WO2022196417A1 - Cathéter pour diagnostic d'image - Google Patents

Cathéter pour diagnostic d'image Download PDF

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Publication number
WO2022196417A1
WO2022196417A1 PCT/JP2022/009775 JP2022009775W WO2022196417A1 WO 2022196417 A1 WO2022196417 A1 WO 2022196417A1 JP 2022009775 W JP2022009775 W JP 2022009775W WO 2022196417 A1 WO2022196417 A1 WO 2022196417A1
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WO
WIPO (PCT)
Prior art keywords
inner tube
tube
outer tube
drive shaft
flow path
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Application number
PCT/JP2022/009775
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English (en)
Japanese (ja)
Inventor
恭宏 柿本
智弘 福田
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テルモ株式会社
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Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Priority to JP2023506984A priority Critical patent/JPWO2022196417A1/ja
Publication of WO2022196417A1 publication Critical patent/WO2022196417A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/015—Control of fluid supply or evacuation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters

Definitions

  • the present disclosure relates to diagnostic imaging catheters.
  • a diagnostic imaging catheter generally has a pull-back mechanism at its proximal end that changes the relative position between the sheath and the drive shaft in order to continuously observe cross-sections within the body cavity (see, for example, Patent Document 1).
  • the pullback mechanism includes an outer tube, and an inner tube that is provided radially inwardly of the outer tube and radially outwardly of the drive shaft and is axially movable relative to the outer tube and integrally with the drive shaft.
  • priming is performed to fill the lumen with liquid. Priming is usually performed in the most retracted state in which the inner tube is pulled out from the outer tube.
  • the priming liquid entrains air from the inner tube into the outer tube where the cross-sectional area of the flow path is widened, the air may become bubbles and become difficult to escape from the pullback mechanism.
  • an object of the present disclosure is to provide a diagnostic imaging catheter capable of suppressing the formation of air bubbles in the pullback mechanism during priming, thereby achieving good priming properties.
  • a diagnostic imaging catheter as a first aspect of the present disclosure includes an outer tube, a drive shaft provided radially inward of the outer tube, and radially inner than the outer tube and radially outer than the drive shaft. and an inner tube axially displaceable relative to said outer tube and integrally with said drive shaft, wherein said inner tube defines a flow path within said inner tube with said inner tube. It has a notch that communicates with the flow path between the outer tube.
  • the notch in the diagnostic imaging catheter, includes a hole that connects a flow path within the inner tube to a flow path between the inner tube and the outer tube.
  • the hole penetrates a recess provided in the outer peripheral surface of the inner tube so as to extend from the distal end of the inner tube to the proximal side.
  • the inner tube has a narrowed portion that narrows the tip of the flow path in the inner tube.
  • a diagnostic imaging catheter as a second aspect of the present disclosure includes an outer tube, a drive shaft provided radially inward of the outer tube, and radially inner than the outer tube and radially outer than the drive shaft. and an inner tube that is axially movable relative to the outer tube and integrally with the drive shaft; an elastic membrane facing the distal end surface, the elastic membrane having a hole that connects a channel on the proximal side of the elastic membrane to a channel between the elastic membrane and the outer tube.
  • the outer tube integrally includes the elastic membrane.
  • the diagnostic imaging catheter is provided radially inward of the inner tube and radially outward of the drive shaft, relative to the inner tube and the outer tube.
  • An integrally axially movable support tube is provided, and the support tube integrally includes the elastic membrane.
  • a diagnostic imaging catheter capable of suppressing the formation of air bubbles in the pullback mechanism during priming, thereby achieving good priming properties.
  • FIG. 2 is a plan view showing a state in which an external device is connected to the diagnostic imaging catheter as the first embodiment; 2 is a side view showing the diagnostic imaging catheter shown in FIG. 1 in the most advanced state before pullback operation; FIG. 2 is a side view showing the diagnostic imaging catheter shown in FIG. 1 in the most retracted state after a pullback operation; FIG. FIG. 2 is a cross-sectional view showing the distal end portion of the diagnostic imaging catheter shown in FIG. 1; FIG. 2 is a cross-sectional view showing the proximal end portion of the diagnostic imaging catheter shown in FIG. 1; FIG. 2 is a cross-sectional view showing a pullback mechanism of the diagnostic imaging catheter shown in FIG. 1; FIG.
  • FIG. 6 is a cross-sectional view showing an enlarged part of the pullback mechanism shown in FIG. 5;
  • FIG. 7 is a cross-sectional view taken along the line AA of FIG. 6;
  • FIG. 7 is an external view showing how the distal end portion of the inner tube shown in FIG. 6 is assembled. It is a sectional view showing a part of pullback mechanism in a 2nd embodiment.
  • FIG. 10 is a cross-sectional view taken along the line BB of FIG. 9;
  • the diagnostic imaging catheter 1 is a dual type that uses both intravascular ultrasound (IVUS) and optical coherence tomography (OCT).
  • the dual-type diagnostic imaging catheter 1 has three modes: a mode for acquiring a tomographic image only by IVUS, a mode for acquiring a tomographic image only by OCT, and a mode for acquiring tomographic images by both IVUS and OCT. It exists and can be used by switching between these modes.
  • a diagnostic imaging catheter 1 is connected to and driven by an external device 2 .
  • An imaging diagnostic apparatus 3 is composed of the diagnostic imaging catheter 1 and the external device 2 .
  • a diagnostic imaging catheter 1 includes a sheath 4 inserted into a body cavity such as a blood vessel (a blood vessel such as a coronary artery) of a living body, and an outer sheath 4 connected to the proximal end of the sheath 4.
  • a tube 5 an inner tube 6 inserted into the outer tube 5 so as to be able to move back and forth, a unit connector 7 connected to the proximal end of the outer tube 5 and holding the inner tube 6 so as to move back and forth, and the proximal end of the inner tube 6. and a hub 8 connected to the part.
  • the diagnostic imaging catheter 1 includes a driving shaft 9, a housing 10 fixed to the distal end of the driving shaft 9, and a signal transmitting/receiving section 11 accommodated in the housing 10 and transmitting/receiving ultrasonic and/or light signals. and an imaging core 12 .
  • the imaging core 12 is inserted into the sheath 4 , the outer tube 5 and the inner tube 6 , and is axially movable with respect to the sheath 4 and the outer tube 5 together with the inner tube 6 .
  • the distal end means the end of the diagnostic imaging catheter 1 that is inserted into the body cavity
  • the proximal end means the end that is held outside the body cavity of the diagnostic imaging catheter 1.
  • the axial direction means the direction along the central axis O of the drive shaft 9 (that is, the direction in which the drive shaft 9 extends)
  • the radial direction means the direction along a straight line orthogonal to the central axis O
  • the circumferential direction It means the direction around the central axis O.
  • the drive shaft 9 extends through the sheath 4, the outer tube 5 and the inner tube 6 to the inside of the hub 8.
  • the hub 8 , the inner tube 6 , the drive shaft 9 , the housing 10 , and the signal transmitter/receiver 11 are connected to each other so as to be axially movable integrally with respect to the sheath 4 and the outer tube 5 . Therefore, for example, when the hub 8 is pushed toward the distal end side, that is, when a pushing operation is performed, the inner tube 6 connected to the hub 8 is pushed into the outer tube 5 and the unit connector 7, and the drive shaft is pushed. 9.
  • the housing 10 and the signal transmitting/receiving unit 11, that is, the imaging core 12 advance inside the sheath 4, that is, move to the distal side.
  • the inner tube 6 is pulled out from the outer tube 5 and the unit connector 7 as indicated by arrow A1 in FIGS. 1 and 2B.
  • Imaging core 12 moves proximally inside sheath 4 as indicated by arrow A2.
  • the tip of the inner tube 6 reaches the vicinity of the relay connector 13 when the inner tube 6 is in the most advanced state in which it is pushed to the tip side.
  • the signal transmitter/receiver 11 is positioned at the distal end of the sheath 4 (near the distal end surface of the lumen of the sheath 4).
  • a relay connector 13 connects the sheath 4 and the outer tube 5 .
  • the distal end of the inner tube 6 is provided with a locking portion 14 for preventing it from slipping off.
  • the locking portion 14 prevents the inner tube 6 from slipping out of the outer tube 5 .
  • the locking portion 14 is formed on the inner wall of the unit connector 7 when the hub 8 is pulled most proximally, that is, when the inner tube 6 is most pulled out from the outer tube 5 and the unit connector 7 . It is configured to hook into place.
  • the drive shaft 9 is an elongated hollow member, in which an electric signal line (electric cable) 15 and an optical signal line (optical fiber) 16 connected to the signal transmitter/receiver 11 are provided. are placed.
  • the drive shaft 9 is formed of a coil shaft. Although illustration is omitted, the coil shaft can be formed of, for example, multiple layers of coils with different winding directions. Each coil is made of metal such as stainless steel or Ni--Ti (nickel-titanium) alloy.
  • the signal transmission/reception unit 11 has an ultrasonic transmission/reception unit 11a that transmits/receives ultrasonic waves and an optical transmission/reception unit 11b that transmits/receives light.
  • the ultrasonic transmission/reception unit 11a has a transducer that transmits ultrasonic waves based on pulse signals into the body cavity and receives ultrasonic waves that have been reflected from living tissue in the body cavity.
  • the vibrator is electrically connected via an electrical signal line 15 to an electrical connector 15a (see FIG. 4).
  • the vibrator can be made of, for example, a piezoelectric material such as ceramics or crystal.
  • the light transmitting/receiving unit 11b has an optical element that transmits light into the body cavity and receives light reflected from the living tissue within the body cavity.
  • the optical element is optically connected via an optical signal line 16 to an optical connector 16a (see FIG. 4).
  • the optical element can be formed by a lens, such as a ball lens, for example.
  • the signal transmitter/receiver 11 is housed inside the housing 10 .
  • a proximal end of the housing 10 is fixed to a distal end of the drive shaft 9 .
  • the housing 10 is formed of a metal cylindrical tube, and is provided with an opening 10a in its peripheral surface so as not to hinder the progress of signals transmitted and received by the signal transmitter/receiver 11 .
  • the housing 10 can be formed by laser processing or the like, for example. It should be noted that the housing 10 may be formed by cutting a metal block or by MIM (metal powder injection molding).
  • a tip member 17 is provided at the tip of the housing 10 .
  • the tip member 17 has a substantially hemispherical outer shape, thereby suppressing friction and catching with the inner surface of the sheath 4 .
  • it is good also as a structure which does not provide the front-end
  • the sheath 4 has a lumen 4a into which the drive shaft 9 is inserted so as to be advanced and retracted.
  • a tubular guide wire insertion member 18 through which a guide wire can be passed is attached to the distal end of the sheath 4 so as to be offset from the axial center of the lumen of the sheath 4 .
  • the sheath 4 and the guide wire insertion member 18 are joined by welding or the like.
  • the guidewire insertion member 18 is provided with a marker 19 having X-ray imaging properties.
  • the marker 19 is composed of a metal pipe such as Pt, Au, or the like, which is highly opaque to X-rays.
  • a communicating hole 20 is formed at the distal end of the sheath 4 to communicate the inside and the outside of the lumen 4a.
  • a reinforcing member 21 that is joined to the guide wire inserting member 18 is provided at the distal end of the lumen 4 a of the sheath 4 .
  • a through hole is formed in the reinforcing member 21 to allow the communication hole 20 to communicate with the inner lumen 4 a arranged on the proximal side of the reinforcing member 21 . Note that the reinforcing member 21 may not be provided at the distal end of the sheath 4 .
  • the communication hole 20 is a priming liquid discharge hole for discharging the priming liquid.
  • the priming liquid is released from the communication hole 20 to the outside during the priming process of filling the sheath 4 with the priming liquid, and the priming liquid and gas such as air are introduced into the sheath 4. can be discharged from the inside of the priming liquid and gas such as air.
  • the sheath 4, the guide wire insertion member 18, and the reinforcing member 21 are made of a material having flexibility, and the material is not particularly limited, and examples include styrene, polyolefin, polyurethane, polyester, polyamide, Polyimide-based, polybutadiene-based, trans-polyisoprene-based, fluororubber-based, chlorinated polyethylene-based, and other thermoplastic elastomers, etc., and combinations of one or more of these (polymer alloys, polymer blends, , laminates, etc.) can also be used.
  • the hub 8 includes a hub body 8a which has a tubular shape coaxial with the inner tube 6 and is detachably attached to the external device 2, and a hub body 8a protruding radially outward from the hub body 8a.
  • a port 8b that communicates with the inside of the drive shaft 9;
  • a connecting pipe 8c that is integrally attached to the outer peripheral surface of the drive shaft 9;
  • a bearing 8d that rotatably supports the connecting pipe 8c;
  • It includes a seal member (first seal member 8e) for preventing the priming liquid from leaking sideways, an electrical connector 15a and an optical connector 16a, and is detachably and integrally attached to the first driving section 2a of the external device 2.
  • a connector portion 8f The connector portion 8f can rotate integrally with the connection pipe 8c and the drive shaft 9. As shown in FIG.
  • the proximal end of the inner tube 6 is integrally connected to the distal end of the hub body 8a.
  • the drive shaft 9 is pulled out from the inner tube 6 inside the hub body 8a.
  • the port 8b is connected to an injection device 22 for injecting a priming solution during priming.
  • the injection device 22 has a connector 22a connected to the port 8b and a syringe (not shown) connected to the connector 22a via a tube 22b.
  • the external device 2 comprises a first drive section 2a for rotationally driving the drive shaft 9, a second drive section 2b for moving the drive shaft 9 in the axial direction (i.e. for push/pullback operations), have.
  • the first drive section 2a can be configured by, for example, an electric motor.
  • the second drive section 2b can be configured by, for example, an electric motor and a linear motion conversion mechanism.
  • the linear motion conversion mechanism can convert rotary motion into linear motion, and can be composed of, for example, a ball screw, a rack and pinion mechanism, or the like.
  • the operations of the first drive section 2a and the second drive section 2b are controlled by a control device 2c electrically connected thereto.
  • the control device 2c includes a CPU (Central Processing Unit) and memory.
  • the control device 2c is electrically connected to the display 2d.
  • the signal received by the ultrasonic transmission/reception unit 11a is transmitted to the control device 2c via the electrical connector 15a, subjected to predetermined processing, and displayed as an image on the display 2d.
  • the signal received by the optical transmitter/receiver 11b is transmitted to the controller 2c through the optical connector 16a, subjected to predetermined processing, and displayed as an image on the display 2d.
  • the sheath 4 is inserted into the body cavity, and the imaging core 12 is rotationally driven at a constant rotation speed of about 1000 to 10000 rpm by the first driving section 2a of the external device 2.
  • the imaging core 12 is retracted at a constant speed within the lumen 4a of the sheath 4 by the pullback operation by the driving portion 2b.
  • the control device 2 c of the external device 2 causes the signal transmission/reception unit 11 to transmit and receive signals. Based on the signal received by scanning by rotating and retreating this signal, the state of the tissue around the body cavity is displayed as an image on the display 2d.
  • the diagnostic imaging catheter 1 has a pull-back mechanism 23 at its proximal portion that changes the relative position between the sheath 4 and the drive shaft 9 in order to continuously observe the internal cross section of the body cavity.
  • the pullback mechanism 23 is provided radially inward of the outer tube 5 and radially outward of the drive shaft 9 and is attached to the outer tube 5 .
  • An inner tube 6 axially movable relative to and integrally with the drive shaft 9 , a support tube 24 provided radially inside the inner tube 6 and radially outside the drive shaft 9 , and an outer tube 5 . and the support tube 24 , the relay connector 13 , and the unit connector 7 .
  • the relay connector 13 is integrally connected to the sheath 4 and the inner tube 6 is integrally connected to the hub 8 .
  • the unit connector 7 is provided with a seal member (second seal member 7a) that prevents the priming liquid from leaking from between the unit connector 7 and the inner tube 6 toward the base end side.
  • the outer tube 5, the support tube 24, the inner tube 6 and the drive shaft 9 are provided coaxially and have a common central axis O.
  • the relay connector 13 has a cylindrical shape, and has a cylindrical inner peripheral surface 13a and a cylindrical inner peripheral surface 13a connected to the tip of the proximal inner peripheral surface 13a via an annular stepped portion 13b. and a distal end side inner peripheral surface 13c.
  • the outer peripheral surface of the proximal end of the sheath 4 is joined to the distal inner peripheral surface 13c by welding or the like.
  • the outer peripheral surface of the distal end of the outer tube 5 is joined to the base end side inner peripheral surface 13a by welding or the like.
  • the spacer 25 has a cylindrical shape, the outer peripheral surface of the spacer 25 is in contact with the inner peripheral surface of the distal end of the outer tube 5, and the inner peripheral surface of the spacer 25 is in contact with the outer peripheral surface of the distal end of the support tube 24. .
  • the outer peripheral surface of the spacer 25 is joined to the inner peripheral surface of the distal end of the outer tube 5 by welding or the like, and the inner peripheral surface of the spacer 25 is joined to the outer peripheral surface of the distal end of the support tube 24 by welding or the like.
  • the spacer 25 is made of synthetic resin or metal, for example.
  • the support tube 24 can be formed of, for example, a single-layer or multiple-layer coil or tube.
  • the support tube 24 is made of synthetic resin or metal, for example.
  • Priming is normally performed in the most retracted state in which the inner tube 6 is pulled out from the outer tube 5 (see FIGS. 1 and 5).
  • the priming liquid introduced from the port 8b passes through the inner tube 6 and branches into a flow path between the outer tube 5 and the support tube 24 and a flow path inside the support tube 24 to form a pullback mechanism. It flows toward the tip side inside 23 .
  • the priming liquid flowing through the flow path between the outer tube 5 and the support tube 24 passes through a communication path configured by notches (not shown) provided at the tip of the support tube 24 and/or the spacer 25, and flows through the support tube. It merges with the priming liquid flowing through the channel inside 24 and flows toward the tip side.
  • the inner tube 6 communicates the flow path in the inner tube 6 with the flow path between the outer peripheral surface of the inner tube 6 and the inner peripheral surface of the outer tube 5. It has a notch 26 that allows The cutouts 26 are provided with two holes 27 that allow the flow path in the inner tube 6 to communicate with the flow path between the outer peripheral surface of the inner tube 6 and the inner peripheral surface of the outer tube 5, and the inner and two recesses 28 provided to extend from the distal end of the tube 6 toward the proximal end.
  • the two holes 27 are provided at positions facing each other across the central axis O, one hole 27 penetrating one recess 28 and the other hole 27 penetrating the other recess 28 . Each hole 27 extends radially.
  • Each hole 27 is circular in cross section.
  • the inner tube 6 has a narrowed portion 29 that narrows the tip of the flow path in the inner tube 6 . That is, the inner peripheral surface of the inner tube 6 is reduced in diameter at the constricted portion 29 .
  • a locking portion 14 is provided at a portion behind the notch 26 of the inner tube 6 .
  • the engaging portion 14 is configured by an enlarged diameter portion formed by enlarging the outer peripheral surface of the inner tube 6 , and the rear end surface of the engaging portion 14 protrudes radially outward from the outer peripheral surface of the inner tube 6 and It forms an annular shape centered on .
  • the unit connector 7 has a stopper surface 7b that abuts against the rear end surface of the locking portion 14 to restrict further retraction of the inner tube 6. As shown in FIG.
  • the inner tube 6 is composed of a cylindrical inner tube main body 6a and a flow path adjusting member 6b joined to the tip of the inner tube main body 6a by welding or the like.
  • the flow path adjusting member 6b has a tubular shape having a notch 26 and a narrowed portion 29.
  • At the proximal end portion of the flow path adjusting member 6b there is an insertion recess 6c formed by an inner peripheral surface in contact with the outer peripheral surface of the distal end portion of the inner pipe main body 6a and an end surface in contact with the distal end surface of the inner pipe main body 6a. is provided.
  • a base end surface of the flow path adjusting member 6b constitutes a rear end surface of the engaging portion 14. As shown in FIG.
  • the inner tube 6 is not limited to being formed by joining the flow path adjusting member 6b to the inner tube main body 6a as described above. It may be formed by
  • the notch 26 can flow not only from the flow path along the inner peripheral surface of the inner tube 6, but also from the notch 26 as indicated by the white arrow in FIG.
  • the priming liquid can also flow out toward the distal end side from the flow path between the outer peripheral surface of the inner tube 6 and the inner peripheral surface of the outer tube 5 through the opening. That is, in the present embodiment, the priming liquid flowing out from inside the inner tube 6 can flow to the radially outer portion inside the outer tube 5 . Therefore, it is possible to suppress the formation of air bubbles in the pullback mechanism 23 during priming.
  • the inner pipe 6 has the throttle portion 29 as described above, the flow rate of the priming liquid flowing out from the flow path along the inner peripheral surface of the inner pipe 6 is suppressed by the throttle portion 29, thereby Through the notch 26, the flow rate of the priming liquid flowing out from the flow path between the outer peripheral surface of the inner tube 6 and the inner peripheral surface of the outer tube 5 can be increased. Therefore, by providing the narrowed portion 29, it is possible to more reliably suppress air bubbles in the pullback mechanism 23 during priming.
  • the inner tube 6 has the notch 26 that allows the flow path in the inner tube 6 to communicate with the flow path between the inner tube 6 and the outer tube 5. It is possible to suppress the formation of air bubbles in the pull-back mechanism 23 during priming, thereby achieving good priming performance.
  • the notch 26 includes two holes 27 that allow the flow path in the inner tube 6 to communicate with the flow path between the inner tube 6 and the outer tube 5, so that pullback during priming is prevented. Air bubbling in the mechanism 23 can be more reliably suppressed, thereby more reliably achieving good priming performance.
  • the two holes 27 pass through the two concave portions 28 provided on the outer peripheral surface of the inner tube 6 so as to extend from the distal end portion of the inner tube 6 toward the proximal end side. Air bubbling in the pullback mechanism 23 during priming can be more reliably suppressed, thereby more reliably achieving good priming performance.
  • the number, arrangement, shape, direction, etc. of the holes 27 and recesses 28 that form the notch 26 can be appropriately set.
  • the inner tube 6 has the narrowed portion 29 that narrows the tip of the flow path in the inner tube 6, so that the air bubble formation in the pullback mechanism 23 during priming is more reliably performed. Therefore, it is possible to achieve good priming performance more reliably.
  • the pull-back mechanism 23 has a notch 26 in the inner tube 6 in order to suppress air bubbles in the pull-back mechanism 23 during priming and thereby achieve good priming performance.
  • the inner cylinder 6 has a tubular shape without the notch 26, and the inner diameter is constant in the axial direction.
  • the outer tube 5 integrally has a convex elastic membrane 30 protruding toward the tip side.
  • the elastic membrane 30 can be provided integrally with the outer tube 5 by, for example, joining it to the inner peripheral surface of the outer tube 5 by welding or the like.
  • An opening 30a through which the drive shaft 9 and the support tube 24 are passed is provided at the tip of the elastic membrane 30 .
  • the elastic membrane 30 faces the distal end surface of the inner tube 6 in the most retracted state in which the inner tube 6 is most pulled out of the outer tube 5 , and is elastically deformed by the advancement of the inner tube 6 from the most retracted state. It is configured to be penetrated by the tube 6 .
  • the elastic membrane 30 is made of synthetic resin or rubber, for example.
  • the elastic membrane 30 has four holes 30 b that connect the flow path on the proximal side of the elastic membrane 30 to the flow path between the proximal surface of the elastic membrane 30 and the inner peripheral surface of the outer tube 5 .
  • the four holes 30b are provided at intervals of 90° in the circumferential direction about the central axis O. As shown in FIG. Each hole 30b has a circular cross section.
  • the configuration other than the pullback mechanism 23 is the same as that of the first embodiment.
  • the pullback mechanism 23 since the pullback mechanism 23 has the elastic membrane 30, the flow direction of the priming liquid flowing out from the flow path in the inner tube 6 to the flow path in the outer tube 5 is shown in white in FIG. It can be bent radially outward through each hole 30b of the elastic membrane 30, as indicated by the arrows. That is, in the present embodiment as well, the priming liquid flowing out from inside the inner tube 6 can flow to the radially outer portion inside the outer tube 5 . Therefore, it is possible to suppress the formation of air bubbles in the pullback mechanism 23 during priming, thereby achieving good priming performance.
  • the number, arrangement, shape, etc. of the holes 30b provided in the elastic film 30 can be appropriately set.
  • the outer tube 5 integrally has the elastic membrane 30
  • the support tube 24 may integrally have the elastic membrane 30 .
  • the elastic membrane 30 may be provided so as to be integrally connected to the support tube 24 at the opening 30 a and to be separate from the outer tube 5 .
  • the elastic membrane 30 faces the distal end surface of the inner tube 6 in the most retracted state in which the inner tube 6 is most pulled out of the outer tube 5, and is elastically deformed by the advancement of the inner tube 6 from the most retracted state. It is configured to be inserted into the inner tube 6 by being bent. Other configurations are the same as in the case of the second embodiment.
  • the priming liquid flowing out from the inner tube 6 can flow through the four holes 30b of the elastic membrane 30 to the radially outer portion in the outer tube 5, so that the pullback mechanism 23 during priming can be operated. It is possible to suppress bubbling of the air inside, thereby achieving good priming performance.
  • the diagnostic imaging catheter 1 of the first embodiment includes an outer tube 5 , a drive shaft 9 provided radially inside the outer tube 5 , and radially inside the outer tube 5 and radially outside the drive shaft 9 . and an inner tube 6 which is axially movable relative to the outer tube 5 and integrally with the drive shaft 9, the inner tube 6 connecting the flow path in the inner tube 6 with the inner tube 6.
  • Various modifications are possible as long as it has a notch 26 that communicates with the flow path between 6 and outer tube 5 .
  • the notch 26 preferably includes a hole 27 that allows the flow path in the inner tube 6 to communicate with the flow path between the inner tube 6 and the outer tube 5. .
  • the hole 27 preferably penetrates a recess 28 provided in the outer peripheral surface of the inner tube 6 so as to extend from the distal end of the inner tube 6 to the proximal side. .
  • the inner tube 6 preferably has a narrowed portion 29 that narrows the tip of the flow path in the inner tube 6 .
  • the diagnostic imaging catheter 1 of the second embodiment includes an outer tube 5 , a drive shaft 9 provided radially inside the outer tube 5 , and radially inside the outer tube 5 and radially outside the drive shaft 9 . and an inner tube 6 that is axially movable relative to the outer tube 5 and integrally with the drive shaft 9, and an inner tube 6 in the most retracted state in which the inner tube 6 is most pulled out of the outer tube 5. and an elastic membrane 30 facing the distal end surface of the elastic membrane 30 , the elastic membrane 30 connecting the flow path on the proximal side of the elastic membrane 30 to the flow path between the elastic membrane 30 and the outer tube 5 .
  • Various changes are possible as long as it has 30b.
  • the outer tube 5 preferably has the elastic membrane 30 integrally therewith.
  • the diagnostic imaging catheter 1 of the second embodiment is provided radially inward of the inner tube 6 and radially outward of the drive shaft 9 , relatively to the inner tube 6 and integrated with the outer tube 5 . It is preferable to have a support tube 24 that is axially movable in the center, and that the support tube 24 has an elastic membrane 30 integrally therewith.
  • diagnostic imaging catheter 1 of the first and second embodiments is not limited to a dual type using both IVUS and OCT, and may be a type using only IVUS or only OCT.
  • diagnostic imaging catheter 2 external device 2a first drive unit 2b second drive unit 2c control device 2d display 3 diagnostic imaging device 4 sheath 4a lumen of sheath 5 outer tube 6 inner tube 6a inner tube main body 6b flow path adjusting member 6c Insertion recess 7 Unit connector 7a Second seal member 7b Stopper surface 8 Hub 8a Hub body 8b Port 8c Connection pipe 8d Bearing 8e First seal member 8f Connector portion 9 Drive shaft 10 Housing 10a Opening 11 Signal transmitter/receiver 11a Ultrasonic transmitter/receiver 11b Optical transmitter/receiver 12 Imaging core 13 Relay connector 13a Base end side inner peripheral surface 13b Stepped portion 13c Distal side inner peripheral surface 14 Locking portion 15 Electrical signal line 15a Electrical connector 16 Optical signal line 16a Optical connector 17 Tip member 18 Guide wire Insertion member 19 Marker 20 Communication hole 21 Reinforcing member 22 Injection device 22a Connector 22b Tube 23 Pullback mechanism 24 Support tube 25 Spacer 26 Notch 27 Hole 28 Recess 29

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  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

Ce cathéter pour diagnostic d'image comprend : un tube externe ; un arbre d'entraînement disposé radialement à l'intérieur du tube externe ; et un tube interne qui est disposé radialement à l'intérieur du tube externe et radialement à l'extérieur de l'arbre d'entraînement et qui peut se déplacer axialement par rapport au tube externe et d'un seul bloc avec l'arbre d'entraînement, le tube interne ayant une encoche par laquelle un trajet d'écoulement à l'intérieur du tube interne communique avec un trajet d'écoulement entre le tube interne et le tube externe.
PCT/JP2022/009775 2021-03-17 2022-03-07 Cathéter pour diagnostic d'image WO2022196417A1 (fr)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002200081A (ja) * 2000-12-27 2002-07-16 Aloka Co Ltd 超音波探触子
JP2002360578A (ja) * 2001-06-08 2002-12-17 Terumo Corp 超音波カテーテル
US20090270815A1 (en) * 2008-04-29 2009-10-29 Infraredx, Inc. Catheter Priming System
JP2011072680A (ja) * 2009-09-30 2011-04-14 Terumo Corp 画像診断用カテーテル
JP2016000123A (ja) * 2014-06-12 2016-01-07 テルモ株式会社 医療用デバイス
JP2017000442A (ja) * 2015-06-10 2017-01-05 テルモ株式会社 カテーテル

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002200081A (ja) * 2000-12-27 2002-07-16 Aloka Co Ltd 超音波探触子
JP2002360578A (ja) * 2001-06-08 2002-12-17 Terumo Corp 超音波カテーテル
US20090270815A1 (en) * 2008-04-29 2009-10-29 Infraredx, Inc. Catheter Priming System
JP2011072680A (ja) * 2009-09-30 2011-04-14 Terumo Corp 画像診断用カテーテル
JP2016000123A (ja) * 2014-06-12 2016-01-07 テルモ株式会社 医療用デバイス
JP2017000442A (ja) * 2015-06-10 2017-01-05 テルモ株式会社 カテーテル

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