WO2021210188A1

WO2021210188A1 - Catheter

Info

Publication number: WO2021210188A1
Application number: PCT/JP2020/021738
Authority: WO
Inventors: 紘一郎田代
Original assignee: 紘一郎田代
Priority date: 2020-04-17
Filing date: 2020-06-02
Publication date: 2021-10-21
Also published as: JP2021168846A

Abstract

Provided is a catheter with which it is possible to more accurately identify the length of a blood clot using an X-ray transmission image.　A catheter body 10 of a catheter 1 comprises a contrast medium release section 100 provided in a region at a distal end side when inserted into a blood vessel, and a plurality of release holes 110 provided in a side surface of the contrast medium release section 100. At least one release hole 110 is provided in each end of the contrast medium release section 100 in a central axis direction X.

Description

catheter

The present invention relates to a catheter inserted into a blood vessel.

Conventionally, a stent system including a wire and a stent connected to the distal side thereof has been used as an instrument for capturing a thrombus generated in a blood vessel. This stent system is inserted into a blood vessel together with a catheter. After the thrombus is captured by the stent, the thrombus is recovered by being connected to the wire and the stent that has captured the thrombus is pulled out of the body (see, for example, Patent Document 1).

Japanese Unexamined Patent Publication No. 2019-005587

When collecting a thrombus with a stent, it is necessary to select a stent suitable for the length of the thrombus in advance. Conventionally, before the stent is sent to the thrombus site, a contrast medium (X-ray opaque) is discharged from the tip of the catheter into the thrombus, and the position and length of the thrombus are grasped by an X-ray transmission image. ing. However, with conventional catheters for contrast media, it is difficult for the contrast medium released from the tip to reach the distal end of the thrombus, so it is difficult to accurately grasp the length of the thrombus from an X-ray transmission image. There are challenges. In order to solve such a problem, for example, it is conceivable to select a longer stent. However, when a long stent is used, when the stent that has captured the thrombus is pulled out of the body, the stent is likely to be caught on the blood vessel wall, which increases the burden on the blood vessel wall.

An object of the present invention is to provide a catheter capable of more accurately grasping the length of a thrombus by an X-ray transmission image.

The first invention is a catheter provided with a tubular catheter body, wherein the catheter body has a contrast medium discharge portion provided in a region on the distal end side when inserted into a blood vessel, and the contrast medium discharge portion. The catheter comprises a plurality of discharge holes provided on the side surface of the portion, and the discharge holes are provided at least one at both ends in the central axial direction of the contrast medium discharge portion.

In the above invention, the plurality of discharge holes may be provided at equal intervals along the central axis direction of the contrast medium discharge portion.

In the above invention, the plurality of discharge holes may be provided at equal intervals along the circumferential direction of the contrast medium discharge portion.

In the above invention, the plurality of the discharge holes may be provided at positions facing each other in the radial direction of the contrast medium discharge portion.

In the above invention, at least one of the plurality of discharge holes may penetrate in a direction orthogonal to the central axis direction of the contrast medium discharge portion.

In the above invention, at least one of the plurality of discharge holes is such that the inner opening is located on the distal end side of the contrast medium discharge portion and the outer opening is located on the rear end side of the contrast medium discharge portion. It may penetrate in a direction diagonally intersecting the central axis direction of the contrast medium discharging portion.

According to the catheter according to the present invention, the length of the thrombus can be grasped more accurately from the X-ray transmission image.

It is a figure which shows the structure of the catheter 1 of 1st Embodiment. It is a side view of the contrast medium discharge part 100. FIG. 2 is a cross-sectional view taken along the line AA of FIG. FIG. 2 is a cross-sectional view taken along the line BB of FIG. FIG. 2 is a cross-sectional view taken along the line CC of FIG. It is a conceptual diagram of a catheter stent system 30. Is a schematic diagram showing a procedure for imaging a thrombus in a blood vessel with a catheter 1. Is a schematic diagram showing a procedure for imaging a thrombus in a blood vessel with a catheter 1. Is a schematic diagram showing a procedure for imaging a thrombus in a blood vessel with a catheter 1. Is a schematic diagram showing a procedure for collecting a thrombus in a blood vessel by a catheter stent system 30. Is a schematic diagram showing a procedure for collecting a thrombus in a blood vessel by a catheter stent system 30. Is a schematic diagram showing a procedure for collecting a thrombus in a blood vessel by a catheter stent system 30. Is a schematic diagram showing a procedure for collecting a thrombus in a blood vessel by a catheter stent system 30. It is a figure which shows the structure of the contrast medium discharge part 100 of 2nd Embodiment. It is sectional drawing which shows the modification of the contrast medium discharge part 100. Is a side view showing a modified example of the contrast medium discharging unit 100. Is a side view showing a modified example of the contrast medium discharging unit 100.

Hereinafter, embodiments of the catheter according to the present invention will be described. The drawings attached to the present specification are all schematic drawings, and the shape, scale, aspect ratio, etc. of each part are changed or exaggerated from the actual product in consideration of ease of understanding. Further, in the drawings, hatching indicating a cross section of the member is appropriately omitted.
In the present specification and the like, terms that specify the shape, geometric conditions, and their degrees, such as "parallel", "orthogonal", and "direction", are used in addition to the strict meaning of the terms. It includes a range that can be regarded as almost parallel, almost orthogonal, etc., and a range that can be regarded as being in that direction.

[First Embodiment]
FIG. 1 is a diagram showing the configuration of the catheter 1 of the first embodiment. FIG. 2 is a side view of the contrast medium discharging unit 100. FIG. 3 is a cross-sectional view taken along the line AA of FIG. FIG. 4 is a cross-sectional view taken along the line BB of FIG. FIG. 5 is a cross-sectional view taken along the line CC of FIG.
In the present specification, as shown in FIG. 2 and the like, in a direction parallel to the central axis a of the contrast medium discharging portion 100 (hereinafter, also referred to as “central axis direction X”), the proximal end side (or the posterior end side) described later ) Is in the X1 direction, and the tip side is in the X2 direction. Regarding the longitudinal direction of the catheter body 10, the proximal end side is the X1 direction and the distal end side is the X2 direction. In the present specification, in the contrast medium discharging unit 100 shown in FIG. 2, the direction orthogonal to the central axis direction X is defined as the Y (Y1-Y2) direction. The Y direction also coincides with the radial direction of the catheter body 10. Further, in the present specification, in the contrast medium discharging unit 100 shown in FIG. 3, the vertical direction of the paper surface is the Z (Z1-Z2) direction. The Z direction is a direction orthogonal to the XY direction shown in FIG. Further, in the present specification, the "-direction" is also appropriately referred to as a "-side".

(Catheter 1)
As shown in FIG. 1, the catheter 1 includes a catheter body 10 and a hub 20.
The catheter 1 shown in FIG. 1 is used, for example, for imaging a thrombus formed in a cerebral blood vessel and for collecting a thrombus with a stent (described later). In the present specification, the side where the catheter body 10 is inserted into the blood vessel is referred to as the "tip side" (X2 side), and the front side (hub 20 side) where the practitioner operates the catheter 1 is referred to as the "base end side" (the proximal end side). X1 side). Although not shown, the catheter 1 is used while being inserted into the guiding catheter, and is guided to a target site in the blood vessel together with the guide wire 11 (described later).

The catheter body 10 is a portion to be inserted into a blood vessel, and the entire catheter body 10 is formed in an elongated tubular shape. The catheter body 10 has a spiral coil as a core material, a mesh-like braided coil, and the like coated with a resin layer, and has flexibility as a whole. The outer diameter of the catheter body 10 is, for example, 0.55 to 2.1 mm. The inner diameter of the catheter body 10 is, for example, 0.33 to 1.78 mm. In the cross-sectional view of FIG. 2 and the like, the above-mentioned spiral coil, resin layer, and the like are not shown. As shown in FIG. 1, the catheter body 10 is provided with a contrast medium discharging portion 100 (described later) in a region on the distal end side when inserted into a blood vessel.

The hub 20 is a member provided on the proximal end side of the catheter body 10. The inside of the hub 20 communicates with the catheter body 10. The hub 20 is a portion that serves as an entrance when a contrast medium is injected into the catheter body 10 or a stent (described later) is inserted. The hub 20 is also a portion that the practitioner grips when operating the catheter body 10 and the like.

(Contrast agent release unit 100)
As shown in FIG. 2, in the present embodiment, the portion of the range S1 provided on the distal end side of the catheter main body 10 is the contrast medium discharging portion 100. The range S1 is provided at the distal end side end of the discharge hole 110 provided on the most proximal end side (X1 side) and on the most distal end side (X2 side) in the central axial direction X of the contrast medium discharge portion 100. It is between the end of the discharge hole 110 on the distal end side.

The length of the range S1 of the contrast medium discharging portion 100 is set according to the length in the longitudinal direction of the thrombus to be imaged. For example, when the length of the thrombus to be imaged is assumed to be 50 mm, the length of the range S1 of the contrast medium discharging portion 100 is about 80 mm. When angiography of a thrombus is performed, a catheter 1 (catheter body 10) having a contrast medium discharging portion 100 suitable for the assumed length of the thrombus is selected. The assumed length of the thrombus is comprehensively determined by the practitioner based on, for example, the site of the blood vessel into which the catheter 1 is inserted, the inner diameter, the blood flow rate, and the like.

In the present embodiment, the outer diameter and inner diameter of the contrast medium discharging portion 100 are the same as those of the catheter main body 10. In the embodiment, an example of the number, arrangement, diameter, etc. of the discharge holes 110 (described later) provided in the contrast medium discharge unit 100 will be specified, but these are the outer diameter, inner diameter, and length of the range S1 of the contrast agent discharge unit 100. Etc., it is appropriately selected.

As shown in FIG. 2, a plurality of (18 in total in this example) discharge holes 110 are provided on the side surface of the contrast medium discharge unit 100 along the central axis direction X of the contrast medium discharge unit 100. There is. The discharge hole 110 is a portion that discharges the contrast medium injected into the catheter body 10 to the outside. As shown in FIGS. 2 and 3, each discharge hole 110 of the first embodiment penetrates in a direction orthogonal to the central axis direction X of the contrast medium discharge portion 100.

In the catheter body 10, a tip opening 101 is provided on the tip side (X2 side) of the contrast medium discharging portion 100. At the time of collecting the thrombus, the stent 31 (described later) is pushed out from the tip opening 101. At the time of contrasting the thrombus, the contrast medium injected into the catheter body 10 is discharged not only from the discharge hole 110 of the contrast medium discharge portion 100 but also from the tip opening 101. In the catheter body 10, a marker 102 is provided between the tip opening 101 and the contrast medium discharging portion 100. The marker 102 is a ring-shaped member that serves as a mark for confirming the position of the catheter body 10 on the distal side. The marker 102 is made of a metal material having X-ray impermeable property.

As shown in FIGS. 2 and 3, the plurality of discharge holes 110 are formed on the side surface of the contrast agent discharge unit 100 in the Y (Y1-Y2) direction and Z (Z1) along the central axis direction X of the contrast agent discharge unit 100. The sides in the −Z2) direction are provided at equal intervals. As shown in FIG. 3, a discharge hole 110 provided on the side surface of the contrast medium discharge unit 100 in the Y (Y1-Y2) direction and a discharge hole provided on the side surface of the contrast medium discharge unit 100 in the Z (Z1-Z2) direction. The 110s are arranged at equal intervals at a pitch of a distance L in the central axis direction X of the contrast medium discharging unit 100. The distance L is, for example, 1 to 80 mm. The diameter d of the discharge hole 110 (see FIG. 2) is, for example, 0.2 to 0.6 mm. The discharge hole 110 can be formed, for example, by irradiating a region to be the contrast medium discharge portion 100 with a laser beam or piercing a hole punch or the like in the catheter main body 10.

As shown in FIG. 2, four discharge holes 110 are provided on the side surfaces of the contrast medium discharge unit 100 in the Y (Y1-Y2) direction along the central axis direction X of the contrast medium discharge unit 100. There is. The discharge holes 110 provided on the side surface of the contrast medium discharge unit 100 in the Y (Y1-Y2) direction are the discharge holes provided on the side surface in the Z (Z1-Z2) direction in the central axis direction X of the contrast medium discharge unit 100. It is arranged alternately with the holes 110.

Further, each discharge hole 110 provided on the side surface of the contrast medium discharge unit 100 in the Y (Y1-Y2) direction is the center of the contrast medium discharge unit 100 at each position in the central axial direction X, as shown in FIG. It is provided at positions facing each other in the radial direction with the shaft a in between. That is, each discharge hole 110 provided on the side surface of the contrast medium discharge unit 100 in the Y (Y1-Y2) direction is provided at two locations at each position in the central axial direction X, and is provided in the circumferential direction of the contrast medium discharge unit 100. They are arranged at 180 degree intervals along the CD. In other words, on the side surface of the contrast medium discharging unit 100 in the Y (Y1-Y2) direction, the discharge holes 110 are arranged at equal intervals along the circumferential CD of the contrast medium discharging unit 100.

As shown in FIG. 3, five discharge holes 110 are provided on the side surfaces of the contrast medium discharge unit 100 in the Z (Z1-Z2) direction along the central axis direction X of the contrast medium discharge unit 100. There is. Each discharge hole 110 provided on the side surface of the contrast medium discharge unit 100 in the Z (Z1-Z2) direction is provided on the side surface in the Y (Y1-Y2) direction in the central axis direction X of the contrast medium discharge unit 100. It is arranged alternately with the discharge holes 110.

Further, each discharge hole 110 provided on the side surface of the contrast medium discharge unit 100 in the Z (Z1-Z2) direction is the center of the contrast agent discharge unit 100 at each position in the central axial direction X, as shown in FIG. It is provided at positions facing each other in the radial direction with the shaft a in between. That is, each discharge hole 110 on the side surface of the contrast medium discharge unit 100 in the Z (Z1-Z2) direction is provided at two locations at each position in the central axial direction X, and is along the circumferential direction CD of the contrast medium discharge unit 100. They are arranged at intervals of 180 degrees. In other words, on the Z (Z1-Z2) direction side surfaces of the contrast medium discharge unit 100, the discharge holes 110 are arranged at equal intervals along the circumferential CD of the contrast medium discharge unit 100.
As shown in FIGS. 4 and 5, the discharge holes 110 on the side surface in the Y (Y1-Y2) direction and the side surface in the Z (Z1-Z2) direction of the contrast medium discharge unit 100 are provided at positions orthogonal to each other. There is.

(Catheter Stent System 30)
Before explaining the procedure for imaging the thrombus with the catheter 1 of the present embodiment, the configuration of the catheter stent system 30 for collecting the thrombus after the imaging will be described.
FIG. 6 is a conceptual diagram of the catheter stent system 30. As shown in FIG. 6, the catheter stent system 30 includes a catheter body 10 (catheter 1) and a stent 31. The catheter stent system 30 is a system in which the catheter 1 (see FIG. 1) and the stent 31 selected according to the length of the thrombus are combined. In FIG. 6, the contrast medium discharging portion 100 provided on the distal end side (X2 side) of the catheter main body 10 is not shown.

The stent 31 is a member having a mesh pattern capable of accommodating a thrombus inside. The stent 31 is inserted into the catheter body 10 in a reduced diameter state. FIG. 6 schematically shows a cross section of the reduced diameter stent 31. A wire 33 is connected to the proximal end portion 32 of the stent 31. The wire 33 is sent to the distal end side (X2 side) when pushing the stent 31 to the target site in the blood vessel, and is pulled out to the proximal end side (X1 side) when the stent 31 is taken out of the body.

(Thrombus contrast)
Next, a procedure for imaging a thrombus using the catheter 1 of the first embodiment will be described. 7A, 7B and 7C are schematic views showing a procedure for imaging a thrombus in a blood vessel with a catheter 1. In FIGS. 7A to 7C, the guide wire 11 and the contrast medium discharge portion 100 in the thrombus BC are shown by solid lines in order to make the position of the discharge hole 110 easy to understand. Further, in FIGS. 7A to 7C, the proximal side close to the practitioner is referred to as D1 and the distal side away from the practitioner is referred to as D2 in the blood vessel BV. In addition to the following description, various operations are performed when contrasting the thrombus, but the description will be omitted here.

First, as shown in FIG. 7A, the guide wire 11 is inserted into the patient's blood vessel BV, sent to the distal side D2, penetrates the inside of the thrombus BC which is the lesion site, and reaches the distal side of the thrombus BC. Let me. The guide wire 11 does not have to penetrate the thrombus BC, and may be passed between the thrombus BC and the inner surface of the blood vessel BV, for example. In addition, the position of thrombus BC can be roughly identified by performing head CT, MRI examination, cerebral angiography, etc. in advance. Whether or not the guide wire 11 has penetrated the inside of the thrombus BC is determined based on angiography performed by injecting a contrast medium from a guiding catheter or a microcatheter, information obtained by a preliminary examination, and the like.

Next, as shown in FIG. 7B, the catheter body 10 is sent from the proximal side D1 to the distal side D2 so as to be extrapolated to the guide wire 11, and the tip of the catheter body 10 is inserted into the distal side D2 of the thrombus BC. To reach. Subsequently, the guide wire 11 is pulled out from the catheter body 10.

Next, the contrast medium is injected from the proximal end side of the catheter body 10. As a result, as shown in FIG. 7C, the contrast medium (small arrow in the figure) is discharged from each discharge hole 110 and the tip opening 101 of the contrast medium discharge unit 100. The released contrast medium diffuses to the proximal side D1 and the distal side D2 of the thrombus BC and stays in the vicinity thereof. In FIG. 7C, reference numeral CA1 indicates a contrast region due to the contrast agent retained in D1 on the proximal side of thrombus BC. Reference numeral CA2 indicates a contrast-enhanced region due to the contrast medium retained in D2 on the distal side of thrombus BC. In the X-ray transmission image, the contrast areas CA1 and CA2 have different brightness from other parts in the blood vessel (for example, thrombus BC), so that the practitioner can see the contrast areas CA1 and CA2 in the X-ray transmission image. The positions of the proximal side D1 and the distal side D2 of the thrombus BC can be confirmed by visually recognizing. The practitioner stops the injection of the contrast medium when the positions of the proximal side D1 and the distal side D2 of the thrombus BC are confirmed in the X-ray transmission image.

Through the above work, the practitioner can confirm the positions of the proximal side D1 and the distal side D2 of the thrombus BC in the contrast-enhanced areas CA1 and CA2, respectively, in the X-ray transmission image. Therefore, the practitioner can more accurately grasp the length of the thrombus BC by measuring the distance between the contrast-enhanced regions CA1 and CA2 in the X-ray transmission image. After this, the practitioner selects the stent 31 according to the length of the thrombus BC and collects the thrombus BC.

(Recovery of blood clots)
Next, the procedure for operating the catheter stent system 30 (see FIG. 6) to collect the thrombus will be described.
8A, 8B, 8C and 8D are schematic views showing the procedure for collecting a thrombus in a blood vessel by the catheter stent system 30. Here, an example in which thrombus BC is imaged and then thrombus is collected will be described. In FIGS. 8A to 8D, the reference numerals of the contrast medium discharge unit 100 (release hole 110) and the like are omitted.

First, as shown in FIG. 8A, the stent 31 is inserted into the catheter body 10 in a reduced diameter state, and the wire 33 is operated to send the stent 31 to the distal side D2 of the thrombus BC. Then, the tip of the stent 31 is positioned on the distal side D2 of the thrombus BC.

Next, as shown in FIG. 8B, the stent 31 is pushed out from the tip of the catheter body 10 at the position of the thrombus BC and deployed. Specifically, by pulling the catheter body 10 from the position shown in FIG. 8A into the proximal side D1, the stent 31 is relatively pushed out from the catheter body 10 and deployed. The entire stent 31 is extruded from the catheter body 10.

Next, as shown in FIG. 8C, the catheter body 10 is pulled into the proximal side D1 together with the wire 33. As a result, as shown in FIG. 8D, the stent 31 that has captured the thrombus BC can be pulled out of the body.
By operating the catheter stent system 30 in the above procedure, the thrombus BC can be recovered from the inside of the blood vessel BV to the outside of the body.

According to the catheter 1 of the first embodiment described above, a larger amount of the contrast medium can be diffused to the distal side D2 of the thrombus BC as compared with the case where the contrast medium is discharged from the tip end portion of the catheter body 10. .. Therefore, the practitioner can confirm the position of the proximal side D1 and the position of the distal side D2 of the thrombus BC by the contrast regions CA1 and CA2 in the X-ray transmission image. Therefore, the practitioner can more accurately grasp the length of the thrombus BC from the X-ray transmission image. In addition, when the practitioner selects a stent 31 having the minimum necessary length suitable for the length of the thrombus BC, when the stent 31 that has captured the thrombus is pulled out of the body, a longer stent is selected as compared with the case where the stent 31 is selected. Since the stent 31 is less likely to be caught on the blood vessel wall, the burden on the blood vessel wall can be reduced.

In the contrast medium discharge unit 100 of the first embodiment, the discharge holes 110 are provided at equal intervals along the central axis direction X of the contrast medium discharge unit 100. According to this, since the contrast medium is evenly discharged in the central axis direction X of the contrast medium discharge unit 100, the length of the thrombus BC can be grasped more accurately in the X-ray transmission image. For example, even if the length of the thrombus BC is shorter than expected, the contrast medium is evenly released in the central axis direction X of the contrast medium discharging portion 100, so that the contrast medium BC is more located at the position of the distal side D2 of the thrombus BC. Contrast medium can be diffused.

In the contrast medium discharge unit 100 of the first embodiment, the discharge holes 110 are arranged at equal intervals along the circumferential CD of the contrast medium discharge unit 100. Therefore, the contrast medium can be discharged more evenly in the circumferential CD of the contrast medium discharge unit 100.

In the contrast medium discharge unit 100 of the first embodiment, the discharge holes 110 are provided at positions facing each other in the radial direction of the contrast medium discharge unit 100. Therefore, it is possible to prevent the contrast medium discharge portion 100 from being displaced in the direction orthogonal to the central axis a due to the reaction when the contrast medium is discharged from each discharge hole 110.

[Second Embodiment]
The contrast medium discharging unit 100 of the second embodiment has a different penetrating direction of the discharge holes 110 provided on the side surface from that of the first embodiment. Therefore, in FIG. 9, which will be described later, only the contrast medium discharging portion 100 (catheter body 10) is shown, and the entire catheter 1 is not shown. Further, in the description and drawings of the second embodiment, members and the like equivalent to those of the first embodiment are designated by the same reference numerals as those of the first embodiment, and duplicate description will be omitted.

FIG. 9 is a diagram showing the configuration of the contrast medium discharging unit 100 of the second embodiment. FIG. 9 is a diagram corresponding to FIG. 2 of the first embodiment. In FIG. 9, only the discharge hole 110 provided on the side surface of the contrast medium discharge unit 100 in the Z (Z1-Z2) direction is shown. The XX directions shown in FIG. 9 are based on FIG. 2.

As shown in FIG. 9, in the contrast medium discharging portion 100 of the second embodiment, the opening OP1 inside each of the discharging holes 110 is located on the tip side (X2 side) of the contrast medium discharging portion 100, and the outer opening OP2 is contrasted. It penetrates in a direction diagonally intersecting the central axis direction X so as to be located on the rear end side (X1 side) of the agent discharging portion 100. The angle α at which the central axis b of each discharge hole 110 intersects the central axis a of the contrast medium discharge portion 100 is, for example, 30 ° to less than 90 °.

According to the catheter body 10 provided with the contrast medium discharging unit 100 of the second embodiment, the stent 31 (see FIG. 6) inserted into the catheter body 10 in a reduced diameter state is placed on the distal end side of the contrast medium discharging unit 100. When extruded to (X2 side), the stent 31 is less likely to be caught in the opening OP1 of the discharge hole 110. Therefore, the stent 31 can be more smoothly deployed from the tip opening 101 of the contrast agent discharging portion 100.

In the contrast medium discharging portion 100 of the second embodiment, the angle α at which the central axis b of each discharging hole 110 and the central axis a of the contrast medium discharging portion 100 intersect may be the same, or the angle α of the discharging hole 110 may be the same. It may be different depending on the position. Further, in the contrast medium discharge unit 100 of the second embodiment, the angle α at which the central axis b intersects with the central axis a of the contrast medium discharge unit 100 is 90 °, as in the discharge hole 110 of the first embodiment. The hole 110 may be included.

Although the embodiments of the present invention have been described above, the present invention is not limited to the first and second embodiments described above (hereinafter, also collectively referred to as “embodiments”), and the modified embodiments described later. Various modifications and changes are possible, such as, which are also included within the technical scope of the present disclosure. In addition, the effects described in the embodiments are merely a list of the most suitable effects resulting from the present disclosure, and are not limited to those described in the embodiments. The above-described embodiment and the modified form described later can be used in combination as appropriate, but detailed description thereof will be omitted.

(Transformed form)
FIG. 10 is a cross-sectional view showing a modified example of the contrast medium discharging portion 100. FIG. 10 corresponds to, for example, a cross-sectional view of FIG. 4 or FIG. 5 of the first embodiment.
As shown in FIG. 10, in the modified contrast medium discharging portion 100, the discharging holes 110 are provided at positions 120 ° apart from each other on the side surface of the contrast medium discharging portion 100. That is, the discharge holes 110 of the contrast medium discharge unit 100 shown in FIG. 10 are provided at three locations at each position in the central axial direction X, and are provided at intervals of 120 degrees along the circumferential CD of the contrast medium discharge unit 100. ing.
The discharge holes 110 of the contrast medium discharge unit 100 may be provided with 4 or more at each position in the central axial direction X, or different numbers of discharge holes 110 are provided at each position in the central axial direction X. You may be.

11A and 11B are side views showing a modified example of the contrast medium discharging portion 100. 11A and 11B correspond to, for example, the side views shown in FIG. 2 of the first embodiment.
In the contrast medium discharge unit 100 shown in FIG. 11A, the discharge holes 110 are provided at different pitches along the central axis direction X. Specifically, of the six discharge holes 110 provided along the central axis direction X of the contrast medium discharge portion 100, two discharge holes provided on the rear end side (X1 side) and the front end side (X2 side). The

holes

110a and 110b are arranged at a pitch of a distance L1. The discharge holes 110b and the discharge holes 110c adjacent thereto are arranged at a pitch of a distance L2 (> L1). The discharge holes 110c and the discharge holes 110d adjacent thereto are arranged at a pitch of a distance L3 (> L2). The side surface on which the discharge hole 110 is provided may be in either the Y direction or the Z direction of the contrast medium discharge portion 100.

In the contrast medium discharge portion 100 shown in FIG. 11A, the discharge holes 110 are densely arranged on both ends in the central axial direction X, and the discharge holes 110 are sparsely arranged near the center. That is, it is considered that the contrast medium releasing portion 100 of the present embodiment is located on the proximal side (D1 side) and the distal side (D2 side) of the thrombus BC when it is penetrated through the thrombus BC of the assumed length. The pitches of the

discharge holes

110a and 110b are shortened, and the pitches of the discharge holes 110c and 110d, which are considered to be located near the middle of the thrombus BC, are lengthened.

According to the contrast medium discharge unit 100 of the present embodiment, when the contrast medium discharge unit 100 is penetrated through the thrombus BC, the discharge holes that are considered to be located outside the thrombus BC are arranged at a short pitch, so that the contrast medium is imaged. More agent can be delivered to the proximal side (D1) and the distal side (D2) of thrombus BC. Further, according to the contrast medium discharge unit 100 of the present embodiment, when the contrast medium discharge unit 100 is penetrated through the thrombus BC, the discharge holes considered to be located near the middle of the thrombus BC are arranged at a longer pitch. Therefore, the amount of contrast medium released that is not involved in contrast can be reduced. In addition, in FIG. 11A, an example in which discharge holes 110 are provided at six locations on the side surface of the contrast medium discharge portion 100 has been described. In the present embodiment, the positions where the discharge holes 110 are provided may be 5 or less, or 7 or more.

The contrast medium discharge unit 100 shown in FIG. 11B is provided with

discharge holes

110e and 110f at one location on both ends in the central axial direction X, respectively. That is, the contrast medium discharge unit 100 of the present embodiment has a discharge hole 110a located on the proximal side (D1 side) of the thrombus BC and a distal side (D2) when the thrombus BC of the assumed length is penetrated. It has only a discharge hole 110b located on the side). For example, when the assumed length of the thrombus BC is 50 mm, the distance between the

discharge holes

110a and 110b of the contrast medium discharge unit 100 of the present embodiment (or the range S1 in FIG. 2) is about 80 mm.

Also in the contrast medium releasing section 100 of the present embodiment, when the contrast medium releasing section 100 is penetrated through the thrombus BC, more contrast medium is applied to the proximal side (D1) and the distal side (D2) of the thrombus BC. Can be reached. Further, according to the contrast medium discharging unit 100 of the present embodiment, when the contrast medium discharging unit 100 is penetrated through the thrombus BC, a discharge hole is not provided at a position considered to be near the middle of the thrombus BC. The amount of contrast medium released that is not involved in contrast can be further reduced.

In the embodiment, an example in which a part of the region on the distal end side of the catheter body 10 is configured as the contrast medium discharging portion 100 has been described. Not limited to this, a contrast medium discharging portion 100 separate from the catheter main body 10 may be attached to the tip of the catheter main body 10.

In the embodiment, as shown in FIGS. 8A to 8D, an example in which the stent 31 is inserted into the same catheter body 10 after the contrast medium is discharged from the contrast medium discharge unit 100 has been described. Not limited to this, after the contrast medium is discharged from the contrast medium discharge unit 100, the catheter body 10 may be pulled out of the body and another catheter body 10 into which the reduced-diameter stent 31 is inserted may be inserted. In that case, the contrast medium discharging portion 100 of the catheter body 10 for contrast medium may have a configuration in which the distal end side (X2 side) is sealed. By sealing the tip end side of the contrast medium discharging section 100, a larger amount of contrast medium can be discharged from the discharging holes 110 provided on the side surface of the contrast medium discharging section 100.

1 Catheter 10 Catheter body 100 Contrast medium discharge part 110 Release hole

Claims

A catheter with a tubular catheter body
The catheter body includes a contrast medium discharge portion provided in a region on the distal end side when inserted into a blood vessel, and a plurality of discharge holes provided on the side surface of the contrast medium discharge portion.
A catheter provided with at least one discharge hole at both ends in the central axis direction of the contrast agent discharge portion.
The catheter according to claim 1, wherein the plurality of discharge holes are provided at equal intervals along the central axis direction of the contrast medium discharge portion.
The catheter according to claim 1 or 2, wherein the plurality of discharge holes are provided at equal intervals along the circumferential direction of the contrast medium discharge portion.
The catheter according to any one of claims 1 to 3, wherein the plurality of discharge holes are provided at positions facing each other in the radial direction of the contrast medium discharge portion.
The catheter according to any one of claims 1 to 4, wherein at least one of the plurality of discharge holes penetrates in a direction orthogonal to the central axis direction of the contrast medium discharge portion.
At least one of the plurality of discharge holes releases the contrast medium so that the inner opening is located on the distal end side of the contrast medium discharge portion and the outer opening is located on the rear end side of the contrast medium discharge portion. The catheter according to any one of claims 1 to 4, which penetrates in a direction obliquely intersecting the central axis direction of the portion.