connected.
 本発明によると、メッシュ部材を適切に拡張することができる。 According to the present invention, the mesh member can be appropriately expanded.
第1実施形態に係るカテーテルの概略的断面図である。It is the schematic sectional drawing of the catheter which concerns on 1st Embodiment. 第1実施形態に係るコアワイヤの接続状態を示す図である。It is a figure which shows the connection state of the core wire which concerns on 1st Embodiment. 第1実施形態に係るカテーテルの使用状態の一例を概略的断面図である。It is a schematic cross-sectional view of an example of the use state of the catheter which concerns on 1st Embodiment. 第1実施形態に係るカテーテルの血管の屈曲部での状態の一例を示す図である。It is a figure which shows an example of the state at the bending part of the blood vessel of the catheter which concerns on 1st Embodiment. 比較例に係るカテーテルの血管の屈曲部でのメッシュ部材の拡張の一例を示す図である。It is a figure which shows an example of the expansion of the mesh member at the bending part of the blood vessel of the catheter which concerns on a comparative example. 第1実施形態に係るカテーテルの血管の屈曲部でのメッシュ部材の拡張の一例を示す図である。It is a figure which shows an example of the expansion of the mesh member at the bending part of the blood vessel of the catheter which concerns on 1st Embodiment. 第2実施形態に係るカテーテルの概略的断面図である。It is the schematic sectional drawing of the catheter which concerns on 2nd Embodiment. 第3実施形態に係るカテーテルの概略的断面図である。It is the schematic sectional drawing of the catheter which concerns on 3rd Embodiment. 変形例に係るコアワイヤの接続状態を示す図である。It is a figure which shows the connection state of the core wire which concerns on a modification.
 実施形態に係るカテーテルについて図面を参照して説明するが、本発明は、当該図面に記載の実施形態にのみ限定されるものではない。また、各図面に示したカテーテルの寸法は、実施内容の理解を容易にするために示した寸法であり、実際の寸法に対応するものではない。 The catheter according to the embodiment will be described with reference to the drawings, but the present invention is not limited to the embodiments described in the drawings. Further, the dimensions of the catheter shown in each drawing are the dimensions shown for facilitating the understanding of the implementation contents, and do not correspond to the actual dimensions.
 なお、本明細書において、「順行性ガイドワイヤ」とは、血管などの体腔内の術部に押し進められ、その術部にカテーテルを導くために用いられるガイドワイヤを意味し、「逆行性ガイドワイヤ」とは、体腔内をカテーテルの先端側から向かって来るガイドワイヤを意味する。 In addition, in this specification, "forward guide wire" means a guide wire used to guide a catheter to a surgical part in a body cavity such as a blood vessel, and "retrograde guide". "Wire" means a guide wire that comes into the body cavity from the distal end side of the catheter.
 また、本明細書において、「先端側」とは、カテーテルの長手方向に沿った方向(中空シャフトの軸方向に沿う方向)であって、中空シャフトに対してメッシュ部材が位置する方向を意味する。また、「基端側」とは、カテーテルの長手方向に沿った方向に沿う方向であって、先端側と反対側の方向を意味する。また、「先端」とは、任意の部材または部位における先端側の端部、「基端」とは、任意の部材または部位における基端側の端部をそれぞれ示す。 Further, in the present specification, the "tip side" means a direction along the longitudinal direction of the catheter (a direction along the axial direction of the hollow shaft) and a direction in which the mesh member is located with respect to the hollow shaft. .. Further, the "base end side" means a direction along the longitudinal direction of the catheter and a direction opposite to the distal end side. Further, the "tip" refers to the end portion on the distal end side of any member or portion, and the "base end" indicates the end portion on the proximal end side of any member or portion.
 また、本明細書において、「先端側視」とは、カテーテルの先端側から視ることを示す。 Further, in the present specification, "tip side view" means viewing from the tip side of the catheter.
[第1実施形態]
 図1は、第1実施形態に係るカテーテルの概略的断面図である。
[First Embodiment]
FIG. 1 is a schematic cross-sectional view of the catheter according to the first embodiment.
 カテーテル1は、概略的に、中空シャフト11と、メッシュ部材21と、誘導膜31と、先端チップ41と、複数のコアワイヤ51と、コネクタ61とを備える。 The catheter 1 roughly includes a hollow shaft 11, a mesh member 21, an induction membrane 31, a tip tip 41, a plurality of core wires 51, and a connector 61.
 中空シャフト11は、中空形状のシャフトであり、先端がメッシュ部材21の基端部に接続されている。中空シャフト11は、例えば、中空形状の先端側シャフト111と、中空形状の基端側シャフト112とを有している。 The hollow shaft 11 is a hollow shaft, and its tip is connected to the base end portion of the mesh member 21. The hollow shaft 11 has, for example, a hollow tip side shaft 111 and a hollow base end side shaft 112.
 先端側シャフト111は、メッシュ部材21の基端部に接続されている。先端側シャフト111は、先端から基端まで貫通する内腔111aを有しており、例えば、図示していない順行性ガイドワイヤ、逆行性ガイドワイヤW(図3参照)や、コアワイヤ51等が挿通される。基端側シャフト112は、先端側シャフト111の基端に接続され、先端から基端まで貫通する内腔112aを有しており、例えば、コアワイヤ51等が挿通される。 The tip end side shaft 111 is connected to the base end portion of the mesh member 21. The tip-side shaft 111 has a lumen 111a penetrating from the tip to the base end, and for example, an antegrade guide wire, a retrograde guide wire W (see FIG. 3), a core wire 51, and the like (not shown) are included. It is inserted. The proximal end side shaft 112 is connected to the proximal end of the distal end side shaft 111 and has a lumen 112a penetrating from the distal end to the proximal end, and for example, a core wire 51 or the like is inserted therethrough.
 先端側シャフト111と中空形状の基端側シャフト112との接続部には、基端側に向かって開口する連通孔113が形成されている。連通孔113は、例えば、中空シャフト11の先端側シャフト111の内腔111aに受け入れられた逆行性ガイドワイヤWをカテーテル1の外部に送出するためのガイドワイヤポートとして用いられる。なお、本実施形態では、先端側シャフト111と基端側シャフト112とが一体的に形成されている。 A communication hole 113 that opens toward the proximal end side is formed at the connection portion between the distal end side shaft 111 and the hollow proximal end side shaft 112. The communication hole 113 is used, for example, as a guide wire port for sending the retrograde guide wire W received in the cavity 111a of the distal shaft 111 of the hollow shaft 11 to the outside of the catheter 1. In this embodiment, the distal end side shaft 111 and the proximal end side shaft 112 are integrally formed.
 中空シャフト11を構成する材料としては、中空シャフト11が血管などの体腔内に挿通されることから、抗血栓性、可撓性および生体適合性を有していることが好ましく、樹脂材料、金属材料を採用することができる。先端側シャフト111としては、柔軟性などを向上する観点から、例えば、ポリアミド樹脂、ポリオレフィン樹脂、ポリエステル樹脂、ポリウレタン樹脂、シリコーン樹脂、フッ素樹脂等の樹脂材料を採用することが好ましい。基端側シャフト112としては、押し込み性などを向上する観点から、例えば、ステンレス鋼(SUS304など)等の金属材料を採用することが好ましい。基端側シャフト112としては、好ましくはハイポチューブ(金属管)を用いることができる。 As the material constituting the hollow shaft 11, since the hollow shaft 11 is inserted into a body cavity such as a blood vessel, it is preferable that the hollow shaft 11 has antithrombotic property, flexibility and biocompatibility, and is preferably a resin material or a metal. The material can be adopted. From the viewpoint of improving flexibility and the like, it is preferable to use a resin material such as a polyamide resin, a polyolefin resin, a polyester resin, a polyurethane resin, a silicone resin, or a fluororesin as the tip side shaft 111. From the viewpoint of improving pushability and the like, it is preferable to use a metal material such as stainless steel (SUS304 or the like) for the base end side shaft 112. As the proximal end side shaft 112, a hypotube (metal tube) can be preferably used.
 メッシュ部材21は、径方向に拡縮可能なチューブ状の部材である。このメッシュ部材21は、例えば、中空シャフト11の先端部に接合(固定)されている。メッシュ部材21と中空シャフト11との接合方法としては、例えば、メッシュ部材21の基端部を中空シャフト11の先端部に溶着等で埋設する方法等を採用することができる。 The mesh member 21 is a tubular member that can be expanded and contracted in the radial direction. The mesh member 21 is joined (fixed) to, for example, the tip of the hollow shaft 11. As a method of joining the mesh member 21 and the hollow shaft 11, for example, a method of embedding the base end portion of the mesh member 21 in the tip end portion of the hollow shaft 11 by welding or the like can be adopted.
 メッシュ部材21は、例えば、メッシュ状に編組された線材21aで構成されており、変形(拡縮)容易である。メッシュ部材21は、例えば、メッシュ状に編組された線材21aで構成されており、変形(拡縮)容易であると共に開口21bを通して逆行性ガイドワイヤWを受け入れることができる。メッシュ部材21は、基端部が中空シャフト11の先端部に接合(固定)されている。このため、後述するコアワイヤ51を基端側に向かって引っ張るとメッシュ部材21は径外側へ膨出(拡径)し、拡がった開口21bを介して逆行性ガイドワイヤWをメッシュ部材21内に取り込むことができる。一方、コアワイヤ51の基端部を先端側に向かって中空シャフト11内に押し込むとメッシュ部材21が縮径し、当該メッシュ部材21がコンパクトになって体腔内においてカテーテル1を容易に移動させることができる。 The mesh member 21 is made of, for example, a wire rod 21a braided into a mesh shape, and is easily deformed (expanded / contracted). The mesh member 21 is made of, for example, a wire rod 21a braided in a mesh shape, is easily deformed (expanded / contracted), and can receive the retrograde guide wire W through the opening 21b. The base end of the mesh member 21 is joined (fixed) to the tip of the hollow shaft 11. Therefore, when the core wire 51 described later is pulled toward the base end side, the mesh member 21 bulges (diameters) outward in diameter, and the retrograde guide wire W is taken into the mesh member 21 through the widened opening 21b. be able to. On the other hand, when the base end portion of the core wire 51 is pushed into the hollow shaft 11 toward the tip end side, the diameter of the mesh member 21 is reduced, the mesh member 21 becomes compact, and the catheter 1 can be easily moved in the body cavity. it can.
 メッシュ部材21を構成する線材21aの材料としては、例えば、ステンレス鋼(例えば、SUS304など)、ニッケルチタン合金、コバルトクロム合金等の金属材料;ポリアミド、ポリエステル、ポリアクリレート、ポリエーテルエーテルケトンなどの樹脂材料等が挙げられる。これらの中で、強度および可撓性を向上させる観点や、手技中に使用される確認用の映像の視認性を向上させる観点からは、線材21aの材料としては、金属材料であることが好ましい。なお、メッシュ部材21が複数本の線材で構成されている場合、これらの線材は、同一の材料で形成されていてもよく、異なる材料で形成されていてもよい。 Examples of the material of the wire rod 21a constituting the mesh member 21 include metal materials such as stainless steel (for example, SUS304), nickel-titanium alloys, and cobalt-chromium alloys; resins such as polyamide, polyester, polyacrylate, and polyetheretherketone. Materials and the like can be mentioned. Among these, from the viewpoint of improving the strength and flexibility and improving the visibility of the confirmation image used during the procedure, the material of the wire rod 21a is preferably a metal material. .. When the mesh member 21 is composed of a plurality of wire rods, these wire rods may be formed of the same material or may be formed of different materials.
 誘導膜31は、基端がメッシュ部材21の基端に位置しかつメッシュ部材21の一部を被覆する膜状の部材である。この誘導膜31によれば、例えば、メッシュ部材21の開口21bを通して受け入れた逆行性ガイドワイヤWを中空シャフト11の開口11bに向かって円滑に導くことができる。誘導膜31は、具体的には、例えば、先端が先端チップ41の基端と中空シャフト11の先端との間に位置し、基端が中空シャフト11の先端に位置している。 The induction film 31 is a film-like member whose base end is located at the base end of the mesh member 21 and covers a part of the mesh member 21. According to the guide film 31, for example, the retrograde guide wire W received through the opening 21b of the mesh member 21 can be smoothly guided toward the opening 11b of the hollow shaft 11. Specifically, for example, the tip of the inductive film 31 is located between the base end of the tip tip 41 and the tip end of the hollow shaft 11, and the base end is located at the tip end of the hollow shaft 11.
 誘導膜31を構成する材料としては、例えば、ポリエチレン、ポリウレタン、ポリアミド、ポリアミドエラストマー、ポリオレフィン、ポリエステル、ポリエステルエラストマー等が挙げられる。これらの中では、上記材料としては、表面の滑動性を向上させる観点から、ポリウレタンであることが好ましい。 Examples of the material constituting the induction film 31 include polyethylene, polyurethane, polyamide, polyamide elastomer, polyolefin, polyester, polyester elastomer and the like. Among these, polyurethane is preferable as the material from the viewpoint of improving the sliding property of the surface.
 誘導膜31は、その一部がメッシュ部材21に接合されていてもよく、例えば、誘導膜31の先端部(例えば、誘導膜31の先端外周など)、基端部および/または中央部を接合することができる。誘導膜31とメッシュ部材21とを接合する方法としては、例えば、誘導膜31を形成する材料を加熱溶融し、この溶融した材料中にメッシュ部材21を浸漬して線材21aどうしを架橋(開口21bを閉塞)する方法、漏斗状のフィルムの開口端をメッシュ部材21に溶着する方法等を採用することができる。 A part of the inductive membrane 31 may be joined to the mesh member 21, for example, the tip end portion (for example, the outer periphery of the tip end end of the inductive membrane 31), the proximal end portion and / or the central portion of the inductive membrane 31 are joined. can do. As a method of joining the induction film 31 and the mesh member 21, for example, the material forming the induction film 31 is heated and melted, the mesh member 21 is immersed in the melted material, and the wire rods 21a are crosslinked (opening 21b). , A method of welding the open end of the funnel-shaped film to the mesh member 21, and the like can be adopted.
 本実施形態の誘導膜31は、先端がメッシュ部材21の軸方向略中央部、基端が中空シャフト11の先端に位置しており、メッシュ部材21の線材21aどうしが架橋(開口21bを閉塞)するように、誘導膜31とメッシュ部材21とが接合されている。 In the guide film 31 of the present embodiment, the tip is located at a substantially central portion in the axial direction of the mesh member 21, the base end is located at the tip of the hollow shaft 11, and the wire rods 21a of the mesh member 21 are crosslinked (the opening 21b is closed). The induction film 31 and the mesh member 21 are joined so as to be used.
 先端チップ41は、メッシュ部材21の先端部に接続された中空形状の部材である。先端チップ41は、例えば、カテーテル1が体腔内を前進する際の抵抗を減らし、カテーテル1を円滑に進行させることができる。先端チップ41は、具体的には、例えば、ガイドワイヤ(例えば、順行性ガイドワイヤ(不図示))挿通用の内腔41aを備えていると共に、先端部が先端側に向かって丸みを帯びた略尖鋭形状となるように形成することができる。先端チップ41は、基端部がメッシュ部材21等の先端部に接合(固定)されている。 The tip tip 41 is a hollow member connected to the tip of the mesh member 21. The tip tip 41 can, for example, reduce the resistance of the catheter 1 to move forward in the body cavity and allow the catheter 1 to advance smoothly. Specifically, the tip tip 41 is provided with a cavity 41a for inserting a guide wire (for example, an antegrade guide wire (not shown)), and the tip portion is rounded toward the tip side. It can be formed so as to have a substantially sharp shape. The base end portion of the tip tip 41 is joined (fixed) to the tip end portion of the mesh member 21 or the like.
 先端チップ41を構成する材料としては、体腔等への衝撃を緩和できるように、柔軟性を有することが好ましい。このような材料としては、例えば、ポリウレタン、ポリウレタンエラストマーなどの樹脂材料等が挙げられる。 The material constituting the tip tip 41 is preferably flexible so as to reduce the impact on the body cavity and the like. Examples of such a material include resin materials such as polyurethane and polyurethane elastomer.
 先端チップ41とメッシュ部材21との接合方法としては、例えば、メッシュ部材21を構成する各線材21aそれぞれの先端部を先端チップ41の基端部に溶着等で埋設する方法等を採用することができる。 As a method of joining the tip tip 41 and the mesh member 21, for example, a method of burying the tip of each wire rod 21a constituting the mesh member 21 in the base end of the tip tip 41 by welding or the like can be adopted. it can.
 コアワイヤ51は、先端部がメッシュ部材21の先端および/または先端チップ41に接続され、基端が中空シャフト11の基端よりも基端側に位置するようにメッシュ部材21および中空シャフト11の内部を通って延びている。コアワイヤ51は、具体的には、例えば、先端部が先端チップ41に接合(固定)され、メッシュ部材21の内部の空間、中空シャフト11の先端側シャフト111の内腔111aおよび後述するコネクタ61の内腔61aを通って基端が外部に露出するように配置することができる。 The inside of the mesh member 21 and the hollow shaft 11 so that the tip end portion of the core wire 51 is connected to the tip end and / or the tip end tip 41 of the mesh member 21 and the base end is located closer to the base end side than the base end of the hollow shaft 11. Extends through. Specifically, for example, the core wire 51 has a tip end portion bonded (fixed) to the tip tip 41, and has a space inside the mesh member 21, a cavity 111a of the tip side shaft 111 of the hollow shaft 11, and a connector 61 described later. It can be arranged so that the proximal end is exposed to the outside through the lumen 61a.
 コアワイヤ51を構成する材料としては、メッシュ部材21を確実に拡縮しかつコアワイヤ51自身の切断を防止する観点から、十分な剛性および引張強度を有していることが好ましい。このような材料としては、例えば、ステンレス鋼(SUS304など)、ニッケルチタン合金、コバルトクロム合金などの金属材料等が挙げられる。 The material constituting the core wire 51 preferably has sufficient rigidity and tensile strength from the viewpoint of reliably expanding and contracting the mesh member 21 and preventing the core wire 51 itself from being cut. Examples of such a material include metal materials such as stainless steel (SUS304 and the like), nickel titanium alloys, and cobalt-chromium alloys.
 コアワイヤ51と、先端チップ41および/またはメッシュ部材21との接合方法としては、例えば、コアワイヤ51の先端部を先端チップ41の基端部に溶着等で埋設する方法、および/またはコアワイヤ51の先端部とメッシュ部材21の先端部とを溶接する方法等を採用することができる。 As a method of joining the core wire 51 and the tip tip 41 and / or the mesh member 21, for example, a method of burying the tip of the core wire 51 in the base end of the tip tip 41 by welding or the like, and / or the tip of the core wire 51. A method of welding the portion and the tip portion of the mesh member 21 or the like can be adopted.
 コネクタ61は、オペレータがカテーテル1を把持する部材である。コネクタ61は、中空シャフト11の基端部に接続されている。コネクタ61には、コアワイヤ51が外部に露出するように、中空シャフト11の内腔111aに連通する内腔61aと、内腔61aの基端に形成された開口61bとが形成されている。なお、コネクタ61の形態は、本発明の効果を損なわない限り特に限定されない。 The connector 61 is a member for which the operator grips the catheter 1. The connector 61 is connected to the base end portion of the hollow shaft 11. The connector 61 is formed with a cavity 61a communicating with the cavity 111a of the hollow shaft 11 and an opening 61b formed at the base end of the cavity 61a so that the core wire 51 is exposed to the outside. The form of the connector 61 is not particularly limited as long as the effect of the present invention is not impaired.
 次に、本実施形態に係るコアワイヤ51と先端チップ41との接続状態について詳細に説明する。 Next, the connection state between the core wire 51 and the tip tip 41 according to the present embodiment will be described in detail.
 図2は、第1実施形態に係るコアワイヤの接続状態を示す図である。図2は、先端側視での先端チップ41と複数のコアワイヤ51との接続状態を示している。 FIG. 2 is a diagram showing a connection state of the core wire according to the first embodiment. FIG. 2 shows a connection state between the tip tip 41 and the plurality of core wires 51 when viewed from the tip side.
 先端チップ41は、円筒状の中空形状の部材である。複数(図2の例では、2つ)のコアワイヤ51(51A、51B)は、先端チップ41の先端側視での中心Oから外れた位置の先端チップ41の基端側に接続されている。本実施形態では、コアワイヤ51A、51Bは、中心Oをその中心とする円周上の位置に接続されている。また、コアワイヤ51Aとコアワイヤ51Bとは、それらが中心Oを通る同一直線上とならない位置に接続されている。すなわち、コアワイヤ51Bは、コアワイヤ51Aと中心Oを結ぶ直線上からずれた位置に接続されている。ここで、コアワイヤを複数備えるようにした場合には、引っ張る際の力を分散させることができるので、一本のコアワイヤを備えた場合に比して、コアワイヤの径を細くすることができる。これにより、先端チップ41の取り付け部分を小さくすることができる。また、コアワイヤの径を細くすることができるために、逆行性ガイドワイヤWを中空シャフト11に誘導する際におけるコアワイヤによる障害(例えば、コアワイヤを避けられないような障害)の発生を低減することができる。 The tip tip 41 is a cylindrical hollow member. A plurality of (two in the example of FIG. 2) core wires 51 (51A, 51B) are connected to the base end side of the tip tip 41 at a position deviated from the center O in the tip side view of the tip tip 41. In the present embodiment, the core wires 51A and 51B are connected to positions on the circumference centered on the center O. Further, the core wire 51A and the core wire 51B are connected at positions where they are not on the same straight line passing through the center O. That is, the core wire 51B is connected at a position deviated from the straight line connecting the core wire 51A and the center O. Here, when a plurality of core wires are provided, the force at the time of pulling can be dispersed, so that the diameter of the core wires can be reduced as compared with the case where a single core wire is provided. As a result, the mounting portion of the tip tip 41 can be made smaller. Further, since the diameter of the core wire can be reduced, it is possible to reduce the occurrence of obstacles due to the core wire (for example, obstacles that cannot avoid the core wire) when guiding the retrograde guide wire W to the hollow shaft 11. it can.
 次に、カテーテル1の使用態様について説明する。なお、ここでは、血管内の閉塞物が存在する部位(以下、「閉塞部位」ともいう)に逆行性ガイドワイヤWを通過させる手技について説明する。 Next, the usage mode of the catheter 1 will be described. Here, a procedure for passing the retrograde guide wire W through a site where an obstruction exists in a blood vessel (hereinafter, also referred to as an “occlusal site”) will be described.
 まず、順行性ガイドワイヤ(不図示)を血管内に挿入した後、血管に沿って閉塞部位まで順行性ガイドワイヤを押し進める。次いで、順行性ガイドワイヤの先端が閉塞部位に到達した後、順行性ガイドワイヤをガイドとしてバルーンカテーテルを閉塞部位まで押し進める。そしてバルーンカテーテルが備えるバルーンを拡張・収縮させて閉塞部位に腔を形成したした後、バルーンカテーテルを引っ張り体外へ取り出す。次に、先端チップ41の内腔41aに順行性ガイドワイヤをその基端から挿入し、順行性ガイドワイヤをガイドとしてカテーテル1の先端を血管内にて閉塞部位に形成した腔まで押し進める。この際、カテーテル1は、メッシュ部材21が縮径された状態で血管に挿入され、メッシュ部材21が縮径された状態が維持されたまま、カテーテル1の先端が閉塞部位の腔に到達する推し進められる。 First, an antegrade guide wire (not shown) is inserted into the blood vessel, and then the antegrade guide wire is pushed along the blood vessel to the occluded site. Next, after the tip of the antegrade guide wire reaches the occluded site, the balloon catheter is pushed to the occluded site using the antegrade guide wire as a guide. Then, the balloon provided in the balloon catheter is expanded and contracted to form a cavity in the obstructed site, and then the balloon catheter is pulled out of the body. Next, an antegrade guide wire is inserted into the lumen 41a of the tip tip 41 from its base end, and the tip of the catheter 1 is pushed into the blood vessel to the cavity formed at the occlusion site using the antegrade guide wire as a guide. At this time, the catheter 1 is inserted into the blood vessel with the mesh member 21 reduced in diameter, and the tip of the catheter 1 reaches the cavity of the occlusion site while the mesh member 21 is maintained in the reduced diameter state. Be done.
 カテーテルの先端が閉塞部位の腔に到達した後、カテーテル1に対して順行性ガイドワイヤを基端側に引っ張ることで順行性ガイドワイヤをカテーテル1から抜去する。次いで、コネクタ61の開口61bから外部に露出しているコアワイヤ51の端部を基端側に向かって引っ張る。ここで、複数のコアワイヤ51の端部を同時に引っ張ってもよいし、いずれか一部のコアワイヤ51の端部を引っ張ってもよい。このように、コアワイヤ51の端部が基端側に向かって引っ張られると、カテーテル1においては、図3に示すように、メッシュ部材21の先端と中空シャフト11の先端との間隔が狭まり、結果としてメッシュ部材21が径外側に向かって膨出(拡径)する。この際、メッシュ部材21の拡径に伴ってメッシュ部材21の開口21bも拡張されるので、先端側から向かって来る逆行性ガイドワイヤWを受け入れやすい状態となる。なお、本実施形態では、誘導膜31の先端がメッシュ部材21の軸方向略中央部に接合されているので、メッシュ部材21の拡径に追従して誘導膜31の先端部も拡径され、誘導膜31が全体として漏斗形状に展開する。 After the tip of the catheter reaches the cavity of the occlusion site, the antegrade guide wire is pulled from the catheter 1 by pulling the antegrade guide wire toward the proximal end side with respect to the catheter 1. Next, the end portion of the core wire 51 exposed to the outside from the opening 61b of the connector 61 is pulled toward the base end side. Here, the ends of the plurality of core wires 51 may be pulled at the same time, or the ends of any part of the core wires 51 may be pulled. When the end of the core wire 51 is pulled toward the proximal end side in this way, the distance between the tip of the mesh member 21 and the tip of the hollow shaft 11 is narrowed in the catheter 1 as shown in FIG. 3, resulting in As a result, the mesh member 21 bulges (expands) toward the outside of the diameter. At this time, since the opening 21b of the mesh member 21 is also expanded as the diameter of the mesh member 21 is expanded, it becomes easy to accept the retrograde guide wire W coming from the tip side. In the present embodiment, since the tip of the guide film 31 is joined to the substantially central portion in the axial direction of the mesh member 21, the tip of the guide film 31 is also expanded in diameter following the expansion of the mesh member 21. The induction film 31 develops in a funnel shape as a whole.
 この状態において、先端側から向かって来る逆行性ガイドワイヤWを、カテーテル1に受け入れる。逆行性ガイドワイヤWが向かってくる経路としては、例えば、閉塞部位を囲繞する血管壁内の偽腔、閉塞部位を貫通する貫通孔等が想定されるが、いずれの経路からの逆行性ガイドワイヤWであってもよい。逆行性ガイドワイヤWは、拡径したメッシュ部材21の開口21bを通してメッシュ部材21の内側の空間に受け入れられた後、中空シャフト11先端の開口11bを介して先端側シャフト111の内腔111aに受け入れられ、連通孔113を介してカテーテル1の外部に送出される。 In this state, the retrograde guide wire W coming from the distal end side is received in the catheter 1. As the path to which the retrograde guide wire W is directed, for example, a false cavity in the blood vessel wall surrounding the obstruction site, a through hole penetrating the obstruction site, or the like is assumed, and the retrograde guide wire from any of the routes is assumed. It may be W. The retrograde guide wire W is received in the space inside the mesh member 21 through the opening 21b of the enlarged mesh member 21, and then is received in the cavity 111a of the tip side shaft 111 through the opening 11b at the tip of the hollow shaft 11. It is delivered to the outside of the catheter 1 through the communication hole 113.
 以上のように、カテーテル1は、上記構成であるので、例えば逆行性ガイドワイヤWをメッシュ部材21により受け入れて、中空シャフト11の内腔111aに適切に誘導することができる。 As described above, since the catheter 1 has the above configuration, for example, the retrograde guide wire W can be received by the mesh member 21 and appropriately guided to the cavity 111a of the hollow shaft 11.
 次に、本実施形態に係るカテーテルを血管の屈曲部で使用する場合の一例について説明する。 Next, an example of the case where the catheter according to the present embodiment is used at the flexed portion of the blood vessel will be described.
 図4は、第1実施形態に係るカテーテルの血管の屈曲部での状態の一例を示す図である。 FIG. 4 is a diagram showing an example of the state of the catheter according to the first embodiment at the bent portion of the blood vessel.
 カテーテル1の先端が血管200の屈曲部まで推し進められると、例えば、図4に示すように、先端チップ41及びメッシュ部材21が血管200の屈曲部の屈曲外側(図中上側)に接触した状態で屈曲した状態となる。 When the tip of the catheter 1 is pushed to the bent portion of the blood vessel 200, for example, as shown in FIG. 4, the tip tip 41 and the mesh member 21 are in contact with the bent outer side (upper side in the figure) of the bent portion of the blood vessel 200. It will be in a bent state.
 ここで、比較例に係るカテーテルの血管の屈曲部でのメッシュ部材の拡張の一例について説明する。 Here, an example of expansion of the mesh member at the bending portion of the blood vessel of the catheter according to the comparative example will be described.
 図5は、比較例に係るカテーテルの血管の屈曲部でのメッシュ部材の拡張の一例を示す図である。なお、比較例に係るカテーテル100において、本実施形態に係るカテーテル1と同一部分については、同一符号を用いて説明する。 FIG. 5 is a diagram showing an example of expansion of a mesh member at a bending portion of a blood vessel of a catheter according to a comparative example. In the catheter 100 according to the comparative example, the same portion as the catheter 1 according to the present embodiment will be described with reference to the same reference numerals.
 カテーテル100においては、コアワイヤ51が1つ備えられており、コアワイヤ51は、先端チップ41の先端側視での中心から外れた位置の基端側に接続されている。図5に示す状態では、コアワイヤ51は、先端チップ41の血管200の屈曲部の屈曲外側に近い位置に接続されている。 The catheter 100 is provided with one core wire 51, and the core wire 51 is connected to the proximal end side of the distal end tip 41 at a position off-center in the distal end side view. In the state shown in FIG. 5, the core wire 51 is connected to the tip tip 41 at a position close to the bent outer side of the bent portion of the blood vessel 200.
 この状態において、コアワイヤ51の端部が基端側に向かって引っ張られると、メッシュ部材21の先端と中空シャフト11の先端との間隔が狭まる。この際には、メッシュ部材21の屈曲部の屈曲内側は、障害がないので十分に拡張される一方、メッシュ部材21の屈曲部の屈曲外側は、先端チップ41の移動方向等により、血管200の内壁と接触することによって、十分に拡張することができない。 In this state, if the end of the core wire 51 is pulled toward the base end side, the distance between the tip of the mesh member 21 and the tip of the hollow shaft 11 is narrowed. At this time, the bent inside of the bent portion of the mesh member 21 is sufficiently expanded because there is no obstacle, while the bent outside of the bent portion of the mesh member 21 is formed by the moving direction of the tip tip 41 of the blood vessel 200. It cannot be fully expanded by contacting the inner wall.
 次に、実施形態に係るカテーテル1の血管の屈曲部でのメッシュ部材の拡張の一例について説明する。 Next, an example of expansion of the mesh member at the bent portion of the blood vessel of the catheter 1 according to the embodiment will be described.
 図6は、第1実施形態に係るカテーテルの血管の屈曲部でのメッシュ部材の拡張の一例を示す図である。 FIG. 6 is a diagram showing an example of expansion of a mesh member at a bent portion of a blood vessel of the catheter according to the first embodiment.
 図6に示す状態では、一方のコアワイヤ51は、先端チップ41の血管の屈曲部の屈曲外側に近い位置に接続されているが、他方のコアワイヤ51は、先端チップ41の血管200の屈曲部の屈曲外側から遠い位置(屈曲内側)に接続されている。 In the state shown in FIG. 6, one core wire 51 is connected to a position close to the outside of the bend of the bent portion of the blood vessel of the tip tip 41, while the other core wire 51 is connected to the bent portion of the blood vessel 200 of the tip tip 41. It is connected to a position far from the outside of the bend (inside the bend).
 この状態において、血管200の屈曲部の屈曲外側から遠いコアワイヤ51の端部が基端側に向かって引っ張られると、メッシュ部材21の先端と中空シャフト11の先端との間隔が狭まる。この際には、メッシュ部材21の屈曲部の屈曲内側は、障害がないので十分に拡張される。また、メッシュ部材21の先端と中空シャフト11の先端との間隔を狭める屈曲外側から遠いコアワイヤ51は、比較例に係るカテーテル100のコアワイヤ51と比べて屈曲外側の血管200の内壁との距離が離れているので、比較例に比べて、メッシュ部材21が変形しやすく、より効果的に拡張することができる。また、血管200の屈曲部の屈曲外側から近いコアワイヤ51と、屈曲外側から遠いコアワイヤ51との両方を操作することにより、メッシュ部材21の向き等を調整することができ、メッシュ部材21の拡張をより効果的に行うことができる。この結果、メッシュ部材21により、逆行性ガイドワイヤWを受け入れて、中空シャフト11の内腔111aに適切に誘導することができる。 In this state, when the end of the core wire 51 far from the bent outside of the bent portion of the blood vessel 200 is pulled toward the proximal end side, the distance between the tip of the mesh member 21 and the tip of the hollow shaft 11 is narrowed. At this time, the bent inside of the bent portion of the mesh member 21 is sufficiently expanded because there is no obstacle. Further, the core wire 51 far from the bent outer side that narrows the distance between the tip of the mesh member 21 and the tip of the hollow shaft 11 is farther from the inner wall of the blood vessel 200 on the bent outer side than the core wire 51 of the catheter 100 according to the comparative example. Therefore, as compared with the comparative example, the mesh member 21 is easily deformed and can be expanded more effectively. Further, by operating both the core wire 51 near the bent outer side of the bent portion of the blood vessel 200 and the core wire 51 far from the bent outer side, the orientation of the mesh member 21 and the like can be adjusted, and the mesh member 21 can be expanded. It can be done more effectively. As a result, the mesh member 21 can accept the retrograde guide wire W and appropriately guide it to the cavity 111a of the hollow shaft 11.
 なお、本実施形態においては、上述したように、2つのコアワイヤが、それらが先端チップ41の先端側視の中心Oを通る同一直線上とならない位置に接続されている。この構成により、例えば、血管の屈曲部において、屈曲する方向に対して、2つのコアワイヤが同様な位置関係となること、具体的には、例えば、屈曲外側からコアワイヤ51が等距離となることが防げる。これにより、2つのコアワイヤ51を調整することによりメッシュ部材21をより拡張しやすい状態に調整することができる。 In the present embodiment, as described above, the two core wires are connected at positions where they are not on the same straight line passing through the center O of the tip side view of the tip tip 41. With this configuration, for example, in the bending portion of the blood vessel, the two core wires have the same positional relationship with respect to the bending direction, specifically, for example, the core wire 51 is equidistant from the outside of the bending. Can be prevented. Thereby, by adjusting the two core wires 51, the mesh member 21 can be adjusted to a state in which it is easier to expand.
[第2実施形態]
 次に、第2実施形態に係るカテーテルについて説明する。
[Second Embodiment]
Next, the catheter according to the second embodiment will be described.
 図7は、第2実施形態に係るカテーテルの概略的断面図である。なお、第1実施形態に係るカテーテルと同一部分には、同一符号を付すこととする。 FIG. 7 is a schematic cross-sectional view of the catheter according to the second embodiment. The same parts as those of the catheter according to the first embodiment are designated by the same reference numerals.
 カテーテル1Aは、複数のコアワイヤ51に代えて、複数のコアワイヤ52を備える。コアワイヤ52と先端チップ41との接続方法は、コアワイヤ51と先端チップ41との接続方法と同じでよい。また、コアワイヤ52を構成する材料は、コアワイヤ51を構成する材料と同じでよい。 The catheter 1A includes a plurality of core wires 52 instead of the plurality of core wires 51. The method of connecting the core wire 52 and the tip tip 41 may be the same as the method of connecting the core wire 51 and the tip tip 41. Further, the material constituting the core wire 52 may be the same as the material constituting the core wire 51.
 コアワイヤ52は、中空シャフト11の先端側シャフト111の中間部までの長さとなっている。複数のコアワイヤ52は、接続部材53を介して接続されている。接続部材53は、1つの共通ワイヤ54に接続されている。共通ワイヤ54は、中空シャフト11の先端側シャフト111の内腔111aおよびコネクタ61の内腔61aを通って基端が外部に露出する長さに構成されている。 The core wire 52 has a length up to the middle portion of the tip side shaft 111 of the hollow shaft 11. The plurality of core wires 52 are connected via a connecting member 53. The connecting member 53 is connected to one common wire 54. The common wire 54 is configured to have a length such that the base end is exposed to the outside through the cavity 111a of the tip end side shaft 111 of the hollow shaft 11 and the cavity 61a of the connector 61.
 本実施形態に係るカテーテル1Aでは、共通ワイヤ54が引っ張られることにより、コアワイヤ52により先端チップ41が引っ張られて、メッシュ部材21が拡張されることとなる。 In the catheter 1A according to the present embodiment, when the common wire 54 is pulled, the tip tip 41 is pulled by the core wire 52, and the mesh member 21 is expanded.
 このような構成により、本実施形態に係るカテーテルによると、第1実施形態と同様な効果が得られる。また、本実施形態に係るカテーテルによると、手技者は、共通ワイヤ54を操作すればよいので、手技における煩雑さを低減することができる。 With such a configuration, according to the catheter according to the present embodiment, the same effect as that of the first embodiment can be obtained. Further, according to the catheter according to the present embodiment, the operator only needs to operate the common wire 54, so that the complexity of the procedure can be reduced.
[第3実施形態]
 次に、第3実施形態に係るカテーテルについて説明する。
[Third Embodiment]
Next, the catheter according to the third embodiment will be described.
 図8は、第3実施形態に係るカテーテルの概略的断面図である。なお、第1実施形態に係るカテーテルと同一部分には、同一符号を付すこととする。 FIG. 8 is a schematic cross-sectional view of the catheter according to the third embodiment. The same parts as those of the catheter according to the first embodiment are designated by the same reference numerals.
 カテーテル1Bは、複数のコアワイヤ51に代えて、複数のコアワイヤ55を備える。コアワイヤ55と先端チップ41との接続方法は、コアワイヤ51と先端チップ41との接続方法と同じでよい。また、コアワイヤ55を構成する材料は、コアワイヤ51を構成する材料と同じでよい。 Catheter 1B includes a plurality of core wires 55 instead of the plurality of core wires 51. The method of connecting the core wire 55 and the tip tip 41 may be the same as the method of connecting the core wire 51 and the tip tip 41. Further, the material constituting the core wire 55 may be the same as the material constituting the core wire 51.
 コアワイヤ55は、中空シャフト11の先端側シャフト111の中間部までの長さとなっている。複数のコアワイヤ55は、1つの共通ワイヤ56に接続されている。共通ワイヤ56は、中空シャフト11の先端側シャフト111の内腔111aおよびコネクタ61の内腔61aを通って基端が外部に露出する長さに構成されている。なお、コアワイヤ55は、共通ワイヤ56を分岐させて構成してもよい。 The core wire 55 has a length up to the middle portion of the tip side shaft 111 of the hollow shaft 11. The plurality of core wires 55 are connected to one common wire 56. The common wire 56 is configured to have a length such that the base end is exposed to the outside through the cavity 111a of the tip end side shaft 111 of the hollow shaft 11 and the cavity 61a of the connector 61. The core wire 55 may be configured by branching the common wire 56.
 本実施形態に係るカテーテル1Bでは、共通ワイヤ56が引っ張られることにより、コアワイヤ55により先端チップ41が引っ張られて、メッシュ部材21が拡張されることとなる。 In the catheter 1B according to the present embodiment, when the common wire 56 is pulled, the tip tip 41 is pulled by the core wire 55, and the mesh member 21 is expanded.
 このような構成により、本実施形態に係るカテーテルによると、第1実施形態と同様な効果が得られる。また、本実施形態に係るカテーテルによると、手技者は、共通ワイヤ56を操作すればよいので、手技における煩雑さを低減することができる。 With such a configuration, according to the catheter according to the present embodiment, the same effect as that of the first embodiment can be obtained. Further, according to the catheter according to the present embodiment, the operator only needs to operate the common wire 56, so that the complexity of the procedure can be reduced.
[変形例]
 次に、上記した第1乃至第3実施形態に係るカテーテルの変形例について説明する。
[Modification example]
Next, a modified example of the catheter according to the first to third embodiments described above will be described.
 図9は、変形例に係るコアワイヤの接続状態を示す図である。 FIG. 9 is a diagram showing a connection state of the core wire according to the modified example.
 上記各実施形態では、具体例として、2つのコアワイヤ51(52,55)を備えたカテーテル1,1A,1Bを説明したが、本発明はこれに限られず、コアワイヤを3つ以上備えるようにしてもよい。 In each of the above embodiments, catheters 1, 1A and 1B provided with two core wires 51 (52, 55) have been described as specific examples, but the present invention is not limited to this, and three or more core wires are provided. May be good.
 例えば、3つのコアワイヤ51(52,55)を備える場合においては、各コアワイヤ51(52,55)については、図9に示すように、先端チップ41の中心Oを中心とする円周上の位置に3つのコアワイヤ51を接続すればよい。例えば、各コアワイヤ51(52,55)を接続する位置の間隔が均等となるように、換言すると、コアワイヤ51を接続する位置が、中心Oを重心とする正三角形の頂点の位置となるようにしてもよい。なお、より多くのコアワイヤ51(52,55)を備える場合には、各コアワイヤ51(52,55)を接続する位置を、中心Oを重心とする、コアワイヤ51(52,55)の数に対応する正多角形の頂点の位置とすればよい。 For example, when three core wires 51 (52, 55) are provided, each core wire 51 (52, 55) is located on the circumference centered on the center O of the tip tip 41 as shown in FIG. It suffices to connect three core wires 51 to. For example, the positions where the core wires 51 (52, 55) are connected are evenly spaced, in other words, the positions where the core wires 51 are connected are the positions of the vertices of an equilateral triangle whose center of gravity is the center O. You may. When more core wires 51 (52, 55) are provided, the position where each core wire 51 (52, 55) is connected corresponds to the number of core wires 51 (52, 55) with the center O as the center of gravity. It may be the position of the apex of the regular polygon.
 このような構成とすると、コアワイヤ51(52,55)により先端チップ41を引っ張る位置、引っ張る力、引っ張る長さを調整することもできるし、先端チップ41に対して、均等な力を加えて引っ張ることもでき、メッシュ部材21を適切に拡張することができる。 With such a configuration, the position where the tip tip 41 is pulled, the pulling force, and the pulling length can be adjusted by the core wire 51 (52, 55), and the tip tip 41 is pulled by applying an even force. It is also possible to appropriately expand the mesh member 21.
 なお、本発明は、上述した実施形態の構成に限定されるものではなく、特許請求の範囲によって示され、特許請求の範囲と均等の意味および範囲内での全ての変更が含まれることが意図される。 It should be noted that the present invention is not limited to the configuration of the above-described embodiment, but is indicated by the scope of claims, and is intended to include all modifications within the meaning and scope equivalent to the scope of claims. Will be done.
 例えば、上述した実施形態では、中空シャフト11が先端側シャフト111と基端側シャフト112と連通孔113とを備えているカテーテル1について説明したが、カテーテルは、連通孔を有さずかつ先端から基端に亘って延設された単一の内腔を有する中空シャフトを備えたカテーテル(オーバー・ザ・ワイヤータイプ(OTW)のカテーテル)であってもよい。 For example, in the above-described embodiment, the catheter 1 in which the hollow shaft 11 includes the distal end side shaft 111, the proximal end side shaft 112, and the communication hole 113 has been described, but the catheter does not have a communication hole and is from the distal end. It may be a catheter (over-the-wire type (OTW) catheter) with a hollow shaft having a single lumen extending over the proximal end.
 1,1A,1B カテーテル
 11 中空シャフト
 111 先端側シャフト
 111a 内腔
 21 メッシュ部材
 41 先端チップ
 51,52,55 コアワイヤ
 54,56 共通ワイヤ
 W 逆行性ガイドワイヤ
1,1A, 1B Catheter 11 Hollow shaft 111 Tip side shaft 111a Cavity 21 Mesh member 41 Tip tip 51, 52, 55 Core wire 54, 56 Common wire W Retrograde guide wire

Claims (5)

  1.  径方向に拡縮可能なチューブ状のメッシュ部材と、
     前記メッシュ部材の基端部に接続された中空シャフトと、
     前記メッシュ部材の先端部に接続された中空の先端チップと、
     先端部が前記メッシュ部材の先端部および/または前記先端チップに接続され、前記メッシュ部材および前記中空シャフトの内部を通って延びる複数のコアワイヤと、を備え、
     複数の前記コアワイヤは、先端部が前記メッシュ部材の先端部および/または前記先端チップの先端側視における中心から外れた位置に接続されている
    カテーテル。
    A tubular mesh member that can be expanded and contracted in the radial direction,
    A hollow shaft connected to the base end of the mesh member and
    A hollow tip connected to the tip of the mesh member and
    A plurality of core wires having a tip end portion connected to the tip portion of the mesh member and / or the tip tip and extending through the inside of the mesh member and the hollow shaft.
    A catheter in which the tip of the core wire is connected to the tip of the mesh member and / or at a position off-center in the tip side view of the tip.
  2.  複数の前記コアワイヤのそれぞれは、基端が前記第中空シャフトの基端よりも基端側に位置するように延びている
    請求項1に記載のカテーテル。
    The catheter according to claim 1, wherein each of the plurality of core wires extends so that the proximal end is located closer to the proximal end than the proximal end of the hollow shaft.
  3.  複数の前記コアワイヤは、基端が同一の共通ワイヤに接続され、前記共通ワイヤは、前記中空シャフトの基端よりも基端側に位置するように延びている
    請求項1に記載のカテーテル。
    The catheter according to claim 1, wherein the plurality of core wires are connected to a common wire having the same proximal end, and the common wire extends so as to be located closer to the proximal end side than the proximal end of the hollow shaft.
  4.  前記コアワイヤを3以上備え、
     3以上の前記コアワイヤは、それぞれの先端部が、前記メッシュ部材の先端部および/または前記先端チップの先端側視における中心をその中心とする円周上における、それぞれの前記先端部の間隔が均等となる位置に接続されている
    請求項1から請求項3のいずれか一項に記載のカテーテル。
    With 3 or more of the core wires
    In the three or more core wires, the respective tip portions are evenly spaced from each other on the circumference centered on the tip portion of the mesh member and / or the center of the tip end side view. The catheter according to any one of claims 1 to 3, which is connected to a position.
  5.  前記コアワイヤを2つ備え、
     2つの前記コアワイヤは、それぞれの先端部が、前記メッシュ部材の先端部および/または前記先端チップの先端側視における中心を通る同一直線上とならない位置に接続されている
    請求項1から請求項3のいずれか一項に記載のカテーテル。
    With two of the core wires
    Claims 1 to 3 in which the two core wires are connected at positions where their respective tips are not on the same straight line passing through the tip of the mesh member and / or the center of the tip in the tip side view. The catheter according to any one of the above.
PCT/JP2019/038625 2019-09-30 2019-09-30 Catheter WO2021064825A1 (en)

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PCT/JP2019/038625 WO2021064825A1 (en) 2019-09-30 2019-09-30 Catheter
JP2021550778A JPWO2021064825A1 (en) 2019-09-30 2019-09-30

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090163891A1 (en) * 2007-12-20 2009-06-25 Bayer Schering Pharma Ag Catheter having a core wire and a low profile bond
JP2013509946A (en) * 2009-11-09 2013-03-21 セント・ジュード・メディカル・エイトリアル・フィブリレーション・ディヴィジョン・インコーポレーテッド Device for reducing axial contraction of catheter or sheath due to repeated bending
WO2018193599A1 (en) * 2017-04-20 2018-10-25 朝日インテック株式会社 Catheter

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090163891A1 (en) * 2007-12-20 2009-06-25 Bayer Schering Pharma Ag Catheter having a core wire and a low profile bond
JP2013509946A (en) * 2009-11-09 2013-03-21 セント・ジュード・メディカル・エイトリアル・フィブリレーション・ディヴィジョン・インコーポレーテッド Device for reducing axial contraction of catheter or sheath due to repeated bending
WO2018193599A1 (en) * 2017-04-20 2018-10-25 朝日インテック株式会社 Catheter

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