WO2021255879A1

WO2021255879A1 - Catheter

Info

Publication number: WO2021255879A1
Application number: PCT/JP2020/023861
Authority: WO
Inventors: 武治桂田
Original assignee: 朝日インテック株式会社
Priority date: 2020-06-17
Filing date: 2020-06-17
Publication date: 2021-12-23

Abstract

The purpose of the present invention is to provide a catheter whereby the diameter to which a mesh member expands in response to operation of a core wire can be reliably ascertained.　This catheter 1 comprises: a tubular mesh member 11 capable of expanding and contracting; a hollow shaft 21; a distal-end tip 31; a core wire 41; a guide membrane 51 attached to the mesh member 11; and a radioopaque first marker 61 and second marker 71 attached to any of the mesh member 11, the hollow shaft 21, the distal-end tip 31, the core wire 41, and the guide membrane 51. The first marker 61 and the second marker 71 are attached to mutually different members such that the distance between the first marker 61 and the second marker 71 changes in accordance with the degree of diameter expansion of the mesh member 11 by the core wire 41.

Description

catheter

The present invention relates to a catheter.

As a medical device for improving blood flow by removing obstructions that occlude blood vessels such as chronic total 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, Non-Patent Document 1).

Such a technique is called the Reverse CART method. For example, a catheter having a tubular member formed of a mesh is placed in a blood vessel proximal to the occlusion, and a core wire connected to the member is pulled. Extend the mesh with and capture the retrograde guidewire through the opening of the mesh.

However, in the conventional catheter as described above, the tension of the core wire and the expansion diameter of the mesh member do not always correspond to each other. For this reason, it is not always possible to accurately grasp the expanded state of the mesh member when the core wire is pulled only by the operation at hand. For example, when the core wire is pulled excessively, the core wire comes off from the mesh member or the like. There is a risk.

The present invention has been made based on the above circumstances, and an object of the present invention is to provide a catheter capable of reliably grasping the expansion diameter of a mesh member accompanying the operation of a core wire.

Some aspects of this disclosure include
(1) 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,
A hollow tip connected to the tip of the mesh member,
The tip portion is connected to the tip portion of the mesh member and / or the tip tip, and passes through the inside of the mesh member and the hollow shaft so that the proximal end is located closer to the proximal end side than the proximal end of the hollow shaft. With the extending core wire,
An induction film attached to the mesh member and having a tip located between the base end of the tip and the tip of the hollow shaft.
A radiation opaque first marker and a second marker attached to any of the mesh member, the hollow shaft, the tip tip, the core wire, and the induction membrane.
The first marker and the second marker are attached to different members whose distances between the first marker and the second marker change according to the degree of expansion of the mesh member by the core wire. catheter,
(2) The catheter according to (1) above, wherein the first marker is attached to the induction membrane and the second marker is attached to the core wire.
(3) The second marker is attached to a plurality of points of the core wire along the long axis direction.
The catheter according to (2), wherein each of the plurality of locations is arranged so as to correspond to the degree of expansion of the mesh member.
(4) The second marker is attached to a plurality of points of the core wire along the long axis direction.
The catheter according to (2) above, wherein the intervals between adjacent second markers among the plurality of locations are the same.
(5) The first marker is attached to the hollow shaft, and the second marker is attached to any one of the mesh member, the tip tip, the core wire, and the induction film. The catheter according to (1),
(6) The second marker is attached to the core wire.
The catheter according to (5) above, wherein the second marker can be moved from the distal end side to the proximal end side with respect to the first marker, and (7) the first marker or the second marker attached to the core wire. The outer shape of the marker is the catheter according to any one of (1) to (6) above, which has an ellipsoidal shape.

In the present specification, the "tip side" means the direction along the long axis direction of the catheter and the direction in which the mesh member is located with respect to the hollow shaft. The "base end side" is a direction along the long axis direction of the hollow shaft, and means a direction opposite to the tip end side. The "tip" refers to the end portion on the distal end side of any member or portion, and the "base end" refers to the end portion on the proximal end side of any member or portion. Unless otherwise specified, the "major axis direction" means the longitudinal direction of the catheter and the "diametrical direction" means the direction orthogonal to the major axis direction.

The present invention can provide a catheter capable of reliably grasping the expansion diameter of the mesh member accompanying the operation of the core wire.

It is a schematic cross-sectional view which shows the 1st Embodiment, and is the figure which the mesh member is in the reduced diameter state. It is a schematic sectional drawing which shows an example of the arrangement of the 2nd marker. It is a schematic sectional drawing which shows an example of the arrangement of the 2nd marker. It is a schematic sectional drawing which shows an example of the arrangement of the 2nd marker. It is the schematic sectional drawing which shows the attachment | attachment part of the 2nd marker enlarged. It is a schematic cross-sectional view which shows the reduced diameter state of 1st Embodiment. It is a schematic cross-sectional view which shows an example of the diameter expansion state of 1st Embodiment. It is a schematic cross-sectional view which shows an example of the diameter expansion state of 1st Embodiment. It is a schematic cross-sectional view which shows an example of the diameter expansion state of 1st Embodiment. It is a schematic cross-sectional view which shows the 2nd Embodiment, and is the figure which the mesh member is in the reduced diameter state. It is a schematic cross-sectional view which shows the reduced diameter state of 2nd Embodiment. It is the schematic sectional drawing which shows an example of the diameter expansion state of 2nd Embodiment. It is a schematic cross-sectional view which shows the modification of the marker attached to a core wire. It is a schematic cross-sectional view which shows the modification of the marker attached to a core wire. It is a schematic cross-sectional view which shows the modification of the marker attached to a core wire.

The catheter of the present disclosure is, for example, 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 hollow tip tip connected to the tip end portion of the mesh member. And / or the inside of the mesh member and the hollow shaft so that the tip portion is connected to the tip portion of the mesh member and / or the tip end and the proximal end is located closer to the proximal end side than the proximal end of the hollow shaft. A core wire extending through the mesh member, an induction film attached to the mesh member and having a tip located between the base end of the tip tip and the tip of the hollow shaft, and the mesh member, the hollow shaft, the tip tip, and the tip. The core wire and the first marker and the second marker of radiodensity attached to any of the induction membranes are provided, and the first marker and the second marker are the above-mentioned by the above-mentioned core wire. It is attached to different members whose distances between the first marker and the second marker change according to the degree of diameter expansion of the mesh member.

In the present specification, the "forward guide wire" means a guide wire used to guide the catheter in a body cavity such as a blood vessel, and the "retrograde guide wire" means the inside of the body cavity. It means a guide wire facing the catheter.

Hereinafter, the first and second embodiments of the present invention 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 contents of the implementation, and do not correspond to the actual dimensions. Further, in each drawing, the left side in the drawing is the distal end side (distal side) inserted into the body, and the right side is the proximal end side (proximal side, hand side) operated by a technician such as a doctor.

[First Embodiment]
FIG. 1 is a schematic side view showing the first embodiment, and is a view in which the mesh member has a reduced diameter. As shown in FIG. 1, the catheter 1 generally includes a mesh member 11, a hollow shaft 21, a tip tip 31, a core wire 41, an induction film 51, a first marker 61, and a second marker. It is composed of a marker 71 and a connector 81.

The mesh member 11 is a tube-shaped member that is formed of a mesh-shaped member and can be expanded and contracted in the radial direction. Specifically, the mesh member 11 is composed of, for example, a wire 11w braided into a mesh shape, and can be easily expanded or contracted (deformed) by deforming the wire 11w. The opening 11a of the mesh member 11 can accept, for example, a retrograde guide wire (not shown). The tip of the mesh member 11 is joined to the core wire 41 (described later), and the base end is joined to the hollow shaft 21 (described later). Therefore, when the core wire 41 is pulled toward the base end side, the mesh member 11 bulges outward in the radial direction to expand the diameter, and a larger opening 11a is formed. On the other hand, when the core wire 41 is pushed out toward the tip side, the diameter of the mesh member 11 is reduced and becomes smaller, which facilitates the movement of the catheter 1 in the body cavity.

Examples of the material of the wire 11w constituting the mesh member 11 include a metal material such as stainless steel such as SUS304, a nickel titanium alloy, and a cobalt-chromium alloy; and a resin material such as polyamide, polyester, polyacrylate, and polyether ether ketone. Can be mentioned. Among these, a metal material is preferable from the viewpoint of improving strength and flexibility. When the mesh member 11 is composed of a plurality of strands 11w, the materials of the strands 11w may be the same or different.

The hollow shaft 21 is a hollow shaft connected to the base end portion of the mesh member 11. Specifically, the hollow shaft 21 has a lumen 21h penetrating from the tip end to the base end, for example. For example, a core wire 41, a retrograde guide wire, or the like, which will be described later, is inserted into the lumen 21h.

As the material constituting the hollow shaft 21, it is preferable that the hollow shaft 21 has antithrombotic property, biocompatibility, and flexibility because the hollow shaft 21 is inserted into a body cavity such as a blood vessel. Examples of the material include resin materials such as polyamide resin, polyolefin resin, polyester resin, polyurethane resin, silicone resin, and fluororesin.

As a method of joining the mesh member 11 and the hollow shaft 21 described above, for example, a method of embedding the base end portion of the mesh member 11 in the tip end portion of the hollow shaft 21 by welding or the like can be adopted.

The tip tip 31 is a hollow member connected to the tip of the mesh member 11. The tip 31 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 31 has a lumen 31h for passing an antegrade guide wire (not shown) or the like. The tip portion of the tip tip 31 can be formed into a rounded shape toward the tip side. The tip end portion of the tip end 31 is joined to the tip end portion of the mesh member 11 or the like.

It is preferable that the material constituting the tip tip 31 has flexibility so as to alleviate the impact on the body cavity and the like. Examples of such a material include resin materials such as polyurethane and polyurethane elastomer.

As a method of joining the tip tip 31 and the mesh member 11, for example, a method of burying the tip of each wire 11w constituting the mesh member 11 in the base end of the tip tip 31 by welding or the like can be adopted. can.

The core wire 41 extends through the inside of the mesh member and the hollow shaft so that the tip is connected to the tip and / or the tip of the mesh member and the proximal end is located closer to the proximal end than the proximal end of the hollow shaft. It is a member. Specifically, for example, the tip of the core wire 41 is joined to the tip tip 31 and penetrates the inside of the mesh member 11 (the space inside the mesh member 11) and the lumen 21h of the hollow shaft 21, and the base end thereof. It can be arranged so as to be exposed from the lumen 81h of the connector 81, which will be described later, to the proximal end side. The mesh member 11 can be expanded or contracted by moving the core wire 41 forward and backward along the long axis direction.

The material constituting the core wire 41 preferably has sufficient rigidity and tensile strength from the viewpoint of reliably expanding and contracting the mesh member 11 and preventing the core wire 41 itself from being cut. Examples of such a material include stainless steel such as SUS304, metal materials such as nickel-titanium alloy and cobalt-chromium alloy, and the like.

As a method of joining the core wire 41 and the tip tip 31 and / or the mesh member 11, for example, a method of embedding the tip of the core wire 41 in the base end of the tip tip 31 by welding or the like, and / or the tip of the core wire 41. A method of welding the portion and the tip portion of the mesh member 11 can be adopted.

The guide film 51 is a thin film-like member attached to a mesh member and whose tip is located between the base end of the tip tip and the tip of the hollow shaft. Specifically, for example, the tip of the inductive film 51 is located at the maximum diameter expansion portion 11s of the mesh member 11 (the portion where the outer diameter becomes the largest when the mesh member 11 is expanded), and the base end is a hollow shaft. It can be arranged so as to be located at the tip of 21. According to the guide film 51, for example, the retrograde guide wire received through the opening 11a of the mesh member 11 can be smoothly guided toward the opening 21a at the tip of the hollow shaft 21.

Examples of the material constituting the inductive film 51 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.

The guide film 51 may be bonded to the mesh member over the entire surface, or only a part thereof (for example, the tip portion of the guide film) may be bonded to the mesh member. As a method of joining the guide film and the mesh member, for example, a method of heating and melting the material forming the guide film and immersing the mesh member in the melted material to bridge the strands (close the opening). , A method of welding the outer periphery of the opening on the tip end side of the funnel-shaped film to the mesh member or the like can be adopted.

The tip of the guide film 51 of the present embodiment is located at the maximum diameter expansion portion 11s (substantially central portion in the major axis direction) of the mesh member 11, the base end is located at the tip of the hollow shaft 21, and the mesh member 11 It is formed so as to bridge (close the opening 11a) between the strands 11w.

The first marker 61 and the second marker 71 are radiation opaque markers. The first marker 61 and the second marker 71 are the mesh member 11, the hollow shaft 21, the tip tip 31, the core wire 41, and the guide film 51, which correspond to the degree of expansion of the mesh member 11 by the core wire 41. It is attached to any member different from each other in which the distance between the marker 1 and the marker 2 changes.

Examples of the member to which the first marker 61 is attached include an induction film, a hollow shaft, and the like. When the first marker is attached to the induction membrane, the first marker may be provided, for example, on a part of the induction membrane or may be provided over the entire induction membrane. When the first marker is attached to the hollow shaft, the first marker may be provided at a specific portion of the hollow shaft, for example, or may be provided over the entire hollow shaft.

Examples of the member to which the second marker 71 is attached include a tip tip, a core wire, a mesh member, a hollow shaft, and the like. When the first marker 61 is attached to the inductive membrane, the second marker 71 may be provided, for example, on the tip and / or core wire. When the first marker 61 is attached to the hollow shaft, the second marker 71 may be provided, for example, on the tip tip and / or the core wire.

Each of the first marker 61 and the second marker 71 may be fixed (adhesive, welded, etc.) over a part or the whole on the member to be attached, and may be fixed (adhesion, welding, etc.) to a part or the whole of the member. It may be mixed over. In the case of fixing, for example, a brazing material containing a radiation-impermeable substance may be used as a marker and formed by brazing to a member to which the second marker 71 is attached. In the case of mixing, for example, fine particles containing a radiation-impermeable substance may be used as a marker, and the marker may be formed by dispersing the fine particles inside the member to be attached.

Examples of the radiodensity permeable material used for the first marker 61 and the second marker 71 include gold, platinum, tungsten, or an alloy containing these elements (for example, platinum nickel alloy). The radiodensity material is a combination of a non-radiodensity substance and a radiodensity substance, such as a substance coated with a radiodensity substance on the surface of the substance that is not radiodensity. You may.

It is preferable that the first marker 61 is attached to the induction film 51 and the second marker 71 is attached to the core wire 41. Specifically, for example, as shown in FIG. 2A, a second marker 71 is provided at one location on the core wire 41, or as shown in FIG. 2B, a plurality of different locations on the core wire 41 along the long axis direction. A second marker 71 can be provided on the surface. In such a case, the first and

second markers

61, 71 are arranged so that the position where the specific second marker 71 crosses the first marker 61 corresponds to the optimum expansion state of the mesh member 11. You may. In this way, the first marker 61 is attached to the guide film 51 and the second marker 71 is attached to the core wire 41, so that the expansion diameter of the mesh member 11 is ensured by the positional relationship between the guide film 51 and the core wire 41. Can be grasped.

When the first marker 61 is attached to the guide film 51, the second marker 71 is attached to a plurality of positions of the core wire 41 along the major axis direction, and each of the second marker 71 expands the mesh member 11. It is preferable that they are arranged so as to correspond to the degree of diameter. Specifically, as shown in FIG. 2B, for example, the spacing in the major axis direction of the adjacent

second markers

71 and 71 is determined so that the difference in the expansion diameter (outer diameter) of the mesh member 11 becomes equal. You may do so. As a result, the expanded diameter of the mesh member 11 can be reliably grasped from the positional relationship between the first marker 61 and the second marker 71 that are visually recognized.

When the first marker 61 is attached to the induction film 51, the second marker 71 is attached to a plurality of points of the core wire 41 along the major axis direction, and the second marker 71, which is adjacent to each other, is attached to the plurality of points. It is also preferable that the intervals between 71 are equal. Specifically, as shown in FIG. 2C, for example, a plurality of second markers 71 may be arranged at equal intervals on the core wire 41 along the major axis direction. As a result, even if a part of the second marker 71 out of the plurality of second markers 71 cannot be visually recognized, the position of the second marker 71 that cannot be visually recognized by the visible second marker 71 can be inferred. The expanded diameter of the mesh member 11 can be accurately grasped from the positional relationship between the first marker 61 and the visible or estimated second marker 71.

The outer shape of the marker (first marker or second marker) attached to the core wire 41 is preferably an ellipsoidal shape. Specifically, as shown in FIG. 3, for example, a brazing material containing a radiation-impermeable substance is used, and the brazing material is brazed so as to surround the surface of the core wire 41 to form a second marker 71. The outer shape can be formed into an ellipsoidal shape (see the second marker 711). Thereby, for example, when the retrograde guide wire is received in the hollow shaft 21, the end portion of the retrograde guide wire can be prevented from being caught by the marker, and the retrograde guide wire can be smoothly captured.

In the present embodiment, radiation-impermeable fine particles 61a are used as the first marker 61, and the fine particles 61a are dispersed throughout the induction film 51, and a brazing material is used as the second marker 71. The catheter 1 is exemplified in which a plurality of second markers 711 (71) are waxed to a specific site on the core wire 41.

The connector 81 is a member for which the operator grips the catheter 1. The connector 81 is connected to the base end portion of the hollow shaft 21 and has a lumen 81h communicating with the lumen 21h and an opening 81a located at the base end of the lumen 81h. The form of the connector 81 is not particularly limited as long as the effect of the present invention is not impaired.

Next, the usage mode of the catheter 1 will be described. Here, a procedure for passing a retrograde guide wire through a site where an obstruction is present in a blood vessel (hereinafter, also referred to as an “occluded site”) will be described.

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 obstruction site. After the tip of the antegrade guide wire reaches the occlusion site, a balloon catheter (not shown) is inserted to the occlusion site using the antegrade guide wire as a guide, and the balloon is expanded in diameter to expand the occlusion site. After expanding the occluded area, the balloon is contracted and the balloon catheter is removed from the blood vessel.

Next, the proximal end of the anterograde guide wire passes from the tip opening 31a of the tip tip 31 through the lumen 31h, the space inside the mesh member 11, the lumen 21h, and the lumen 81h, and passes through the opening 81a to the catheter 1. An anterograde guide wire is inserted into the catheter 1 so as to come out of the catheter 1, and the tip of the catheter 1 is pushed to the occlusion site in the blood vessel by using the anterograde guide wire as a guide. At this time, the catheter 1 is inserted into the blood vessel in a state where the mesh member 11 is reduced in diameter, and the diameter is maintained in the reduced state until the tip of the catheter 1 reaches the occlusion site.

Next, after the tip of the catheter 1 reaches the occlusion site expanded by the balloon catheter, the antegrade guide wire is pulled out from the catheter 1 by pulling the antegrade guide wire toward the proximal end side with respect to the catheter 1. .. Next, when the end of the core wire 41 exposed to the outside is pulled from the opening 81a of the connector 81 toward the base end side, the tip of the mesh member 11 and the tip of the hollow shaft 21 are shown as shown in FIGS. 4A to 4D. The distance from the mesh member 11 is narrowed in the order of FIGS. 4A, 4B, 4C, and 4D, and the mesh member 11 is deformed (bulged) outward in the radial direction to expand the diameter. At this time, since the mesh opening 11a is also expanded as the diameter of the mesh member 11 is expanded, it becomes easy to accept the retrograde guide wire. In the present embodiment, since the first marker 61 is attached to the induction film 51 and the second marker 71 is attached to the core wire 41, the first marker 61 and the second marker 71 are positioned at predetermined positions. By pulling the core wire 41 so as to be related, the expansion diameter of the mesh member 11 is adjusted. After the tip of the catheter 1 reaches the obstruction site along the antegrade guide wire, the mesh member 11 is expanded radially outward, and then the antegrade guide wire is pulled out from the catheter 1. May be good.

Next, accept it in the retrograde guide wire catheter 1 coming from the distal end side. As the path to which the retrograde guide wire is directed, for example, a false cavity in the blood vessel wall surrounding the obstruction site, a through hole penetrating the obstruction site, etc. are assumed, but the retrograde guide wire from any of the routes can be used. There may be. The retrograde guide wire RGW is accepted into the space inside the mesh member 11 through the mesh opening 11a of the expanded mesh member 11, and then enters the lumen 21h of the hollow shaft 21 via the opening 21a at the tip of the hollow shaft 21. Accepted (see Figure 4). Next, one end of the retrograde guide wire is pulled out of the body via, for example, a port 21p (see FIG. 1) provided in the middle of the hollow shaft 21.

As described above, since the catheter 1 has the above configuration, it is possible to reliably grasp the expansion diameter of the mesh member 11 accompanying the operation of the core wire 41. As a result, for example, it is possible to prevent the core wire 41 from being excessively pulled and broken from the tip portion and / or the tip tip 31 of the mesh member 11.

[Second Embodiment]
FIG. 4 is a schematic side view showing the first embodiment, and is a view in which the mesh member has a reduced diameter. As shown in FIG. 5, the catheter 2 generally includes a mesh member 11, a hollow shaft 21, a tip tip 31, a core wire 41, an induction film 52, a first marker 62, and a second marker. It is composed of a marker 71 and a connector 81. Catheter 2 is different from the first embodiment in that the induction membrane 52 and the first marker 62 are different from the first embodiment. Since the configurations of the mesh member 11, the hollow shaft 21, the tip tip 31, the core wire 41, the first marker 71, and the connector 81 are the same as those in the first embodiment, the same parts are designated by the same reference numerals. The detailed description thereof will be omitted. Further, since the configurations other than the configurations of the induction membrane 52 and the first marker 62 and the usage mode of the catheter 2 shown below are the same as those of the first embodiment, detailed description thereof will be omitted.

The guide film 52 is a member that is attached to a mesh member and whose tip is located between the base end of the tip tip and the tip of the hollow shaft. The tip of the guide film 52 of the present embodiment is located at the maximum diameter expansion portion 11s (substantially central portion in the major axis direction) of the mesh member 11, the base end is located at the tip of the hollow shaft 21, and the mesh member 11 It is formed so as to bridge (close the opening 11a) between the strands 11w. The induction membrane 52 does not include a marker formed of a radiation-impermeable material (for example, the first marker 61a (fine particles) exemplified in the catheter 1).

The first marker 62 is a radiation opaque marker. In the catheter 2, the first marker 62 is attached to the hollow shaft 21. The mounting position of the first marker 62 may be, for example, provided along the circumferential direction of the tip of the hollow shaft 21 so as to surround the opening 21a at the tip of the hollow shaft 21, and may be provided halfway in the long axis direction of the hollow shaft 21. It may be provided in.

When the first marker 62 is attached to the hollow shaft 21, the second marker is preferably attached to any of a mesh member, a tip tip, a core wire, and an inductive membrane. This makes it possible to reliably grasp the expanded diameter of the mesh member based on the positional relationship between the hollow shaft and other members.

In the present embodiment, the first marker 62 is brazed around the opening 21a at the tip of the hollow shaft 21. A plurality of second markers 71 are attached to different portions on the core wire 41 along the major axis direction so that at least one of them can move from the distal end side to the proximal end side with respect to the first marker 62. ..

In such a catheter 2, for example, when the core wire 41 is pulled toward the proximal end side from the state where the mesh member 11 is reduced in diameter (see FIG. 6A), the identification of the plurality of second markers 71. When the marker (for example, the marker 71 located in the center of the second marker 71 in the long axis direction) crosses the first marker 62, the mesh member 11 is in the optimum expanded state (see FIG. 6B). The second marker 71 may be arranged so as to be. As a result, it is easy for the mesh member 11 to reach a specific expansion diameter (for example, the maximum expandable diameter) by moving the specific second marker 71 closer to the proximal end side than the first marker 62. And it can be surely grasped.

As described above, since the catheter 2 has the above configuration, it is possible to reliably grasp the expansion diameter of the mesh member 11 accompanying the operation of the core wire 41.

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.

For example, in the first embodiment, the catheter 1 in which the first marker 61 is provided over the entire induction membrane 51 and the second marker 71 is provided in a plurality of different sites on the core wire 41 has been described. Further, in the second embodiment, the catheter 2 in which the first marker 62 is provided at the tip of the hollow shaft 21 and the second marker 71 is provided at a plurality of different parts on the core wire 41 has been described. However, the first marker and the second marker may be attached to different members whose distances between the first marker and the second marker change according to the degree of expansion of the mesh member by the core wire. .. For example, when the first marker is provided on the inductive membrane, the second marker is the first of the mesh members to which the first marker is not attached, the hollow shaft, the tip tip, and the inductive membrane. It may be any of the parts where the marker is not attached. Further, when the first marker is provided on the hollow shaft, the second marker may be any of a mesh member, a tip tip, a core wire, and an inductive membrane.

Further, in the first embodiment, the catheter 1 in which the first marker 61 is provided over the entire induction membrane 51 has been described. However, the marker provided on the induction membrane may be inside and / or part of the induction membrane. In this case, the marker may be provided in one annular shape orthogonal to the major axis, or in two or more annular rings orthogonal to the major axis and arranged at predetermined intervals. Further, the marker may be provided in one area or two or more areas.

Further, in the above-mentioned first embodiment, the catheter 1 in which the outer shape of the second marker 71 provided on the core wire 41 has an ellipsoidal shape (second marker 711) has been described. However, the shape of the marker provided on the core wire 41 may be, for example, the same shape as a part of the core wire 41 (a shape in which a part of the core wire 41 contains a radiation-impermeable material). 7A may have a shape that tapers toward the tip side (see marker 732 in FIG. 7B), or may have a cylindrical shape that covers the outer periphery of the core wire 41 (see marker 733 in FIG. 7C). ..

1,2 Catheter 11 Mesh member 21 Hollow shaft 31 Tip tip 41

Core wire

51,52

Induction membrane

61,62 First marker 71 Second marker

Claims

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,
A hollow tip connected to the tip of the mesh member,
The tip portion is connected to the tip portion of the mesh member and / or the tip tip, and passes through the inside of the mesh member and the hollow shaft so that the proximal end is located closer to the proximal end side than the proximal end of the hollow shaft. With the extending core wire,
An induction film attached to the mesh member and having a tip located between the base end of the tip and the tip of the hollow shaft.
A radiation opaque first marker and a second marker attached to any of the mesh member, the hollow shaft, the tip tip, the core wire, and the induction membrane.
The first marker and the second marker are attached to different members whose distances between the first marker and the second marker change according to the degree of expansion of the mesh member by the core wire. catheter.
The catheter according to claim 1, wherein the first marker is attached to the induction membrane, and the second marker is attached to the core wire.
The second marker is attached to a plurality of points of the core wire along the long axis direction.
The catheter according to claim 2, wherein each of the plurality of locations is arranged so as to correspond to the degree of expansion of the mesh member.
The second marker is attached to a plurality of points of the core wire along the long axis direction.
The catheter according to claim 2, wherein the intervals between the second markers adjacent to each other at the plurality of locations are the same.
15. The first marker is attached to the hollow shaft, and the second marker is attached to any one of the mesh member, the tip tip, the core wire, and the induction film. The catheter described.
The second marker is attached to the core wire and
The catheter according to claim 5, wherein the second marker is movable from the distal end side to the proximal end side with respect to the first marker.
The catheter according to any one of claims 1 to 6, wherein the outer shape of the first marker or the second marker attached to the core wire is an ellipsoidal shape.