WO2022154118A1 - Cathéter et ensemble cathéter - Google Patents

Cathéter et ensemble cathéter Download PDF

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Publication number
WO2022154118A1
WO2022154118A1 PCT/JP2022/001382 JP2022001382W WO2022154118A1 WO 2022154118 A1 WO2022154118 A1 WO 2022154118A1 JP 2022001382 W JP2022001382 W JP 2022001382W WO 2022154118 A1 WO2022154118 A1 WO 2022154118A1
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WO
WIPO (PCT)
Prior art keywords
tip
catheter
marker
tube
tip tube
Prior art date
Application number
PCT/JP2022/001382
Other languages
English (en)
Japanese (ja)
Inventor
健一 堀場
大 冨田
春佳 杉村
光則 吉川
Original Assignee
テルモ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2022154118A1 publication Critical patent/WO2022154118A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like

Definitions

  • the present invention relates to a catheter and a catheter assembly having an intermediate opening having a tip tube and a linear shaft connected to the tip tube and extending from the tip tube to the proximal side.
  • a guiding catheter is used to guide a therapeutic catheter (balloon catheter, stent placement catheter, etc.) for inserting into a biological lumen such as a blood vessel for treatment or diagnosis to a target site.
  • a therapeutic catheter balloon catheter, stent placement catheter, etc.
  • PTCA percutaneous coronary angioplasty
  • a guide wire for a guiding catheter is inserted into the artery through the skin of the wrist or thigh to the entrance of the coronary artery. Reach.
  • the guiding catheter is then inserted into the artery along the guide wire, followed by the removal of the guiding catheter guide wire and engagement with the coronary ostium.
  • a thinner guide wire for the therapeutic catheter is inserted into the lumen of the guiding catheter to pass through the lesion in the coronary artery.
  • a balloon catheter is inserted along the guide wire for the therapeutic catheter, the tip of the balloon catheter is projected from the opening of the tip of the guiding catheter, and the tip of the balloon catheter is advanced to the periphery along the guide wire that has passed through the lesion, and the balloon is inserted. Is placed on the lesion and the balloon is expanded for treatment.
  • a guide extension catheter After engaging the tip of the guiding catheter with a predetermined site (for example, the ostium of the coronary artery), a guide extension catheter is used to smoothly advance the therapeutic catheter through the curved or bent coronary artery from the opening of the tip of the guiding catheter to the lesion. May be used (see, eg, Patent Document 1). That is, the guide extension catheter can be inserted closer to the lesion than the guiding catheter, and can further provide a stable backup force to the therapeutic catheter.
  • the guide extension catheter has a tip tube that moves through the lumen of the guiding catheter and can protrude from the tip opening of the guiding catheter to the tip side, and a linear shape that is connected to the tip tube and extends from the tip tube to the proximal side.
  • the base end side of the tip tube is connected to the linear shaft, and the length of the tubular part (tip tube) is short. Therefore, with the guide wire inserted inside the guiding catheter, the guide extension catheter can be easily inserted and removed from the guiding catheter along the guide wire without removing the guide wire.
  • the length of the guide wire protruding toward the proximal end side of the guiding catheter is longer than the length of the tubular portion of the guide extension catheter. Since the guide extension catheter has a linear shaft, the length of the tubular portion can be shortened, so that it is not necessary to use an unnecessarily long guide wire, and the procedure is facilitated.
  • Patent Document 1 describes a catheter in which a shaft is connected to a tip tube. Further, an X-ray opaque marker is arranged on the tip side of the portion where the shaft of the tip tube is connected. The central axis of the shaft is deviated from the tip tube, and the shaft is thinner than the tip tube. For this reason, the catheter in which the shaft is connected to the tip tube is structurally likely to have a decrease in pushing strength and pulling strength.
  • the present invention has been made to solve the above-mentioned problems, and an object of the present invention is to provide a catheter and a catheter assembly having an intermediate opening capable of effectively improving indentation strength and withdrawal strength. ..
  • a catheter having an intermediate opening that achieves the above object is a catheter having an intermediate opening having a tip tube and a linear shaft extending from the tip tube to the proximal end side, and the tip tube has an outer layer and the outer layer. It has a reinforcing layer arranged inside in the radial direction of the shaft and an X-ray impermeable marker arranged on the base end side of the tip tube, and the tip portion of the linear shaft is fixed to the marker. It is characterized by being.
  • the linear shaft can be firmly fixed to the tip tube via the marker, so that the pushing strength and the pulling strength can be effectively improved.
  • the marker may be fixed to the tip of the linear shaft by adhesion. As a result, when the marker and the linear shaft are fixed, they are less likely to be deformed, so that the shape of the catheter can be stabilized and the catheter can be manufactured at low cost.
  • the marker may be a proximal end marker arranged on the proximal end side of the distal tube.
  • the tip tube may have an X-ray opaque tip marker arranged on the tip side of the tip tube. Thereby, the position of the tip tube can be specified by X-ray.
  • At least one of the tip marker or the proximal marker may be arranged at a position separated from the reinforcing layer in the axial direction. As a result, the thickness of the tip tube can be reduced and / or the outer diameter can be reduced.
  • the base end marker may be arranged on the base end side of the base end of the reinforcing layer. As a result, the base end marker to which the linear shaft is fixed does not overlap the reinforcing layer, so that the thickness of the tip tube can be reduced and / or the outer diameter can be reduced.
  • the catheter projects the tip of the therapeutic catheter from the tip opening of the guiding catheter and advances in the coronary artery peripherally along the therapeutic catheter.
  • the guide extension catheter may be provided on the therapeutic catheter for arranging a treatment portion for performing treatment on the lesion portion.
  • a catheter having an intermediate opening having a tip tube and a linear shaft extending from the tip tube to the proximal side
  • the tip tube is: A tubular body having a lumen penetrating from the tip end to the base end, a tip taper portion arranged on the tip end side, a tubular portion arranged on the base end side of the tip end taper portion, and a base of the tubular portion.
  • the tip taper portion is provided with an inclined portion arranged on the end side, the diameter of the tip taper portion is tapered toward the tip side, and the tip tube is an X-ray arranged on the base end side of the tip tube.
  • a catheter having an opaque marker and having an intermediate opening characterized in that the tip of the linear shaft is fixed to the marker may be used.
  • the catheter having an intermediate opening is inserted into the coronary artery together with the guide extension catheter, and as a dilator that smoothly guides the guide extension catheter beyond the lesion such as the stenosis that occurs in the coronary artery or expands the stenosis. Can be used.
  • a catheter assembly that achieves the above object includes a catheter having a first intermediate opening having a first tip tube and a first linear shaft extending from the first tip tube toward the proximal end, and a second. And a catheter with a second intermediate opening having a second linear shaft extending from the second tip tube towards the proximal end, the first tip tube with an outer layer.
  • the first line has a reinforcing layer arranged radially inside the outer layer, and an X-ray opaque first marker arranged at the base end portion of the first tip tube.
  • the tip of the shaped shaft is fixed to the first marker
  • the second tip tube is a tube having a lumen penetrating from the tip to the base, and a tip taper arranged on the tip side.
  • the tip taper portion is provided with a portion, a tubular portion arranged on the base end side of the tip taper portion, and an inclined portion arranged on the base end side of the tubular portion, and the tip taper portion is tapered toward the tip end side.
  • the second tip tube has a second linear X-ray opaque marker located at the base end of the second tip tube.
  • the tip of the shaft is fixed to the second marker, and the catheter having the second intermediate opening is placed in a predetermined position in the first tip tube of the catheter having the first intermediate opening.
  • It may be a catheter assembly characterized in that the first marker and the second marker are separated from each other in the axial direction when inserted.
  • FIG. 1 It is a top view which shows the guide extension catheter, the dilator and the guiding catheter which are the catheters having an intermediate opening which concerns on this embodiment.
  • FIG. 2 It is a figure which shows the guide extension catheter, (A) is a side view, (B) is a plan view, (C) is a partially enlarged view of a linear shaft.
  • FIG. 2 It is a figure which shows the guide extension catheter, (A) is the sectional view along the line AA of FIG. 2, (B) is the sectional view along the line BB of FIG. It is sectional drawing along the C line.
  • It is a figure which shows the dilator (A) is a side view, (B) is a plan view, (C) is a partially enlarged view of a dilator linear shaft.
  • the side of the device to be inserted into the blood vessel is referred to as the "tip side", and the side to be operated is referred to as the "base end side”.
  • the tip tube has a tip opening and an intermediate opening that serves as a base end opening, and the tip opening side is referred to as a "tip portion” and the intermediate opening side is referred to as a "base end portion" from the midpoint between the tip opening and the intermediate opening. I will do it.
  • the catheter having an intermediate opening is inserted into a guiding catheter 100 having a tip soft tip 100A, protrudes from the tip opening 101 of the guiding catheter 100, and guides the therapeutic catheter.
  • a guide extension catheter 10 used to extend the tube for extension from the guiding catheter 100 to the distal end side.
  • a rapid exchange type dilator 50 can be inserted into the guide extension catheter 10.
  • the guide extension catheter 10 includes a tubular tip tube 20 and a linear shaft 30 connected to the tip tube 20 and extending from the tip tube 20 to the proximal end side.
  • the tip tube 20 can move in the lumen of the guiding catheter 100 and project from the tip opening 101 of the guiding catheter 100 toward the tip side. Thereby, the tip tube 20 provides a continuous lumen from the guiding catheter 100. That is, in the procedure, the tip tube 20 of the guide extension catheter 10 can be inserted closer to the lesion than the guiding catheter 100 to provide a stable backup to the therapeutic catheter.
  • the tip tube 20 is a tubular body having a lumen penetrating from the tip to the proximal end, and includes a tubular portion 21 arranged on the distal end side and a half-tube portion 22 arranged on the proximal end side of the tubular portion 21. ing.
  • the tubular portion 21 is formed in a circular tubular shape by being provided with a material within a range of 360 degrees in the circumferential direction.
  • the half-pipe portion 22 is formed in the shape of a half-pipe by being provided with a material within a range of approximately 180 degrees in the circumferential direction.
  • the angle range in which the material of the half-pipe portion 22 is provided is not particularly limited as long as it is less than 360 degrees, and may be less than 180 degrees, for example.
  • the half-pipe portion 22 may not be provided.
  • the length of the tubular portion 21 in the axial direction is not particularly limited, but is, for example, 200 mm to 400 mm.
  • the length of the half-pipe portion 22 in the axial direction is not particularly limited, but is, for example, 5 mm to 200 mm.
  • the inner diameter of the tip tube 20 is not particularly limited, but is, for example, 1.3 mm to 1.5 mm.
  • the outer diameter of the tip tube 20 is not particularly limited, but is, for example, 1.50 mm to 1.90 mm, more preferably 1.55 to 1.75 mm.
  • the rigidity of the tip tube 20 gradually decreases from the base end side to the tip end side.
  • the tip tube 20 has a flexible structure in which the rigidity is reduced toward the tip side, so that it is possible to impart flexibility to the tip portion and to impart high pushability to the base end portion.
  • the rigidity of the tip tube 20 does not have to change from the base end side to the tip end side.
  • the tip tube 20 has a tip 21A formed of a flexible material such as polyurethane at the forefront.
  • the tip tube 20 includes an inner layer 23, a reinforcing layer 24, an outer layer 26, a tip marker 27, and a base end marker 28.
  • the tubular portion 21 is formed by an inner layer 23, a reinforcing layer 24, an outer layer 26, a tip marker 27, and a proximal end marker 28.
  • the half-pipe portion 22 is formed by an inner layer 23 and an outer layer 26. Alternatively, a middle layer may be provided between the inner layer 23 and the outer layer 26.
  • the inner layer 23 is a layer that forms the inner peripheral surface of the tubular portion 21 and the half-tube portion 22 of the tip tube 20.
  • the inner layer 23 is arranged inside the reinforcing layer 24 in the radial direction.
  • the inner layer 23 is preferably formed of a low friction material so that a guide wire, a therapeutic catheter, a dilator 50, or the like can easily slide inside.
  • the low friction material is, for example, a fluorine-based resin such as PTFE (polytetrafluoroethylene) or PFA (tetrafluoroethylene / perfluoroalkoxyethylene copolymer) or a silicon resin, but is not limited thereto.
  • the thickness of the inner layer 23 is not particularly limited, but is, for example, 0.0001 mm to 0.1 mm, preferably 0.005 mm to 0.05 mm, and more preferably 0.01 mm to 0.03 mm.
  • the reinforcing layer 24 is formed by a coil in which at least one wire is spirally wound or a plurality of blades in which a plurality of wires are braided in order to reinforce the tubular portion 21 of the tip tube 20.
  • the reinforcing layer 24 is arranged radially outside the inner layer 23 and radially inside the outer layer 26.
  • the coil and blade are formed of a wire made of a metal material such as stainless steel or tungsten, and the cross-sectional shape of the wire is round, elliptical, oval, rectangular, etc., and the diameter, width, and thickness of the wire are particularly important. It is not limited and is set as appropriate.
  • the angle of intersection between the long axis and the wire is not particularly limited, and may be appropriately set and may be constant or change along the long axis direction.
  • the reinforcing layer 24 is formed by a blade, the number of picks with one of the stitches as a pick (pick), the number of strands included in one pick (number of ends), and the number of picks in one round.
  • the number of spins which is the number of numbers, is appropriately set.
  • the shape and dimensions of the reinforcing wire may differ depending on the winding direction.
  • the wires forming the coil or blade of the reinforcing layer 24 may be arranged at a sparse pitch with a gap, or may be arranged at a dense pitch without a gap.
  • the reinforcing layer 24 can be a contrast marker that improves contrast when the tungsten wires are arranged at a close pitch.
  • the outer layer 26 is a layer that forms the outer peripheral surfaces of the tubular portion 21 and the half-tube portion 22 of the tip tube 20.
  • the outer layer 26 surrounds the outer peripheral surface of the inner layer 23 of the tubular portion 21 and the half-pipe portion 22. That is, the outer layer 26 is arranged on the outer side in the radial direction of the inner layer 23 and is fixed to the inner layer 23.
  • the outer layer 26 further surrounds the outer peripheral surfaces of the tip marker 27 and the proximal marker 28 provided on the tubular portion 21.
  • the outer layer 26 has a convex portion 29 on the outer surface of the portion where the linear shaft 30 is embedded.
  • the convex portion 29 projects radially outward in a cross section orthogonal to the axial center of the tip tube 20.
  • the convex portion 29 is formed at a position corresponding to the linear shaft 30 bent so as to be folded back. Therefore, the outer layer 26 does not become too thin at the portion where the linear shaft 30 is embedded inside the tip tube 20. Therefore, the strength of the tip tube 20 can be improved, the linear shaft 30 can be prevented from coming off from the tip tube 20, the linear shaft 30 does not need to be too thin, and the pushing strength and pulling strength of the guide extension catheter 10 are improved. can.
  • the outer layer 26 has a portion where two convex portions 29 are formed and a portion where one convex portion 29 is formed in a cross section orthogonal to the axis of the tip tube 20.
  • the portion where the two convex portions 29 are formed is arranged on the distal end side of the portion where the one convex portion 29 is formed.
  • a portion of the tip portion of the linear shaft 30 that is folded back and exists so that the two wire rods are lined up is embedded.
  • a portion where one wire rod exists is embedded on the base end side of the folded portion of the tip portion of the linear shaft 30.
  • a concave portion 29A is formed between the two convex portions 29.
  • the two convex portions 29 are continuously connected at the cutting edge where the semicircular portion 34 described later of the linear shaft 30 is located.
  • the convex portion 29 does not have to be formed.
  • the constituent material of the outer layer 26 is not particularly limited, but for example, various thermoplastics such as styrene-based, polyolefin-based, polyurethane-based, polyester-based, polyamide-based, polybutadiene-based, transpolyisoprene-based, fluororubber-based, and chlorinated polyethylene-based.
  • various thermoplastics such as styrene-based, polyolefin-based, polyurethane-based, polyester-based, polyamide-based, polybutadiene-based, transpolyisoprene-based, fluororubber-based, and chlorinated polyethylene-based.
  • examples thereof include elastomers, polyether ketones, and polyimide-based materials, and one or a combination of two or more of these (polymer alloy, polymer blend, laminate, etc.) can be used.
  • polyester elastomers, polyamide elastomers, and the like can be preferably used.
  • the thickness of the outer layer 26 is not particularly limited, but is, for example, 0.0001 mm to 0.1 mm, preferably 0.005 mm to 0.05 mm, and more preferably 0.01 mm to 0.03 mm. Is.
  • the outer peripheral surface of the outer layer 26 may be coated with a lubricating material in order to improve the permeability with blood vessels and the inner wall surface of the guiding catheter 100.
  • Lubricating materials include, for example, epoxy group-containing monomers such as glycidyl acrylate, glycidyl methacrylate, 3,4-epoxycyclohexylmethylacrylate, 3,4-epoxycyclohexylmethylmethacrylate, ⁇ -methylglycidylmethacrylate, and allylglycidyl ether, and N.
  • epoxy group-containing monomers such as glycidyl acrylate, glycidyl methacrylate, 3,4-epoxycyclohexylmethylacrylate, 3,4-epoxycyclohexylmethylmethacrylate, ⁇ -methylglycidylmethacrylate, and allylglycidyl ether, and N.
  • hydrophilic monomer such as methyl acrylamide, N, N-dimethyl acrylamide, acrylamide; (co) polymer composed of the above hydrophilic monomer; Cellulose such as hydroxypropyl cellulose and carboxymethyl cellulose High molecular weight substances: polysaccharides, polyvinyl alcohols, methyl vinyl ether-maleic anhydride copolymers, water-soluble polyamides, poly (2-hydroxyethyl (meth) crylate), polyethylene glycols, polyacrylamides, polyvinylpyrrolidones and the like. It is preferably a hydrophilic lubricating polymer such as a polyacrylamide copolymer containing acrylamide, and may be a hydrophobic lubricating polymer such as a fluororesin.
  • hydrophilic lubricating polymer such as a polyacrylamide copolymer containing acrylamide, and may be a hydrophobic lubricating polymer such as a fluororesin.
  • the tip marker 27 and the proximal marker 28 contain an X-ray opaque metal that can be visually recognized under fluoroscopy.
  • the tip end marker 27 and the base end marker 28 are, for example, ring-shaped members, but may be members having a C-shaped cross section, coils, or the like.
  • X-ray opaque metals are, for example, gold, platinum, silver, bismuth, tungsten, or alloys of two or more of these (eg, platinum-tungsten), barium sulfate, or alloys with other metals (eg, gold).
  • -Iridium, platinum-iridium, platinum-nickel and the like.
  • the tip marker 27 is arranged so as to be sandwiched between the inner layer 23 and the outer layer 26 at the tip of the tubular portion 21.
  • the position where the tip marker 27 is placed is not limited to between the inner layer 23 and the outer layer 26.
  • a middle layer may be provided between the outer layer 26 and the inner layer 23, and the tip marker 27 may be placed between the inner layer 23 and the middle layer. , Or may be arranged outside the outer layer 26.
  • the tip marker 27 is arranged on the tip side of the reinforcing layer 24. Therefore, the tip marker 27 does not overlap the reinforcing layer 24 in the axial direction of the tip tube 20.
  • the thickness of the tip tube 20 can be reduced and the outer diameter can be reduced.
  • the tip marker 27 may overlap the reinforcing layer 24 in the axial direction of the tip tube 20. Further, the tip marker 27 may not be provided.
  • the position where the base end marker 28 is arranged is not limited to between the inner layer 23 and the outer layer 26, and for example, a middle layer may be provided and arranged between the inner layer 23 and the middle layer or outside the outer layer 26.
  • the proximal end marker 28 is arranged closer to the proximal end side than the reinforcing layer 24. Therefore, the proximal end marker 28 does not overlap the reinforcing layer 24 in the axial direction of the distal end tube 20. As a result, the thickness of the tip tube 20 can be reduced and the outer diameter can be reduced.
  • the base end marker 28 may overlap with the reinforcing layer 24 in the axial direction of the tip tube 20.
  • the base end marker 28 may be directly fixed to the reinforcing layer 24 by caulking, adhesion, welding, or the like.
  • the linear shaft 30 is a flexible wire rod, and may be a round wire, a flat wire, or an arc wire, but a round wire is preferable, and the linear shaft 30 is connected to the tip tube 20 and is connected to the tip tube 20. It extends from to the base end side.
  • the linear shaft 30 includes a linear base portion 31 and a tip-shaped portion 32 arranged and shaped on the tip end side of the base portion 31. Since the base 31 is flexible and bends flexibly, it does not have to be linear at all times.
  • an intermediate straight portion 33 extending from the base portion 31 to the tip side, a semicircular portion 34 arranged on the tip side of the intermediate straight portion 33, and an intermediate straight portion 33 from the semicircular portion 34 are arranged. It is provided with a tip straight portion 35 extending to the opposite side of the side.
  • the intermediate straight portion 33 reaches from the proximal end surface of the half-pipe portion 22 to the proximal end portion of the tubular portion 21. Therefore, the tip of the intermediate straight portion 33 is located at the tubular portion 21.
  • the intermediate straight line portion 33 is located on the axis of the base portion 31 and is inclined at a minute angle exceeding 0 degrees with respect to the extension line L1 extending from the base portion 31 toward the tip end side. Therefore, the intermediate straight line portion 33 is arranged so as to be deviated from the extension line L1 to one side. Alternatively, the intermediate straight line portion 33 may be parallel to the extension line L1 or on the extension line L1.
  • the base end of the intermediate straight portion 33 may be located closer to the base end side than the base end of the half pipe portion 22, or may be located on the tip end side of the half pipe portion 22.
  • the starting point at which the intermediate straight portion 33 is located on the axial center of the base portion 31 and is inclined with respect to the extension line L1 extending from the base portion 31 toward the tip side may be in the half pipe portion 22 or in the tubular portion 21. You may.
  • the semicircular portion 34 is bent by changing the direction by about 180 degrees so as to draw a substantially semicircle at the base end portion of the tubular portion 21.
  • the semicircular portion 34 is arranged so as to intersect the extension line L1.
  • the semicircular portion 34 does not have to intersect the extension line exactly.
  • the semicircular portion 34 is arranged at a position overlapping the reinforcing layer 24 in the axial direction of the tip tube 20. That is, both the semicircular portion 34 and the reinforcing layer 24 are provided within a predetermined range in the axial direction of the tip tube 20.
  • the tip straight portion 35 extends from the end portion of the tubular portion 21 opposite to the side in contact with the intermediate straight portion 33 to the proximal end side.
  • the straight tip portion 35 is substantially parallel to the extension line L1, but does not have to be strictly parallel.
  • An extension line L1 is arranged between the intermediate straight line portion 33 and the tip straight line portion 35.
  • the intermediate straight line portion 33, the semicircular portion 34, and the tip straight line portion 35 are arranged on the same plane.
  • the end portion 36 located on the side opposite to the side in contact with the semicircle portion 34 of the tip straight portion 35 is located on the tubular portion 21.
  • the terminal portion 36 may be located at the half pipe portion 22.
  • the end portion 36 is arranged closer to the base end side than the reinforcing layer 24 in the axial direction of the tip tube 20.
  • the tip shape portion 32 may be engaged so as to be hooked on the wire rod forming the reinforcing layer 24.
  • the state in which the tip shape portion 32 is caught by the wire rod forming the reinforcing layer 24 is, for example, the state in which the tip shape portion 32 is from the inner peripheral surface side to the outer peripheral surface side or from the outer peripheral surface side to the inner peripheral surface side of the reinforcing layer 24.
  • a state in which the wire rods constituting the reinforcing layer 24 are passed through the gaps thereof can be mentioned.
  • the radius of curvature of the semicircular portion 34 does not have to be constant, and the direction of the semicircular portion or the semicircular portion may exceed 180 degrees, and conversely, it may be less than 180 degrees.
  • the linear shaft 30 may be coated with a low friction material so that all or at least a part of the portion exposed to the outside can slide with the inner wall surface of the guiding catheter 100 with low friction.
  • the low friction material is, for example, a fluororesin or a silicon resin, but is not limited thereto.
  • the linear shaft 30 may be coated with a lubricating material on all or at least a part of the portion exposed to the outside in order to improve the slidability with the inner wall surface of the guiding catheter 100.
  • the linear shaft 30 has a first straight portion 40 having a constant outer diameter and a first taper having a decreasing outer diameter from the proximal end side to the distal end side. It has a portion 41, a second straight portion 42 having a constant outer diameter, a second tapered portion 43 having a reduced outer diameter, and a third straight portion 44 having a constant outer diameter.
  • the first straight line portion 40 forms the base portion 31.
  • the first tapered portion 41 forms a portion including the boundary between the base portion 31 and the intermediate straight portion 33.
  • the second straight line portion 42, the second tapered portion 43, and a part of the third straight line portion 44 on the proximal end side form an intermediate straight line portion 33.
  • the third straight portion 44 forms a semicircular portion 34 and a tip straight portion 35.
  • the tip straight portion 35, the semicircular portion 34, and the intermediate straight portion 33 may be on the tip side of the second tapered portion 43, that is, the tip shape portion 32 may have a smaller outer diameter than the base portion 31 and may be constant. ..
  • the linear shaft 30 is connected to the tip tube 20 after the tip shape portion 32 is shaped into a predetermined shape.
  • the linear shaft 30 is adhered to the outer peripheral surface or the inner peripheral surface of the proximal end marker 28 by an adhesive 90.
  • the adhesive 90 includes various adhesives such as cyanoacrylate-based, acrylic-based, epoxy-based, urethane-based, hot-melt-based, elastomer-based, and thermoplastic resin-based adhesives, and modified polyolefins (for example, ethylene-vinyl acetate copolymers, etc.).
  • the linear shaft 30 is adhered to the base end marker 28 at, for example, the intermediate straight portion 33 and the tip straight portion 35, but the portion to be adhered is not particularly limited.
  • the bonded base end marker 28 and the linear shaft 30 can be incorporated in a bonded state at the time of manufacturing, which facilitates manufacturing. Further, when the linear shaft 30 and the proximal end marker 28 are fixed by caulking, welding, or the like, the linear shaft 30 and the proximal end marker 28 are likely to be deformed. On the other hand, when the proximal end marker 28 and the linear shaft 30 are fixed by adhesion, they are less likely to be deformed. Therefore, the shape of the catheter can be stabilized and it can be manufactured at low cost.
  • the linear shaft 30 and the proximal end marker 28 may be fixed by a method other than adhesion, and may be fixed by, for example, caulking or welding.
  • the tip of the linear shaft 30 is arranged at a position overlapping the reinforcing layer 24 in the axial direction of the tip tube 20. Thereby, the pushing strength and the pulling strength of the guide extension catheter 10 can be improved. Although the tip of the linear shaft 30 and the reinforcing layer 24 are in direct contact with each other, an intermediate layer may be provided between the tip of the linear shaft 30 and the reinforcing layer 24.
  • the outer diameter of the linear shaft 30 is not particularly limited, but is, for example, 0.05 mm to 1 mm, preferably 0.1 mm to 0.7 mm, and more preferably the tip portion varies from 0.1 mm to 0.25 mm.
  • the base is preferably 0.5 mm.
  • the length of the base portion 31 of the linear shaft 30 in the axial direction is not particularly limited, but is, for example, 1100 mm to 1300 mm.
  • the constituent material of the linear shaft 30 is not particularly limited, but for example, stainless steel, nickel-titanium alloy, or the like can be preferably used.
  • the cross-sectional shape of the linear shaft 30 is not limited to a circle, and may be, for example, a rectangle, a square, an ellipse, or the like, or may have a different shape depending on the portion.
  • the linear shaft 30 may have a visually recognizable depth marker on the base 31 to determine the insertion length into the guiding catheter 100.
  • the rapid exchange type dilator 50 includes a tubular dilator tip tube 60 and a dilator linear shaft 70 connected to the dilator tip tube 60 and extending from the dilator tip tube 60 to the proximal end side. And have. That is, the dilator 50 is also a catheter having an intermediate opening having a tip tube and a linear shaft, like the guide extension catheter 10.
  • the dilator 50 can be called an instrument that is inserted into the coronary artery together with the guide extension catheter 10 and smoothly guides to a lesion such as a stenosis that occurs in the coronary artery.
  • the dilator 50 is called an instrument that is inserted into the coronary artery together with the guide extension catheter 10 and smoothly guides the guide extension catheter 10 beyond a lesion such as a stenosis that occurs in the coronary artery, thereby expanding the stenosis. Can be done.
  • the dilator tip tube 60 is a tubular body having a lumen penetrating from the tip to the base end, and has a tip taper portion 61 arranged on the tip end side and a cylindrical portion 62 arranged on the base end side of the tip taper portion 61. And an inclined portion 63 arranged on the base end side of the tubular portion 62.
  • the tip tapered portion 61 is tapered toward the tip side.
  • the tip tapered portion 61 may have a tubular portion whose diameter is tapered toward the tip side and whose outer diameter is constant.
  • the tubular portion 62 is a cylinder having a uniform outer diameter and inner diameter.
  • the outer diameter of the tubular portion 62 is, for example, 0.05 mm smaller than the inner diameter of the tip tube 20.
  • the inner diameter of the tubular portion 62 is larger than the outer diameter of the guide wire to be inserted.
  • the inclined portion 63 has a base end surface that is inclined with respect to a cross section orthogonal to the axis.
  • the inclined portion 63 may not be provided.
  • the length of the tip tapered portion 61 in the axial direction is not particularly limited, but is, for example, 3 mm to 30 mm.
  • the length of the entire dilator tip tube 60 in the axial direction is not particularly limited, but is, for example, 100 mm to 450 mm.
  • the dilator tip tube 60 preferably has some flexibility and is flexible. Therefore, the constituent materials of the dilator tip tube 60 are, for example, various thermoplastics such as styrene-based, polyolefin-based, polyurethane-based, polyester-based, polyamide-based, polybutadiene-based, transpolyisoprene-based, fluororubber-based, and chlorinated polyethylene-based.
  • the dilator tip tube 60 may contain the above-mentioned X opaque material (contrast medium) in the material.
  • the dilator tip tube 60 may contain the above-mentioned X-impermeable material (contrast medium) in the material, or may have a marker made of an X-ray opaque metal.
  • X-ray opaque metals are, for example, gold, platinum, silver, bismuth, tungsten, or alloys of two or more of these (eg, platinum-tungsten), barium sulfate, or alloys with other metals (eg, gold).
  • -Iridium, platinum-iridium, platinum-nickel and the like.
  • the dilator tip tube 60 is formed, for example, by insert molding the dilator linear shaft 70 in a state of being arranged in a mold.
  • the dilator linear shaft 70 is a flexible wire rod, which is connected to the dilator tip tube 60 and extends from the dilator tip tube 60 to the proximal end side.
  • the dilator linear shaft 70 includes a linear shaft base 71 and a shaft tip shaped portion 72 arranged and shaped on the tip side of the shaft base 71. Since the shaft base 71 is flexible and bends flexibly, it does not have to be always linear.
  • the shaft tip shape portion 72 includes a shaft intermediate straight portion 73 extending from the shaft base 71 to the tip side, a shaft semicircle portion 74 arranged on the tip side of the shaft intermediate straight portion 73, and a shaft from the shaft semicircle portion 74 to the shaft. It includes a shaft tip straight portion 75 extending to the side opposite to the side on which the intermediate straight portion 73 is provided.
  • the shaft intermediate straight portion 73 reaches the cylindrical portion 62 from the proximal end surface of the portion protruding toward the proximal end side of the inclined portion 63 of the dilator tip tube 60. Therefore, the tip of the shaft intermediate straight line portion 73 is located at the tubular portion 62.
  • the shaft intermediate straight line portion 73 is located on the axis of the shaft base portion 71 and is inclined at a minute angle exceeding 0 degrees with respect to the extension line L2 extending from the shaft base portion 71 toward the tip end side. Therefore, the shaft intermediate straight line portion 73 is arranged so as to be deviated from the extension line L2 to one side. Alternatively, the shaft intermediate straight portion 73 may be parallel to the extension line L2 or on the extension line L2.
  • the shaft semicircle portion 74 is bent by changing the direction by about 180 degrees so as to draw a substantially semicircle at the base end portion of the tubular portion 62.
  • the shaft semicircular portion 74 is arranged so as to intersect the extension line L2.
  • the shaft semicircular portion 74 does not have to exactly intersect the extension line L2.
  • the shaft tip straight portion 75 extends from the end of the shaft semicircular portion 74 on the side opposite to the side in contact with the shaft intermediate straight portion 73 toward the proximal end side.
  • the straight portion 75 at the tip of the shaft is substantially parallel to the extension line L2, but does not have to be exactly parallel.
  • An extension line L2 is arranged between the shaft intermediate straight portion 73 and the shaft tip straight portion 75.
  • the shaft intermediate straight portion 73, the shaft semicircular portion 74, and the shaft tip straight portion 75 are arranged on the same plane.
  • the shaft end portion 76 on the side opposite to the side in contact with the shaft semicircle portion 74 of the shaft tip straight portion 75 is located at the tubular portion 62 or the inclined portion 63.
  • the radius of curvature of the shaft semicircular portion 74 does not have to be constant, it may be semi-elliptical, or the direction may exceed 180 degrees, and conversely, it may not be less than 180 degrees.
  • the dilator linear shaft 70 includes a dilator straight portion 80 having a constant outer diameter and a dilator straight portion 80 from the proximal end side to the distal end side. It has a dilator taper portion 81 whose outer diameter is reduced from the tip to the tip of the dilator linear shaft 70.
  • the dilator straight line portion 80 forms the shaft base portion 71.
  • the dilator taper portion 81 forms the tip portion of the shaft base portion 71, the shaft intermediate straight portion 73, the shaft semicircular portion 74, and the shaft tip straight portion 75.
  • the boundary between the dilator straight portion 80 and the dilator taper portion 81 is arranged on the proximal end side of the dilator tip tube 60, but may be arranged at the proximal end of the dilator tip tube 60 or inside the dilator tip tube 60.
  • the dilator linear shaft 70 is connected to the dilator tip tube 60 after the shaft tip shape portion 72 is shaped into a predetermined shape.
  • the outer diameter of the dilator linear shaft 70 is not particularly limited, but is, for example, 0.05 mm to 1 mm, preferably 0.1 mm to 0.7 mm, and more preferably the tip portion is between 0.1 mm and 0.5 mm. It is preferable that the base is 0.5 mm.
  • the length of the shaft base 71 of the dilator linear shaft 70 in the axial direction is not particularly limited, but is, for example, 1000 mm to 1400 mm.
  • the constituent material of the dilator linear shaft 70 is not particularly limited, but for example, stainless steel, nickel-titanium alloy, or the like can be preferably used.
  • the cross-sectional shape of the dilator linear shaft 70 is not limited to a circle, and may be, for example, a rectangle, a square, an ellipse, or the like, or may have a different shape depending on the portion.
  • the dilator linear shaft 70 may have a visually recognizable depth marker to determine the insertion length into the guiding catheter 100.
  • the dilator tip marker 77 and the dilator base end marker 78 contain an X-ray opaque metal that can be visually recognized under fluoroscopy.
  • the dilator tip marker 77 and the dilator base end marker 78 are, for example, ring-shaped members, but may be members having a C-shaped cross section, coils, or the like.
  • X-ray opaque metals are, for example, gold, platinum, silver, bismuth, tungsten, or alloys of two or more of these (eg, platinum-tungsten), barium sulfate, or alloys with other metals (eg, gold).
  • -Iridium, platinum-iridium, platinum-nickel and the like.
  • the dilator linear shaft 70 is adhered to the outer peripheral surface or the inner peripheral surface of the dilator base end marker 78 with an adhesive 91.
  • the adhesive 91 includes various adhesives such as cyanoacrylate-based, acrylic-based, epoxy-based, urethane-based, hot-melt-based, elastomer-based, and thermoplastic resin-based adhesives, and modified polyolefins (for example, ethylene-vinyl acetate copolymers, etc.).
  • the dilator linear shaft 70 is adhered to the dilator base end marker 78 at, for example, the shaft intermediate straight portion 73 and the shaft tip straight portion 75, but the portion to be adhered is not particularly limited.
  • the bonded dilator base end marker 78 and the dilator linear shaft 70 can be incorporated in a bonded state at the time of manufacturing, which facilitates manufacturing. Further, when the dilator linear shaft 70 and the dilator base end marker 78 are fixed by caulking, welding, or the like, the dilator linear shaft 70 and the dilator base end marker 78 are likely to be deformed.
  • the dilator linear shaft 70 and the dilator base end marker 78 may be fixed by a method other than adhesion, and may be fixed by, for example, caulking or welding.
  • the guide extension catheter 10 and the dilator 50 can be used with the dilator 50 inserted in the guide extension catheter 10 as shown in FIG.
  • the guide extension catheter 10 and the dilator 50 may be packaged in the assembled catheter assembly. As a result, the convenience of the procedure is improved, and the procedure can be performed immediately after opening the package. Further, a catheter set in which the guide extension catheter 10 is used as the first catheter, the dilator 50 is used as the second catheter, and the dilator 50, which is the second catheter, is inserted into the guide extension catheter 10 which is the first catheter to a predetermined position.
  • the proximal marker 28 of the guide extension catheter 10 which is the first catheter and the dilator proximal marker 78 of the dilator 50 which is the second catheter are arranged at positions separated from each other in the axial direction. .. Therefore, the protruding length of the dilator 50 protruding from the tip opening 201 of the guide extension catheter 10 by X-ray contrast, or between the depth markers provided on the linear shaft 30 and the second linear shaft 70 of the first catheter, respectively.
  • the distance in the axial direction may be compared with the distance between the proximal end marker 28 and the dilator proximal marker 78 under X-ray contrast to determine the presence or absence of deflection or entanglement of the shaft.
  • the dilator tip tube 60 can move in the lumen of the tip tube 20 of the guide extension catheter 10 and partially project from the tip opening 201 of the tip tube 20 toward the tip side. At this time, the tip tapered portion 61 of the dilator tip tube 60 projects from the tip opening 201 of the tip tube 20 toward the tip side. After engaging (engaging) the tip of the guiding catheter 100 with the coronary artery ostium, the operator causes the guide extension catheter 10 into which the dilator 50 is inserted to protrude from the tip opening 101 of the guiding catheter 100.
  • the dilator tip tube 60 plays a role of smoothly guiding the guide extension catheter 10 to a target position along the guide wire.
  • the target position may be guided to a position in front of the lesion or beyond the lesion.
  • the position of the guide wire is fixed and the dilator tip tube 60 is removed from the guide extension catheter 10.
  • the therapeutic catheter is brought to the lesion along the guide wire through the lumens of the guiding catheter 100 and the guide extension catheter 10.
  • the operator can treat the lesion (for example, dilation with a balloon or placement of a stent) with a therapeutic catheter.
  • the catheter having an intermediate opening is a catheter having an intermediate opening having the tip tube 20 and the linear shaft 30 extending from the tip tube 20 to the proximal end side, and is the tip tube 20.
  • the linear shaft 30 has an outer layer 26, a reinforcing layer 24 arranged radially inside the outer layer 26, and an X-ray impermeable marker arranged on the proximal end side of the tip tube 20. The tip is fixed to the marker.
  • the linear shaft 30 can be firmly fixed to the tip tube 20 via the marker, so that the pushing strength, the pulling strength and the torsional strength can be improved.
  • the marker is fixed to the tip of the linear shaft 30 by adhesion. As a result, when the marker and the linear shaft 30 are fixed, they are less likely to be deformed, so that the shape of the catheter can be stabilized and the catheter can be manufactured at low cost.
  • the marker may be a proximal end marker 28 arranged at the proximal end portion of the distal tube 20.
  • the tip tube 20 has an X-ray opaque tip marker 27 arranged at the tip of the tip tube 20. Thereby, the position of the tip tube 20 can be specified by X-ray.
  • At least one of the tip end marker 27 and the base end marker 28 is arranged at a position separated from the reinforcing layer 24 in the axial direction. Thereby, the thickness of the tip tube 20 can be reduced and / or the outer diameter can be reduced. It is more preferable that both the tip end marker 27 and the base end marker 28 are arranged at positions separated from the reinforcing layer 24 in the axial direction.
  • proximal end marker 28 is arranged closer to the proximal end side than the proximal end of the reinforcing layer 24.
  • the base end marker 28 to which the linear shaft 30 is fixed does not overlap the reinforcing layer 24, so that the thickness of the tip tube 20 can be reduced and / or the outer diameter can be reduced.
  • the catheter having an intermediate opening projects the tip of the therapeutic catheter from the tip opening 101 of the guiding catheter 100 and coronary artery along the therapeutic catheter.
  • It may be a guide extension catheter 10 for advancing the inside to the periphery and arranging a treatment portion provided on the treatment catheter to perform treatment on the lesion portion.
  • the guide extension catheter 10 can effectively transmit the pushing force, the pulling force, and the rotational force to the tip tube 20, and the operation can be performed. It is possible to prevent the tip tube 20 and the linear shaft 30 from separating inside.
  • the treatment unit provided on the treatment catheter for performing treatment is, for example, a balloon or a stent.
  • the catheter having an intermediate opening projects the tip of the therapeutic catheter from the tip opening 101 of the guiding catheter 100 and coronary artery along the therapeutic catheter.
  • It may be a rapid exchange type dilator 50 that advances inside to the periphery and is inserted into a guide extension catheter 10 for arranging a treatment portion provided on the treatment catheter and performing treatment on the lesion portion.
  • the dilator 50 can effectively transmit the pushing force, the pulling force and the rotational force to the dilator tip tube 60, and the operation can be performed. It is possible to prevent the dilator tip tube 60 and the dilator linear shaft 70 from being separated from each other.
  • the catheter having an intermediate opening is a catheter having an intermediate opening having a dilator tip tube 60 and a dilator linear shaft 70 extending from the dilator tip tube 60 to the proximal end side, and the dilator tip tube 60 is a tip.
  • It is a tubular body having a lumen penetrating from the base end to the base end, and has a tip tapered portion 61 arranged on the tip side, a tubular portion 62 arranged on the base end side of the tip tapered portion 61, and a tubular portion 62.
  • the tip tapered portion 61 is tapered toward the distal end side
  • the dilator tip tube 60 is on the proximal end side of the dilator tip tube 60.
  • a catheter having an X-ray opaque marker to be arranged and the tip of the dilator linear shaft 70 may be fixed to the marker.
  • the catheter having an intermediate opening is inserted into the coronary artery together with the guide extension catheter 10, and the guide extension catheter 10 is smoothly guided or dilated beyond the lesion such as the stenosis occurring in the coronary artery. It can be used as a dilator 50.
  • the catheter assembly includes a catheter having a first intermediate opening having a first tip tube and a first linear shaft extending from the first tip tube toward the proximal end side, and a second tip tube. And a catheter with a second intermediate opening having a second linear shaft extending from the second tip tube towards the proximal end, the first tip tube having an outer layer 26 and said outer layer 26.
  • the tip of the first linear shaft has a reinforcing layer 24 arranged radially inward and an X-ray opaque first marker arranged at the base end of the first tip tube.
  • the portion is fixed to the first marker
  • the second tip tube is a tubular body having a lumen penetrating from the tip to the base end, and has a tip taper portion 61 arranged on the tip side and a tip taper.
  • a tubular portion 62 arranged on the base end side of the portion 61 and an inclined portion 63 arranged on the base end side of the tubular portion 62 are provided, and the tip tapered portion 61 is tapered toward the tip side.
  • the second tip tube has a diameter and has a second X-ray opaque marker located at the base end of the second tip tube, with the tip of the second linear shaft ,
  • the first marker when the catheter with the second intermediate opening is inserted into the first tip tube of the catheter with the first intermediate opening, fixed to the second marker, to a predetermined position.
  • It may be a catheter assembly in which the second marker and the second marker are separated from each other in the axial direction.
  • the axis of the tip shape portion 32 may be three-dimensionally arranged beyond the same plane.
  • the end portion 36 is arranged away from the plane on which the intermediate straight portion 33 and the semicircle portion 34 are located.
  • the intermediate straight portion 33, the semicircular portion 34, and the tip straight portion 35 of the linear shaft 30 can be efficiently arranged within the limited thickness range of the tip tube 20, so that the thickness of the tip tube 20 can be increased.
  • the increase can be suppressed.
  • a middle layer may be arranged between the tip shape portion 32 and the reinforcing layer 24, which are three-dimensional shapes of the linear shaft 30, and the tip shape portion 32 may be separated from the reinforcing layer 24.
  • the tip tube 20 of the guide extension catheter 10 is arranged on the distal end side of the proximal lumen 20A having a substantially uniform inner diameter and the distal end of the proximal lumen 20A.
  • the tip lumen 20B may be provided with an inner diameter that tapers toward the side.
  • the tip tube 20 accommodates a part of the tip tapered portion 61 of the dilator 50 in the tip lumen 20B, and the cylindrical portion 62 arranged on the proximal end side of the distal tapered portion 61 is formed in the proximal lumen 20A.
  • the tubular portion 62 having a larger outer diameter than usual can be arranged in the proximal lumen 20A, the pushability and penetrating force of the dilator tip tube 60 can be improved.
  • the dilator tip tube 60 of the dilator 50 may have a base end opening 64 that tapers toward the base end side.
  • the insertability of the guide wire into the dilator tip tube 60 can be improved.
  • the dilator tip tube 60 may have a large diameter portion 65 having a larger outer diameter than the tip portion at the base end portion. By abutting the large diameter portion 65 against the tip tube 20 of the guide extension catheter 10 and causing it to interfere with each other, the dilator 50 can be prevented from protruding too much from the guide extension catheter 10.
  • the dilator tip tube 60 of the dilator 50 may have a plurality of X-ray contrast markers 66 arranged at predetermined intervals (for example, 5 mm intervals) in the axial direction. .. Thereby, the length can be estimated with reference to the X-ray contrast marker 66 under fluoroscopy. This facilitates the surgeon to determine the size of the therapeutic catheter to be inserted later.
  • the color of a part or all of the linear shaft 30 of the guide extension catheter 10 and the dilator linear shaft 70 of the dilator 50 may be different from each other. As a result, it becomes easy to distinguish between the two, and the convenience of the procedure can be improved.
  • linear shaft 30 or the dilator linear shaft 70 may be coated with a lubricant such as silicon to prevent the shafts from being entangled with each other.

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Abstract

L'invention concerne un cathéter permettant d'améliorer efficacement la résistance à la poussée et la résistance à l'arrachement et ayant une ouverture intermédiaire, et un ensemble cathéter.　Ce cathéter ayant une ouverture intermédiaire comprend un tube d'extrémité distale (20) et un arbre linéaire (30) s'étendant à partir du tube d'extrémité distale (20) vers le côté proximal. Le tube d'extrémité distale (20) comprend une couche externe (26), une couche de renforcement (24) disposée sur le côté radialement interne de la couche externe (26), et un marqueur d'extrémité proximale (28) opaque aux rayons X disposé au niveau d'une partie d'extrémité proximale du tube d'extrémité distale (20). La partie d'extrémité distale de l'arbre linéaire (30) est fixée au marqueur d'extrémité proximale (28).
PCT/JP2022/001382 2021-01-18 2022-01-17 Cathéter et ensemble cathéter WO2022154118A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2021-005944 2021-01-18
JP2021005944A JP2024032024A (ja) 2021-01-18 2021-01-18 カテーテルおよびカテーテル組立体

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WO2022154118A1 true WO2022154118A1 (fr) 2022-07-21

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WO (1) WO2022154118A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2012100827A (ja) * 2010-11-09 2012-05-31 Sumitomo Bakelite Co Ltd カテーテル
US20120165756A1 (en) * 2006-05-03 2012-06-28 Vascular Solutions, Inc. Coaxial guide catheter for interventional cardiology procedures
WO2020153321A1 (fr) * 2019-01-23 2020-07-30 ニプロ株式会社 Cathéter de support

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120165756A1 (en) * 2006-05-03 2012-06-28 Vascular Solutions, Inc. Coaxial guide catheter for interventional cardiology procedures
JP2012100827A (ja) * 2010-11-09 2012-05-31 Sumitomo Bakelite Co Ltd カテーテル
WO2020153321A1 (fr) * 2019-01-23 2020-07-30 ニプロ株式会社 Cathéter de support

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