WO2022224359A1 - ワイヤ送出装置 - Google Patents

ワイヤ送出装置 Download PDF

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Publication number
WO2022224359A1
WO2022224359A1 PCT/JP2021/016082 JP2021016082W WO2022224359A1 WO 2022224359 A1 WO2022224359 A1 WO 2022224359A1 JP 2021016082 W JP2021016082 W JP 2021016082W WO 2022224359 A1 WO2022224359 A1 WO 2022224359A1
Authority
WO
WIPO (PCT)
Prior art keywords
wire
state
gripping
elastic body
feeding device
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/JP2021/016082
Other languages
English (en)
French (fr)
Japanese (ja)
Inventor
俊夫 土肥
勇作 藤田
智輝 山極
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Asahi Intecc Co Ltd
Original Assignee
Asahi Intecc Co Ltd
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 Asahi Intecc Co Ltd filed Critical Asahi Intecc Co Ltd
Priority to JP2023515936A priority Critical patent/JP7603798B2/ja
Priority to PCT/JP2021/016082 priority patent/WO2022224359A1/ja
Publication of WO2022224359A1 publication Critical patent/WO2022224359A1/ja
Priority to US18/379,984 priority patent/US20240032959A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • 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
    • A61M25/09—Guide wires
    • A61M25/09041—Mechanisms for insertion of guide wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • A61B2017/00469—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable for insertion of instruments, e.g. guide wire, optical fibre
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00862—Material properties elastic or resilient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A61B2017/22042—Details of the tip of the guide wire
    • A61B2017/22044—Details of the tip of the guide wire with a pointed tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22094—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B2017/320733—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
    • 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
    • A61M25/09—Guide wires
    • A61M2025/09116—Design of handles or shafts or gripping surfaces thereof for manipulating guide wires

Definitions

  • the present invention relates to a wire feeding device for feeding a wire.
  • CTO chronic total occlusion
  • the operator manually grips and manipulates the guide wire, so the distance to which the guide wire is delivered depends on the operator's sense.
  • Patent Literature 1 the technique described in Patent Literature 1 is known as a technique capable of sending out a medical wire by a predetermined amount of movement and capable of satisfactorily transmitting the pressing force of the medical wire. .
  • the present invention has been made based on the above circumstances, and an object of the present invention is to make it possible to adjust the amount of movement of the wire to an appropriate amount and to feed the wire with an appropriate force. to do.
  • a wire feeding device for feeding a wire in a distal direction, which is capable of gripping and releasing the wire and an elastic body capable of urging the gripping part in the distal direction; and an urging part that deforms the elastic body to increase the urging force in the distal direction,
  • the wire held by the gripping portion is delivered in the distal direction by the biasing force of the elastic body, and in response to a first predetermined operation.
  • a series of operations in the following order (a), (b) and (c) are repeatedly executed in response to the first predetermined operation, a) gripping of the wire by the gripping portion and deformation of the elastic body by the biasing portion; (c) releasing the grip of the wire by the gripping portion and moving the gripping portion to the rear end side; in the second mode, executing (a) After that, the above (b) may be executed according to the second predetermined operation.
  • the wire feeding device may further include an operation section capable of switching between the first mode and the second mode.
  • a deformation maintaining section capable of maintaining a deformed state of the elastic body in a predetermined state by increasing the biasing force of the biasing section, and a deformed state of the elastic body by the deformation maintaining section.
  • a maintenance state changing section capable of changing to a state in which maintenance of the elastic body is disabled, wherein the operation section sets the maintenance state changing section to a state in which the deformation maintaining section cannot maintain the deformed state of the elastic body.
  • the holding portion When the changing portion disables the deformation maintaining portion from maintaining the deformed state of the elastic body, the holding portion is moved in the distal direction by the biasing force of the elastic body that cannot maintain the deformed state. It may be configured to move and deliver the wire gripped by the gripping portion in the distal direction.
  • the operation section operates the maintenance state changing section in a state in which the deformation maintenance section cannot maintain the deformed state of the elastic body, It may be operable in the first mode.
  • the wire feeding device further includes an operation fixing section capable of fixing the operation section in a state in which the maintenance state changing section is operated in a state in which the deformation maintaining section cannot maintain the deformed state of the elastic body. good too.
  • the wire feeding device may further include a grasping operation section capable of manipulating the state of grasping of the wire by the grasping section.
  • a wire feeding device is a wire feeding device for feeding a wire in a distal direction, the wire feeding device comprising: a gripping part capable of gripping and releasing the wire and movable in the distal direction and the rearward direction; an elastic body capable of urging the grip portion in the distal direction; an urging portion that deforms the elastic body to increase the urging force in the distal direction; a releasing portion for releasing the deformed state of the elastic body, and the holding portion is moved in the distal direction by the urging force of the elastic body released from the deformed state by the releasing portion, and is held by the holding portion.
  • the apparatus further includes a grasping operation section capable of controlling a state of grasping of the wire by the grasping section.
  • the releasing section includes a deformation maintaining section capable of maintaining a deformed state of the elastic body that has been brought into a predetermined state by the biasing force being increased by the biasing section; a maintenance state changing unit capable of changing the state in which the deformation state of the elastic body cannot be maintained, and when the deformation maintenance unit maintains the deformation state of the elastic body,
  • the gripping portion that grips the wire may be operable to release the grip.
  • the above wire feeding device may further include a striking section disposed on the proximal end side of the gripping section, movable in the axial direction of the wire, and capable of coming into contact with and separating from the gripping section.
  • the gripping section has a first clamping section and a second clamping section that clamp the wire, and a cam section that can adjust the distance between the first clamping section and the second clamping section.
  • the wire feeding device further includes a biasing operation section manually operated by an operator to increase the biasing force of the biasing section on the elastic body, wherein the biasing operation section is positioned at the wire placement position. It may have a handle that is manually manipulated by the operator during operation in a position offset away from the.
  • the amount of movement of the wire can be set to an appropriate amount, and the wire can be delivered with an appropriate force.
  • FIG. 2 is a diagram illustrating a guidewire and catheter connected to a wire delivery device, and a connector for connecting to the wire delivery device;
  • FIG. 4 is a diagram showing a connection state between a guide wire and a catheter, and a connector;
  • 1 is a perspective view of a wire feeding device according to a first embodiment;
  • FIG. 1 is a perspective view of a wire delivery device with a guidewire and catheter attached;
  • FIG. 4 is a top cross-sectional view of the wire feeding device shown in FIG. 3 in an initial state;
  • FIG. It is a block diagram of the grip part of a wire sending-out apparatus.
  • FIG. 6 is a perspective sectional view from the bottom in the initial state shown in FIG.
  • FIG. 5 4 is a perspective view of an ejection switch of the wire feeding device
  • FIG. FIG. 3 is a perspective view of a slider of the wire delivery device
  • Fig. 2 is a perspective view of a hook of the wire delivery device
  • FIG. 4 is a cross-sectional top view of the wire feeding device in a gripping preparation state
  • FIG. 4 is a cross-sectional top view of the wire feeding device in a ready-to-feed state
  • 13 is a perspective cross-sectional view from the bottom in the ready-to-deliver state shown in FIG. 12
  • FIG. It is a bottom cross-sectional view of the wire feeding device at the time of feeding.
  • FIG. 15 is a top cross-sectional view at the time of delivery shown in FIG. 14;
  • FIG. 10 is a side cross-sectional view of the gripping open/close switch of the wire feeding device when it is not operated.
  • FIG. 17 is a cross-sectional top view of the grip opening/closing switch shown in FIG. 16 during operation;
  • FIG. 18 is a side cross-sectional view during the operation shown in FIG. 17;
  • FIG. 11 is a side cross-sectional view of a non-operating grip open/close switch according to a modification;
  • FIG. 20 is a side cross-sectional view when the grip opening/closing switch shown in FIG. 19 is operated;
  • FIG. 17 is a cross-sectional top view of the grip opening/closing switch shown in FIG. 16 during operation
  • FIG. 18 is a side cross-sectional view during the operation shown in FIG. 17
  • FIG. 4 is a perspective view of an ejection switch of the wire feeding device
  • FIG. Fig. 2 is a first perspective view of a slider of the wire delivery device
  • 25 is a second perspective view of the slider shown in FIG. 24
  • FIG. FIG. 4 is a cross-sectional top view of the wire feeding device in a ready-to-feed state
  • 27 is a perspective cross-sectional view from the bottom in the ready-to-deliver state shown in FIG. 26
  • FIG. It is a bottom perspective view of the wire feeding device at the time of feeding. It is a side cross-sectional view after delivery of the wire delivery device.
  • FIG. 11 is a cross-sectional top view of the wire feeding device according to the third embodiment in an initial state;
  • FIG. 31 is a side sectional view in the initial state shown in FIG. 30;
  • FIG. 31 is an exploded perspective view of a grip portion of the wire feeding device shown in FIG. 30;
  • FIG. 33 is a perspective view of the grip portion shown in FIG. 32 in a released state;
  • 34 is a side cross-sectional view of the grip released state shown in FIG. 33;
  • FIG. 10 is a perspective view of a holding state of the holding part;
  • FIG. 4 is a side cross-sectional view of a gripping state of the gripping portion;
  • FIG. 31 is a perspective view of a grip open/close switch of the wire feeding device shown in FIG. 30;
  • FIG. 4 is a cross-sectional top view of the wire feeding device in a ready-to-feed state;
  • FIG. 39 is a side cross-sectional view in the ready-to-deliver state shown in Fig. 38; It is an exploded perspective view of a grip part according to a modification.
  • FIG. 33 is a perspective view of the grip portion shown in FIG. 32 in a released state;
  • FIG. 11 is a top view of the wire feeding device according to the fourth embodiment when the lid is opened;
  • FIG. 43 is a top cross-sectional view when the lid shown in FIG. 42 is opened; It is a top view at the time of lid closing.
  • Fig. 3 is a perspective view of a lid; It is an expansion perspective view of the attachment part of a lid
  • FIG. 4 is a top view showing a state in which a guide wire is placed on the wire delivery device;
  • FIG. 4 is a top view showing a state in which a guide wire is placed on the wire delivery device;
  • FIG. 4 is a top view showing a state in which a guide wire is placed on the wire delivery device;
  • FIG. 3 is a side cross-sectional view of a portion of the wire delivery device including the guide wire housing.
  • Fig. 2 is a perspective view of the wire delivery device in a state where the guide wire can be delivered;
  • FIG. 11 is a perspective view of a wire feeding device according to a fifth embodiment;
  • 51 is a perspective cross-sectional view from the bottom of the wire feeding device shown in FIG. 50 when the ejection switch is not fixed;
  • FIG. FIG. 52 is a perspective cross-sectional view from the bottom surface when the injection switch shown in FIG. 51 is fixed;
  • guidewire means a medical guidewire that is pushed into a surgical site within a body cavity such as a blood vessel and used to guide a catheter to the surgical site.
  • distal side and distal direction refer to the direction along the longitudinal direction of the guidewire (the direction along the axial direction of the guidewire), and means direction.
  • proximal side means a direction along the longitudinal direction of the guidewire, which is opposite to the distal side.
  • distal end refers to the distal end of any member or site, and the term “basal end” refers to the proximal end of any member or site.
  • a wire delivery device 1 (see FIG. 3) according to the first embodiment is a device for delivering a guide wire as an example of a wire.
  • a guide wire is used, for example, to be advanced to a surgical site in a body cavity such as a blood vessel, and to penetrate an obstruction in the surgical site.
  • the wire delivery device 1 is used by connecting a catheter into which a guide wire GW is inserted.
  • FIG. 1 is a diagram for explaining a guide wire and a catheter connected to a wire delivery device 1 and a connector for connecting to the wire delivery device
  • FIG. 2 shows a connection state between the guide wire and the catheter and the connector. It is a diagram.
  • the guide wire GW is inserted into the hollow catheter 51.
  • a catheter hub 52 for adjusting its orientation is non-rotatably mounted on the proximal end side of the catheter 51 .
  • the left side of the drawing is the inside of the patient's body (distal side), and the right side of the drawing is the outside of the patient's body (base end).
  • the catheter 51 is connected to a connector 60 as shown in FIG. 2 and connected to the wire delivery device 1 via the connector 60 .
  • the connector 60 as shown in FIG. 1B, has a dial portion 60A, a mounting portion 60C, and a rear end portion 60D.
  • the dial part 60A is a part for the operator to operate the direction of the catheter 51 connected to the connector 60.
  • the attachment portion 60C is formed in a cylindrical shape and is a portion for attachment to a connector connection portion 3 (see FIG. 3) of the wire feeding device 1, which will be described later.
  • the length of the mounting portion 60C in the axial direction is substantially the same as the width in the X-axis direction of connecting pieces 3A and 3B of the connector connecting portion 3, which will be described later.
  • the rear end portion 60D is formed in a disc shape with a diameter larger than the cylinder of the mounting portion 60C.
  • the rear end portion 60 ⁇ /b>D acts to position the connector 60 in the X-axis direction with respect to the connector connection
  • a through hole 60B extending in the longitudinal direction is formed in the connector 60 .
  • Throughbore 60B is configured to engage rear end 52A of catheter hub 52 .
  • the catheter hub 52 and the connector 60 are coupled and can rotate together.
  • FIG. 3 is a perspective view of the wire delivery device
  • FIG. 4 is a perspective view of the wire delivery device to which the guidewire and catheter are connected.
  • the wire feeding device 1 includes a housing 2 , a lever 31 , a connector connecting portion 3 , a guide wire accommodating portion 4 and a grasping portion 20 .
  • the housing 2 has a substantially rectangular parallelepiped shape whose longitudinal direction is the axial direction (the X-axis direction in the drawing) when the guide wire GW is attached.
  • the lever 31 is rotatable around a lever rotation shaft 31O (see FIG. 5), which will be described later, and is a part operated by the operator when feeding the guide wire GW (first predetermined operation part ). In this embodiment, the operator can deliver the guide wire GW by gripping and rotating the lever 31 with one hand.
  • the connector connecting portion 3 is a portion for connecting the mounting portion 60C, and has a pair of connecting pieces 3A and 3B extending in the X-axis direction.
  • the connection pieces 3A and 3B are made of, for example, an elastic material such as resin, and sandwich the outer peripheral surface of the mounting portion 60C from both sides in the Y-axis direction to connect the connector 60 in a rotatable manner.
  • the guide wire housing portion 4 is a portion that houses the guide wire GW to be delivered, extends in the X-axis direction, and is formed in a concave shape that is open in the positive direction of the Z-axis over the entire X-axis direction.
  • the grasping portion 20 is a portion capable of grasping the guide wire GW and movable in the X-axis direction. ) is open to the outside.
  • the guide wire GW is placed on the surface of the guide wire housing portion 4 in the negative direction of the Z axis (here, also referred to as the bottom surface)
  • the guide wire GW is gripped by the grip surface portion 21A. It is arranged in a clearance (arrangement space) between the grip surface holding the guide wire GW and the surface portion 22A.
  • the guide wire GW at the base end side of the connector 60 is placed on the bottom surface of the concave portion of the guide wire housing portion 4. Then, the attachment portion 60C connected to the catheter 51 into which the guide wire GW is inserted is fitted into the connection pieces 3A and 3B to be attached.
  • the catheter 51 and the guide wire GW are connected to the wire delivery device 1 in this way, it becomes as shown in FIG.
  • the operator can easily adjust the orientation of the catheter 51 by rotating the operation dial 60A (see FIG. 1). can.
  • FIG. 5 is a top cross-sectional view in its initial state.
  • the wire feeding device 1 includes a housing, a gripping portion, a pressing spring, a return spring (see FIG. 11), a slider, a hook, a gripping open/close switch, and an injection switch.
  • FIG. 6 is a configuration diagram of the gripping portion.
  • FIG. 7 is a bottom perspective view of the wire feeding device 1 in its initial state. 8 is a perspective view of a firing switch, FIG. 9 is a perspective view of a slider, and FIG. 10 is a perspective view of a hook.
  • FIG. 7 shows a state in which a part of the housing on the negative direction side of the Z axis is removed from the wire feeding device 1, and the same state may be shown in bottom perspective views of other drawings in this specification.
  • the wire feeding device 1 includes a housing 2, a gripping portion 20, a pressing spring 12, a return spring 16 (see FIG. 11), a slider 13, a hook 14, a gripping open/close switch 40, an ejection switch 45, Prepare.
  • the wire feeding device 1 further comprises a hammer 11, as shown in FIG.
  • the compression spring 12 is an example of an elastic body.
  • the slider 13 and hook 14 are examples of the biasing portion.
  • Hammer 11 is an example of a striking portion.
  • the wire feeding device 1 further includes a lever 31, links 35 and 37, and joints 36 and 38, as shown in FIG.
  • the lever 31, the links 35 and 37, the joints 36 and 38, and the slider 13 are an example of the power transmission mechanism
  • the slider 13, the hook 14, and the ejection switch 45 are an example of the deformation maintaining section, an ejection
  • the switch 45 is an example of a maintenance state changing section and an operation section, and is also an example of a second predetermined operation section.
  • the grip open/close switch 40 is an example of a grip operation unit.
  • the slider 13, hook 14, and firing switch 45 are examples of release portions.
  • the housing 2 has a substantially rectangular parallelepiped shape extending in the axial direction (the X-axis direction in the drawing) when the guide wire GW is attached.
  • the housing 2 accommodates a grip portion accommodating portion 2A that accommodates the grip portion 20 movably in the X-axis direction, and a slider 13 and a hook 14 that are movably accommodated in the X-axis direction.
  • a slider accommodating portion 2B is formed.
  • the housing 2 is formed with a support hole 2C for rotatably supporting the cylindrical portion 35A on the one end side of the link 35. As shown in FIG.
  • the gripping portion 20 capable of gripping the guide wire GW is movable in the X-axis direction in the gripping portion accommodating portion 2A.
  • the gripping portion 20 has a first part 21, a second part 22, and a gripping spring 23, as shown in FIG.
  • the first component 21 has, for example, a gripping surface portion 21A formed extending in the X-axis direction and a substantially cylindrical leg portion 21B extending in the Y-axis direction.
  • the second component 22 is formed to extend in the X-axis direction, and has a gripping surface portion 22A having a surface facing the gripping surface portion 21A of the first component 21, a concave portion 22B having concave portions facing both directions in the Z-axis direction, and a through-hole portion 22C formed with a through-hole into which the leg portion 21B can be inserted.
  • the first component 21 and the second component 22 are combined with the leg portion 21B inserted into the through hole of the through hole portion 22C.
  • a gripping spring 23 is attached so that a biasing force is generated between the leg portion 21B and the second part 22.
  • the side surface (gripping surface) and the surface (gripping surface) of the gripping surface portion 22A of the second component 22 on the side of the first component 21 (gripping surface) act so as to approach each other.
  • the guide wire GW is arranged in a gap (arrangement space) between the gripping surface of the gripping surface portion 21A on the side of the second component 22 and the gripping surface of the gripping surface portion 22A on the side of the first component 21. , and the urging force of the gripping spring 23 allows the gripping portion 20 to grip the guide wire GW.
  • This arrangement space can be opened to the outside by an opening extending over the entire movable direction of the grip part 20 .
  • the guide wire GW is positioned substantially in the center in the Z-axis direction between the gripping surface of the gripping surface portion 21A and the gripping surface of the gripping surface portion 22A.
  • the concave portion 22B engages with a convex portion (not shown) formed on both walls of the grip portion housing portion 2A of the housing 2 in the Z-axis direction and extending in the X-axis direction. Acts to precisely guide movement to.
  • the injection switch 45 has a convex portion 45A, an extension piece 45B, a convex portion 45C, a fixing hole 45D and a spring accommodation portion 45E.
  • the convex portion 45A can come into contact with the convex portion 14B (see FIGS. 10 and 13) of the hook 14 and push up the convex portion 14B.
  • the extension piece 45B is formed extending in the positive direction of the Y-axis.
  • the convex portion 45C is formed at the tip of the extension piece 45B in the positive direction of the Y axis and protrudes in the negative direction of the Z axis.
  • the convex portion 45C engages with the convex portion 13B (see FIGS.
  • the fixing hole 45D is a hole into which a screw 46 for fixing the ejection switch 45 to the housing 2 so as to be rotatable is inserted.
  • the ejection switch 45 is fixed to the housing 2 by screws 46, so that it can rotate around the fixing hole 45D.
  • a spring (not shown) that biases the ejection switch 45 in the negative direction of the Y-axis is accommodated in the spring accommodating portion 45E.
  • the ejection switch 45 itself may be configured to have elasticity and be biased in the negative direction of the Y-axis.
  • the slider 13 has an extension portion 13A extending in the positive direction of the X axis, a projection portion 13B that can engage with the extension piece 45B and the projection portion 45C, and a mounting portion 13C to which the hook 14 can be mounted.
  • the extended portion 13A has a plate-like shape with a surface in the negative direction of the Y-axis on the tip end side in the X-axis direction and having a slope such that the thickness becomes thinner toward the tip end side.
  • the hook 14 is attached to the attachment portion 13C of the slider.
  • the hook 14, as shown in FIG. 10, has a spring hook 14A and a projection 14B.
  • the spring hook 14A is engageable with the projection 11A of the hammer 11.
  • the convex portion 14B is a portion that contacts the convex portion 45A of the ejection switch 45.
  • the hook 14 is elastically deformed, and the spring hook 14A is moved in the same direction.
  • the slider 13 and the hook 14 are configured separately, but they may be integrated.
  • the hammer 11 is arranged on the proximal end side of the grip portion 20 in the X-axis direction so that the longitudinal direction is the X-axis direction.
  • a compression spring 12 is arranged on the base end side of 11 so that the longitudinal direction thereof is in the X-axis direction.
  • the hammer 11 is made of metal, for example, and is movable in the X-axis direction.
  • the hammer 11 is formed with a convex portion 11A on the side of the slider accommodating portion 2B.
  • the convex portion 11A can be engaged with the spring hook 14A.
  • the compression spring 12 is, for example, a metal spring, is deformable (compressible) in the X-axis direction, and can apply a biasing force to the hammer 11 in the positive direction of the X-axis. .
  • the return spring 16 is, for example, a metal spring, is deformable (compressible) in the X-axis direction, and urges the grip portion 20 toward the proximal end.
  • the biasing force exerted by the return spring 16 on the grasping portion 20 is smaller than the biasing force exerted on the grasping portion 20 in the initial state of the push spring 12 (the state in which no compression occurs due to the movement of the hammer 11).
  • the gripping portion 20 is positioned at the most extreme position of the movable range (the most extreme position in the X-axis direction within the gripping portion accommodating portion 2A), and the pressing spring 12 is compressed and no biasing force is applied to the gripping portion 20, the gripping portion 20 is moved by the biasing force of the return spring 16 to the rearmost position of the movable range (inside the gripping portion accommodating portion 2A). position of the rear end in the X-axis direction).
  • the lever 31, the links 35, 37, the joints 36, 38, and the slider 13 constitute a power transmission mechanism.
  • the lever 31 is a part that is manually rotated by the operator using the wire feeding device 1 .
  • the lever 31 is rotatable around a lever rotation shaft 31O.
  • the lever 31 and the cylindrical portion 35A of the link 35 are connected via a joint (not shown) so that the turning force can be transmitted from the lever 31 to the link 35.
  • the link 35 is configured to rotate together with the rotation of the lever 31 .
  • the other end of the link 35 and one end of the link 37 are rotatably connected via a joint 36.
  • the other end of the link 37 and the slider 13 are rotatably connected via a joint 38 .
  • the slider 13 is linearly movable in the X-axis direction.
  • the power transmission mechanism when the lever 31 is rotated in the R1 direction, the link 35 is rotated in the R2 direction. Move with movement.
  • the power transmission mechanism is configured so that the lever 31 can be rotated over the entire range of movement in the X-axis direction, and the links 35 and 37 can be rotated. The length of is adjusted.
  • the spring hook 14A engages with the convex portion 11A of the hammer 11, and when it moves further, the hammer 11 moves to the base end side.
  • the pressing spring 12 is compressed.
  • the projection 45C of the extension piece 45B of the injection switch 45 rides over the projection 13B of the slider 13 in the positive direction of the X axis and engages with each other. As a result, the slider 13 cannot move in the positive direction of the X-axis while the push spring 12 is compressed.
  • the convex portion 45A pushes the convex portion 14B of the hook 14 in the positive direction of the Y axis, and the portion of the hook 14 on the positive side of the X axis is pushed. is deformed in the positive direction of the Y axis, and the engagement between the spring hook 14A of the hook 14 and the projection 11A of the hammer 11 is released. As a result, the deformed state (compressed state) of the compression spring 12 is released at once, and the compression spring 12 pushes the hammer 11 in the X-axis direction.
  • FIGS. 12 and 13 are a top cross-sectional view and a bottom perspective view in a ready-to-feed state
  • FIGS. It is a top sectional view.
  • the wire feeding device 1 (a) grips the guide wire GW, (b) moves the gripping portion 20 toward the distal end of the guide wire GW, (c) releases the grip of the guide wire GW, and moves the gripping portion 20 toward the rear end. , movement, etc. in this order, the grasping portion 20, the hammer 11, the slider 13, and the hook 14 are interlocked.
  • the operator inserts the guidewire GW into the blood vessel, and then pushes the guidewire GW along the blood vessel to the occlusion site.
  • the catheter 51 is advanced to the site of obstruction using the guide wire GW as a guide.
  • the connector 60 is connected to the catheter hub 52 of the catheter 51, and while the connector 60 is pushed into the connector connection portion 3 of the wire delivery device 1 from the positive direction of the Z axis, the base end side of the guide wire GW is guided by the housing 2.
  • the connector 60 is connected to the wire feeding device 1 by accommodating the wire accommodating portion 4 from the positive direction side of the Z axis.
  • the leg portion 21B is pressed in the negative direction of the Y axis by the extension portion 13A, and the gripping spring 23 is compressed. and the surface of the gripping surface portion 22A on the first component 21 side are separated to form an arrangement space, and the gripping of the guide wire GW by the gripping portion 20 is released. Therefore, as described above, by mounting the catheter 51 into which the guide wire GW has been inserted, the guide wire GW can be easily housed in the installation space. Therefore, the preparation time for delivering the guide wire GW by the wire delivery device 1 can be shortened, and the burden on the patient and operator can be reduced.
  • the gripping portion 20 is no longer pushed by the hammer 11 in the positive direction of the X axis, so the gripping portion 20 slides to the rearmost end of the movable range due to the biasing force of the return spring 16 .
  • the grip part 20 is moved by a distance D from the extreme end (initial position) of the movable range to the extreme end of the movable range.
  • This distance D corresponds to the wire feeding amount by the wire feeding device 1 at one time. For example, when the wire feeding amount of the wire feeding device 1 is 2 mm at one time, the wire feeding device 1 is slid to the rear end side by 2 mm from the initial position.
  • the extension part 13A is configured to exist at a position where the gripping spring 23 of the gripping part 20 is compressed, the gripping part 20 does not grip the guide wire GW. ing.
  • the extended portion 13A stops contacting the leg portion 21B and stops compressing the gripping spring 23, and is guided by the surface of the gripping surface portion 21A on the side of the second component 22 and the surface of the gripping surface portion 22A on the side of the first component 21.
  • the wire GW is gripped.
  • the slider 13 and the hook 14 slide further to the proximal side, as shown in FIGS. 12 and 13.
  • the projection 45C of the ejection switch 45 climbs over the projection 13B of the slider 13 and is positioned in the positive direction of the X axis of the projection 13B, and they are engaged with each other.
  • the slider 13 cannot move in the positive direction of the X axis, and the compression spring 12 is maintained in a compressed state, so that a state in which delivery is possible (a state in which compression is maintained: a state in which delivery is possible) is achieved.
  • the biasing force of the push spring 12 is applied to the movement of the hammer 11 in the distal direction at once, the hammer 11 moves in the distal direction, and the distal end side of the hammer 11 collides with the proximal end side of the grip portion 20.
  • the grasping portion 20 that grasps the guide wire GW moves in the distal direction due to the impact caused by the collision with the hammer 11 and stops at the distal end position of the grasping portion 20 .
  • the gripping state of the guide wire GW is maintained.
  • the grasping part 20 moves from the rearmost position to the most distal position while maintaining the state of grasping the guidewire GW.
  • the guide wire GW is delivered to the distal side by a distance D from the rearmost position of the grasping portion 20 to the most distal position.
  • the operation up to this point corresponds to the operation in the single-shot mode (second mode) in which the wire is sent out once.
  • the single-shot mode after (a) the guide wire GW is gripped by the gripping portion 20 and the compression spring 12 is deformed by the slider 13 and the hook 14, the ejection switch 45 is pressed, and (b) the compression spring 12 is deformed.
  • the grasping part 20 grasping the guide wire GW can be delivered to the distal side, and then (c) the grip can be released and the guide wire GW can be delivered.
  • the lever 31 can be rotated continuously and a similar operation can be performed (first mode).
  • the wire feeding device 1 can be operated in continuous mode.
  • the injection switch 45 is kept pressed to enter the continuous mode, the operator operates the lever 31 to compress the push spring 12, causing the projection 45A of the injection switch 45 to move the projection 14B. Since it is in the pressed state, the spring hook 14A of the hook 14 comes off the convex portion 11A of the hammer 11, and the hammer 11 collides with the grip portion 220.
  • the guide wire GW can be delivered in the distal direction.
  • the operator can continuously operate the lever 31 to continuously deliver the guide wire GW to the distal side (first mode). That is, it is possible to repeat a series of operations in the order of (a), (b) and (c) described above.
  • an appropriate amount of guide wire GW can be fed by applying the impact force due to the biasing force accumulated in the compression spring 12 to the guide wire GW.
  • the guidewire GW can effectively penetrate an obstruction.
  • FIGS. 17 and 18 are a top cross-sectional view and a side cross-sectional view of the grip switch when the switch is operated.
  • the grip switch 40 has an L-shaped cross section as shown in FIG. and an action portion 40B that acts to push the leg portion 21B in the negative direction of the Y-axis when the pressing portion 40A is pressed.
  • the grip opening/closing switch 40 is movable in the Y-axis direction.
  • the grip opening/closing switch 40 is biased in the positive direction of the Y axis by a spring 41, and when the operator does not press the pressing portion 40A, the action portion 40B does not contact the leg portion 21B as shown in FIG. position.
  • the grasping open/close switch 40 is positioned so that the operating portion 40B (see FIG. 16) does not come into contact with the extended portion 13A of the slider 13 as shown in FIG. 11 when the operator does not press the pressing portion 40A. is adjusted so that
  • the action portion 40B presses the leg portion 21B in the negative direction of the Y axis, and the gripping spring 23 is compressed.
  • the side surfaces are separated from each other, and the grip of the guide wire GW by the gripping portion 20 is released.
  • the wire feeding device 1 by pressing the grip opening/closing switch 40, even when the wire feeding device 1 is in a state where it can be fed out, for example, as shown in FIG. can be released. Therefore, after the guide wire GW becomes ready to be delivered, it is possible to release the grip of the guide wire GW by the grip part 20 and easily perform adjustments such as changing the position and orientation of the guide wire GW.
  • FIG. 19 is a side cross-sectional view of the grip switch according to the modification when not operated
  • FIG. 20 is a side cross-sectional view when the switch is operated.
  • the grip opening/closing switch 42 is arranged in the negative direction of the Z-axis with respect to a pressing portion 42A to be pressed by the operator and the leg portion 21B of the gripping portion 20. and an action portion 42B that acts to push the leg portion 21B in the negative direction of the Y-axis when is pushed.
  • a surface in the negative direction of the Y-axis at the end of the action portion 42B in the positive direction of the Z-axis forms an inclined surface 42C that becomes more in the negative direction of the Y-axis as it goes in the negative direction of the Z-axis.
  • the grip opening/closing switch 42 is movable in the Z-axis direction.
  • the grip opening/closing switch 42 is biased in the negative direction of the Z-axis by a spring 43, and is positioned so that the slope 42C of the action portion 42B does not come into contact with the leg portion 21B when the operator does not press the pressing portion 42A. is configured to
  • the grasping open/close switch 42 by pressing the grasping open/close switch 42, the grasping of the guide wire GW by the grasping part 20 can be released even when the wire feeding device 1 is in the state of being ready for feeding. Therefore, after the guide wire GW becomes ready to be delivered, it is possible to release the grip of the guide wire GW by the grip part 20 and easily perform adjustments such as changing the position and orientation of the guide wire GW.
  • FIG. 21 and 22 are a top sectional view and a bottom perspective view of the wire feeding device 101 in the initial state
  • FIG. 23 is a perspective view of the ejection switch of the wire feeding device 101
  • FIG. Figure 25 is a perspective view
  • Figure 25 is a second perspective view of the slider
  • the wire feeding device 101 further includes a protrusion 2D (see FIG. 22) on the housing 2, a protrusion 35B on the link 35, a firing switch 110 instead of the firing switch 45, and a slider 13 and hook instead of the slider 13 and hook .
  • a slider 113 is provided.
  • the convex portion 2D of the housing 2 is a portion that can be engaged with the hook 113D of the slider 113.
  • the convex portion 35B of the link 35 is a portion that can be engaged with the convex portion 110D of the ejection switch 110 (see FIG. 23).
  • the injection switch 110 has a convex portion 110A, a convex portion 110B, an extension piece 110C, a convex portion 110D, a fixing hole 110E, and a spring accommodation portion 110F.
  • the convex portion 110A can come into contact with the convex portion 113B (see FIG. 24) of the slider 113 and push up the convex portion 113B.
  • the projection 110B can come into contact with the hook 113D of the slider 113 and push up the hook 113D.
  • the extension piece 110C is formed extending in the positive direction of the Y-axis.
  • the protrusion 110D protrudes in the negative direction of the Z-axis from the tip of the extension piece 110C in the positive direction of the Y-axis.
  • the protrusion 110D engages with the protrusion 35B of the link 35, prevents the engagement between the protrusion 113D and the protrusion 2D, and allows the slider 113 to move in the X-axis direction.
  • the fixing hole 110E is a hole into which a screw 111 (see FIG. 22) is inserted to rotatably fix the injection switch 110 to the housing 2. As shown in FIG.
  • the injection switch 110 is fixed to the housing 2 by screws 111, so that it can rotate around the rotation hole 110E.
  • a spring (not shown) that biases the injection switch 110 in the negative direction of the Y-axis is accommodated in the spring accommodating portion 110F. It should be noted that the injection switch 110 itself may be configured to have elasticity without a spring and be biased in the negative direction of the Y-axis.
  • the slider 113 has an extension 113A, a projection 113B, a spring hook 113C, and a hook 113D.
  • the extended portion 113A extends in the positive direction of the X-axis, and the surface of the negative Y-axis on the tip side in the X-axis direction has a plate shape with an inclination such that the thickness becomes thinner toward the tip side. As shown in FIG.
  • the extension portion 113A when the tip portion of the extension portion 113A is moved to the tip side in the X-axis direction, the extension portion 113A is in a state of pushing down the leg portion 21B in the negative direction of the Y-axis, compressing the grip spring 23 and , to move the leg 21B in the negative direction of the Y-axis.
  • the surface of the gripping surface portion 21A of the first component 21 facing the second component 22 is separated from the surface of the gripping surface portion 22A of the second component 22 facing the first component 21, so that the guide wire GW can be gripped.
  • the convex portion 113B is a portion that contacts the convex portion 110A of the ejection switch 110 .
  • the spring hook 113C is engageable with the projection 11A of the hammer 11. As shown in FIG. When the protrusion 113B is pushed by the protrusion 110A, the spring hook 113C is moved in the same direction.
  • the hook 113D can be engaged with the projection 2D of the housing 2. As shown in FIG. When the hook 113D engages with the protrusion 2D, movement of the slider 113 in the positive direction of the X axis is restricted.
  • 26 and 27 are a top cross-sectional view and a bottom perspective view of the wire feeding device in a ready-to-feed state
  • FIG. 28 is a bottom perspective view of the wire feeding device during feeding
  • FIG. FIG. 10 is a side cross-sectional view at a later time; 26 to 29, the guide wire GW, catheter 51, connector 60, etc. are not shown, but the catheter 51 and connector 60 are connected to the wire delivery device 101. , the subsequent processing will be described.
  • the same parts as those of the wire feeding device according to the first embodiment are denoted by the same reference numerals, and overlapping descriptions are omitted.
  • the wire delivery device 101 also operates in this order to grip the guide wire GW, move the gripping part 20 toward the distal end of the guide wire GW, release the grip of the guide wire GW, and move the gripping part 20 toward the rear end.
  • the grip part 20, the hammer 11, and the slider 113 are configured to interlock with each other.
  • the leg 21B is pressed in the negative direction of the Y axis by the extension 113A, and the gripping spring 23 is compressed.
  • An arrangement space is formed between the surface of the gripping surface portion 21A on the second component 22 side and the surface of the gripping surface portion 22A of the second component 22 on the first component 21 side. is in a released state.
  • the gripping portion 20 since the gripping portion 20 is no longer pushed in the positive direction of the X axis by the hammer 11, the gripping portion 20 slides to the rearmost end of the movable range due to the biasing force of the return spring 16 (see FIG. 11). Thereby, the grip part 20 moves from the extreme end (initial position) of the movable range to the extreme end of the movable range.
  • the slider 113 is further slid to the base end side, and the state in which the spring hook 113C of the slider 113 is engaged with the convex portion 11A of the hammer 11 is maintained. , the hammer 11 moves to the base end side along with the movement of the slider 113, and the compression spring 12 is further compressed.
  • the extension part 113A stops contacting the leg part 21B of the grip part 20 and stops compressing the grip spring 23, and the grip surface part 21A on the side of the second part 22 and the grip surface part 22A on the side of the first part 21
  • the guide wire GW is gripped by the surfaces.
  • the slider 113 slides further to the proximal side, and as shown in FIGS. 26 and 27,
  • the hook 113D climbs over the convex portion 2D of the housing 2 in the negative direction of the X axis, and the hook 113D and the convex portion 2D are engaged.
  • the push spring 12 is maintained in a compressed state and becomes ready to be delivered (compression maintained state: ready to be delivered), and the slider 113 becomes immovable in the positive direction of the X axis.
  • the biasing force of the push spring 12 is applied to the movement of the hammer 11 in the distal direction at once, the hammer 11 moves in the distal direction, and the distal end side of the hammer 11 collides with the proximal end side of the grip portion 20.
  • the grasping portion 20 that grasps the guide wire GW moves in the distal direction due to the impact caused by the collision with the hammer 11 and stops at the distal end position of the grasping portion 20 .
  • the guide wire GW is still gripped.
  • the grasping part 20 moves from the rearmost position to the most distal position while maintaining the state of grasping the guidewire GW.
  • the guide wire GW is delivered to the distal side from the rearmost position of the grasping portion 20 to the most distal position.
  • the projection 110B pushes the hook 113D in the positive direction of the Y axis, and the hook 113D engages the projection 2D of the housing 2. 29, the projection 110D climbs over the projection 35B of the link 35 in the positive direction of the Y axis.
  • the ejection switch 110 is maintained in a state in which the convex portion 110D is located in the positive direction of the Y-axis relative to the convex portion 35B. In this state, the state in which the hook 113D is not engaged with the protrusion 2D is maintained. That is, the state in which the slider 113 can move in the positive direction of the X axis is maintained.
  • the slider 113 moves in the positive direction of the X axis, and the wire feeding device 101 can be returned to the initial state shown in FIG. If the guide wire GW needs to be delivered continuously, the lever 31 can be rotated in the same manner as described above and the same operation can be performed.
  • the wire feeding device 101 it is possible to feed an appropriate amount of guide wire GW by applying the impact force due to the biasing force accumulated in the compression spring 12 to the guide wire GW. In this manner, since an impact force can be applied to the guidewire GW, the guidewire GW can effectively penetrate an obstruction.
  • a wire feeding device 201 according to the third embodiment will be described.
  • 30 and 31 are a top cross-sectional view and a side cross-sectional view of the initial state of the wire feeding device according to the third embodiment. Parts similar to those of the wire feeding devices according to the first and second embodiments are denoted by the same reference numerals, and overlapping descriptions are omitted.
  • the wire feeding device 201 includes a gripping portion 220 instead of the gripping portion 20, a slider 210 instead of the slider 13 and the hook 14, and a gripping open/close switch 240 instead of gripping open/close switches such as the gripping open/close switch 40. I have.
  • the slider 210 has a configuration in which the slider 13 and the hook 14 are integrated, and has an extension 210A instead of the extension 13A.
  • a slit 210B is formed in the extension portion 210A to guide the operation convex portion 223A of the grip portion 220 when the slider 210 is moved.
  • the end of the slit 210B in the positive direction of the X-axis has a width equal to or larger than the movable range of the operation convex portion 223A in the Z-axis direction.
  • the slit 210B is positioned at a position where the gripping portion 220 grips the guide wire GW when the slider 210 moves to the base end side (negative direction side of the Z axis).
  • the operation convex portion 223A is guided to the position (positive direction side of the Z axis) where the grip portion 220 releases the grip of the guide wire GW. is formed to be Note that the shape of the slit 210B is not limited to this, and may be changed according to usage conditions.
  • FIGS. 33 and 34 are a perspective view and a side cross-sectional view of the grip portion in a released state
  • FIGS. 35 and 36 are perspective views and It is a side sectional view.
  • the gripping portion 220 includes a body portion 221 as an example of a first gripping portion, a facing component 222 as an example of a second gripping portion, a cam portion 223, a grip release spring 224, a support pin 225, and a retaining ring 226. and have
  • the body portion 221 has a gripping surface 221A and a wall portion 221B.
  • the grip surface 221A is a surface in the negative direction of the Y axis that grips the guide wire GW, and for example, a rubber member may be attached to this surface.
  • the gripping surface 221A has a surface that intersects the movable direction (X-axis direction) of the gripping portion 220 .
  • the wall portion 221B has a hole 221C into which the support pin 225 that rotatably supports the cam portion 223 is inserted, and a hole 221D into which the support pin 225 that rotatably supports the opposing component 222 is inserted. have.
  • the cam portion 223 has an operation convex portion 223A, a through hole 223B, and a contact surface 223C.
  • the operation convex portion 223A is provided on the side surface of the cam portion 223 and is a portion for operating the state of the cam portion 223 .
  • the through hole 223B is a hole into which a support pin 225 for rotationally supporting the cam portion 223 is inserted.
  • 223 C of contact surfaces are surfaces which contact the surface of the positive direction of the Y-axis of the opposing component 222. As shown in FIG.
  • a cross-sectional shape of the contact surface 223C perpendicular to the X-axis has a linear portion 223D and a curved portion 223E.
  • the cam portion 223 can be maintained in a state in which the grip portion 220 grips the guide wire GW.
  • the facing component 222 has a gripping surface 222A and a through hole 222B.
  • the gripping surface 222A is a surface in the positive direction of the Y-axis that grips the guide wire GW, and has a surface shape corresponding to the gripping surface 221A of the main body 221 .
  • a rubber member may be attached to the grip surface 222A.
  • the through-hole 222B is a hole into which a support pin 225 for supporting the rotation of the opposing component 222 is inserted.
  • the grip release spring 224 is biased and disposed so as to widen the gap between the facing surfaces of the body portion 221 and the facing component 222 .
  • the grip releasing spring 224 is configured such that the cam portion 223 and the opposing component 222 are positioned closer to the Z axis than the maximum outer shape portion 223F. or the linear portion 223D, the gap between the opposing surfaces of the body portion 221 and the opposing component 222 is widened.
  • the support pin 225 is a cylindrical member, has a head portion 225A at a first end, and has a groove portion 225B into which a snap ring 226 is fitted at a second end opposite to the first end. .
  • the retaining ring 226 prevents the support pin 225 from falling out of the holes 221C and 221D by being fitted in the groove 225B of the support pin 225.
  • the support pin 225 is inserted into the hole 221D of the body portion 221 in the negative direction of the X axis, the through hole 222B of the opposing component 222, and the X-axis of the body portion 221.
  • a snap ring 226 is attached to the groove 225B of the support pin 225 by inserting it into the hole 221D in the positive direction of the shaft.
  • the support pin 225 is inserted into the hole 221C of the body portion 221 in the negative direction of the X axis, the through hole 223B of the cam portion 223, and the hole 221C of the body portion 221 in the positive direction of the X axis.
  • a retaining ring 226 is attached to the . Thereby, the grip portion 220 shown in FIG. 33 is completed.
  • the grasping part 220 shown in FIG. 33 is in a state in which the grip of the guide wire GW is released (grip release state).
  • the gripping portion 220 is such that the straight portion 223D of the contact surface 223C of the cam portion 223 is in contact with the surface of the corresponding component 222 in the positive direction of the Y axis, and the gripping surface 222A is in contact. and the gripping surface 221A are separated from each other.
  • the gripping portion 220 is in contact with the surface of the corresponding component 222 in the positive Y-axis direction at a position in the negative Z-axis direction relative to the maximum outer shape portion 223F. and the grip surface 221A are in contact with each other. Since the distance from the rotation axis of the cam portion 223 is longer than the contact position, the maximum outer shape portion 223F suppresses the movement of the cam portion 223 in the direction opposite to the R3 direction. 222A and the gripping surface 221A are kept in contact with each other.
  • FIG. 37 is a perspective view of a grip open/close switch of the wire feeding device
  • the grip opening/closing switch 240 has an operation portion 240A for operation by the operator, and a storage portion 240B in which the operation convex portion 223A of the grip portion 220 is stored.
  • the grip opening/closing switch 240 is mounted on the housing 2 so as to be horizontally movable in the Z-axis direction.
  • the accommodating portion 240B has a rectangular parallelepiped shape in which only the surface in the negative direction of the Y axis is open. It is the width of the movement range of the portion 223A in the X-axis direction. Therefore, it is ensured that the operation convex portion 223A is accommodated in the accommodation portion 240B regardless of the position of the grip portion 220 in the X-axis direction.
  • the position of the operation convex portion 223A in the Z-axis direction can be changed according to the operation regardless of where the grip portion 220 is located in the X-axis direction.
  • FIGS. 38 and 39 which will be described later
  • the position of the operation projection 223A can be changed by the grip opening/closing switch 240. can. Therefore, in the delivery ready state, it is possible to release the grip of the guide wire GW by the grip part 220 and easily perform adjustments such as changing the position and orientation of the guide wire GW.
  • the position of the operation projection 223A cannot be changed by the grip opening/closing switch 240.
  • Figures 38 and 39 are top and side cross-sectional views of the wire delivery device in its ready-to-deliver state.
  • the guide wire GW, the catheter 51 and the connector 60 are omitted in FIGS. 38 and 39, the description assumes that the catheter 51 and the connector 60 are connected to the wire delivery device 201.
  • the wire delivery device 201 operates in this order to grasp the guide wire GW, move the grasping portion 220 toward the distal end of the guide wire GW, release the grasp of the guide wire GW, and move the grasping portion 220 toward the rear end.
  • the grip portion 220, the hammer 11, and the slider 210 are configured to work together.
  • the operation convex portion 223A of the grip portion 220 is guided by the slit 210B of the extension portion 210A to the position where the grip of the grip portion 220 is released.
  • the gripping surface 222A of the opposing component 222 and the gripping surface 221A of the main body component 221 are separated from each other, and the gripping of the guide wire GW by the gripping portion 220 is released.
  • the gripping portion 220 is no longer pushed by the hammer 11 in the positive direction of the X axis, so the gripping portion 220 slides to the rearmost end of the movable range due to the biasing force of the return spring 16 . Thereby, the grip part 20 moves from the extreme end (initial position) of the movable range to the extreme end of the movable range.
  • the operation convex portion 223A may be hooked on the slope of the slit 210B of the slider 210 to return.
  • the slider 210 is further slid to the base end side, and the state in which the spring hook 14A is engaged with the convex portion 11A of the hammer 11 is maintained. , the hammer 11 moves to the base end side, and the compression spring 12 is further compressed.
  • the operation convex portion 223A of the grip portion 220 is guided to a position where the grip portion 220 is gripped by the slit 210B of the extension portion 210A. 221A is gripped.
  • the slider 210 slides further to the proximal side, and as in the case shown in FIGS. 12 and 13,
  • the projecting portion 45C of the ejection switch 45 climbs over the projecting portion 13B of the slider 210 and is positioned in the positive direction of the X axis of the projecting portion 13B, and they are engaged with each other.
  • the compression spring 12 is maintained in a compressed state and becomes ready to be delivered (compression maintained state: ready-to-delivery state), and the slider 210 becomes immovable in the positive direction of the X axis.
  • the projection 45A pushes the projection 14B of the slider 210 in the positive direction of the Y axis, as in the case shown in FIG.
  • the spring hook 14A moves in the positive direction of the Y-axis in the same manner as in the case shown in FIG.
  • the convex portion 45C moves in the positive direction from the surface of the slider 210 in the positive direction of the Y-axis and is no longer engaged with the convex portion 13B, so that the slider 210 can move in the positive direction of the X-axis.
  • the biasing force of the push spring 12 is applied to move the hammer 11 in the distal direction at once, and the hammer 11 moves in the distal direction, and the distal end side of the hammer 11 collides with the proximal end side of the grip portion 220.
  • the grasping portion 220 that grasps the guide wire GW moves in the distal direction due to the impact caused by the collision with the hammer 11 and stops at the distal end position of the grasping portion 220 .
  • the grasping part 220 maintains the state of grasping the guide wire GW.
  • the grasping part 220 moves from the rearmost position to the most distal position while maintaining the state of grasping the guide wire GW.
  • the guide wire GW is delivered to the distal side by the distance from the rearmost position of the grasping portion 220 to the most distal position.
  • the wire feeding device 201 it is possible to apply the impact force due to the urging force accumulated in the compression spring 12 to the guide wire GW and feed out an appropriate amount. In this manner, since an impact force can be applied to the guidewire GW, the guidewire GW can effectively penetrate an obstruction.
  • FIG. 40 is an exploded perspective view of the grip portion 260
  • FIG. 41 is a perspective view of the grip portion 260 in a released state.
  • the gripping portion 260 can be used in the same manner by replacing the gripping portion 220 of the wire feeding device 201 .
  • the gripping portion 260 has a main body portion 261 , a facing part 262 , a back portion 263 , a cam portion 264 and a grip releasing spring 265 .
  • the body portion 261 has a gripping surface 261A and an opposing installation wall portion 261B.
  • the grip surface 261A is a surface in the negative direction of the Y axis that grips the guide wire GW, and for example, a rubber member may be attached to this surface.
  • the installation wall portion 261B includes holes 261C into which the bosses 264B at both ends of the cam portion 264 in the X-axis direction are fitted, holes 261D into which bosses 262B at both ends of the opposing component 262 in the X-axis direction are fitted, and the rear portion 263. and a boss 261E for fitting against.
  • the cam portion 264 has an operating convex portion 264A, a boss 264B, a contact surface 264C, and a fixed convex portion 264D.
  • the operation convex portion 264A is a portion erected on the side surface of the cam portion 264 and used to operate the state of the cam portion 264 .
  • the bosses 264B have a cylindrical shape and are formed at both ends of the cam portion 264 in the X-axis direction.
  • 264 C of contact surfaces are surfaces which contact the surface of the positive direction of the Y-axis of the opposing component 262.
  • the cross-sectional shape of the contact surface 264C has the same shape as the contact surface 223C of the cam portion 223 of the grip portion 220.
  • the fixed convex portion 264D engages with the fixed concave portion 263B of the back surface portion 263, and can maintain the cam portion 264 in a state in which the grip portion 260 grips the guide wire GW.
  • the facing part 262 has a gripping surface 262A and a boss 262B.
  • the gripping surface 262A is a surface in the positive direction of the Y axis that grips the guide wire GW, and for example, a rubber member may be attached to this surface.
  • the bosses 262B have a columnar shape and are formed at both ends of the opposing component 262 in the X-axis direction.
  • the rear portion 263 has a hole 263A and a fixed recess 263B.
  • the holes 263A are holes for fitting the bosses 261E of the body portion 261 at both ends in the X-axis direction.
  • the fixed concave portion 263B engages with the fixed convex portion 264D of the cam portion 264, and the cam portion 264 can be maintained in a state in which the grip portion 260 grips the guide wire GW.
  • the grip releasing spring 265 is biased and arranged so as to widen the gap between the opposing surfaces of the body portion 261 and the opposing component 262 .
  • the grip release spring 265 when the cam portion 264 is not in a state in which the gripped state by the grip portion 260 is not fixed, the grip release spring 265 is configured such that the fixing convex portion 264D of the cam portion 264 is engaged with the fixing concave portion 263B of the back surface portion 263. When not engaged, it acts to widen the space between the facing surfaces of the body portion 261 and the facing component 262 .
  • the opposing component 262 or the body portion 261 is elastically deformed so that the boss 262B of the opposing component 262 is inserted into the hole 261D of the installation wall portion 261B of the body portion 261. fit in.
  • the cam portion 264 or the body portion 261 is elastically deformed to fit the boss 264B of the cam portion 264 into the hole 261C of the installation wall portion 261B of the body portion 261 .
  • the rear portion 263 or the main portion 261 is elastically deformed to fit the bosses 261E of the main portion 261 into the holes 263A of the rear portion 263 .
  • the grip portion 260 shown in FIG. 41 is completed.
  • FIG. 42 and 43 are a top view and a cross-sectional view of the wire feeding device when the lid is open, FIG. 44 is a top view when the lid is closed, FIG. 45 is a perspective view of the lid, and FIG. 4 is an enlarged perspective view of the mounting portion of the lid; FIG.
  • the same parts as those of the wire feeding devices according to the first to third embodiments are denoted by the same reference numerals, and overlapping descriptions are omitted.
  • the wire delivery device 301 further includes an opening/closing portion 310 for covering the guide wire housing portion 4, and instead of the lever 31 used in the device described above, a lever 320 (biasing operation portion example).
  • the opening/closing part 310 has a lid 311, a shaft 312, a spring 313, and a screw 314, as shown in FIG.
  • the lid 311 includes a cylindrical portion 311A extending in the X-axis direction, and a covering portion connected to the cylindrical portion 311A for covering at least a portion of the guide wire accommodating portion 4 (an example of the placing portion). 311C and a rotation operation part 311B for performing an operation to rotate the lid 311. As shown in FIG. 45, the lid 311 includes a cylindrical portion 311A extending in the X-axis direction, and a covering portion connected to the cylindrical portion 311A for covering at least a portion of the guide wire accommodating portion 4 (an example of the placing portion). 311C and a rotation operation part 311B for performing an operation to rotate the lid 311. As shown in FIG.
  • the cylindrical portion 311A has a through hole 311E and a boss portion 311F extending in the longitudinal direction.
  • the through hole 311E is a hole for inserting the shaft 312 for attachment.
  • the boss portion 311F is a boss used to fix the rotating state of the lid 311 in a predetermined state, and is arranged on the side of the through hole 311E on which the rotation operation portion 311B is located.
  • the covering portion 311C has an opening 311D that prevents contact with the rib 2J.
  • the housing 2 of the wire feeding device 301 is formed with a mounting region 2E, non-through holes 2F, through holes 2G, and ribs 2J. Furthermore, the housing 2 is formed with a groove 2H extending in the positive direction of the Z axis and a groove 2I extending in the negative direction of the Y axis with respect to the non-through hole 2F. ing.
  • the lid 311 is attached to the housing 2 by inserting the shaft 312 into the through hole 2G of the housing 2, the spring 313, the through hole 311E of the lid 311, and the non-through hole 2F. is rotatably attached to the center.
  • the shaft 312 is fixed to the through hole 2G of the housing 2 by a screw 314 so as not to drop off from the wire feeding device 301 .
  • a spring 313 biases the lid 311 toward the tip side (positive direction of the X axis).
  • the opening/closing portion 310 When the boss portion 311F engages with the groove 2I, the opening/closing portion 310 is opened, that is, the guide wire housing portion 4 is opened so that the guide wire GW can be placed on the guide wire housing portion 4.
  • the opening/closing portion 310 When the boss portion 311F engages with the groove 2H, the opening/closing portion 310 is closed, that is, at least a portion of the guide wire housing portion 4 is closed so that the guide wire GW cannot be removed from the guide wire housing portion 4.
  • the lid 311 By moving the lid 311 in the negative direction of the X-axis against the bias of the spring 313, the lid 311 becomes rotatable, and the opening/closing portion 310 can be switched between the open state and the closed state.
  • the lever 320 of the wire feeding device 301 has a connection portion 320A extending from a lever rotating shaft 320O that drives the mechanism, and a handle portion 320B that extends from the connection portion 320A and is manually operated by the operator.
  • FIG. 47 is a top view showing a state in which the guide wire GW is placed
  • FIG. 48 is a side cross-sectional view of a portion of the wire delivery device including the guide wire accommodation section.
  • the catheter 51 is connected to the connector 60 and the connector 60 is connected to the connector connecting part 3 as shown in FIG.
  • the guide wire GW inserted into the catheter 51 is accommodated in the guide wire accommodation section 4 .
  • the guide wire GW is placed while being pulled toward the negative direction side of the Y axis of the guide wire housing portion 4 by the ribs 2J. Accordingly, when the opening/closing part 310 is closed, it is possible to appropriately prevent the covering part 311C of the opening/closing part 310 from interfering with the guide wire GW.
  • the guide wire GW is accommodated in the space between the wall surface of the guide wire accommodating portion 4 and the covering portion 311C of the opening/closing portion 310, as shown in FIG. state. As a result, it is possible to appropriately prevent the guide wire GW from falling off from the wire feeding device 301 .
  • FIG. 49 is a perspective view of the wire feeding device in a ready-to-feed state.
  • the connecting portion 320A of the lever 320 extends from the lever rotating shaft 320O in the positive direction of the X axis and the positive direction of the Y axis.
  • the handle portion 320B extends in the negative direction of the X-axis and the positive direction of the Y-axis from the connection portion with the connection portion 320A.
  • the bottom surface of the handle portion 320B is positioned higher than the top surface of the housing 2 by a predetermined height or more.
  • the predetermined height may be a height that takes into consideration the thickness of the expected operator's fingers and hands. By increasing the height, it is possible to appropriately prevent the hand or fingers gripping the handle portion 320B from coming into contact with the guide wire GW.
  • connection portion 320A extends from the lever rotation shaft 320O in the positive direction of the Y axis
  • handle portion 320B extends from the connection portion with the connection portion 320A in the negative direction of the X axis. It has been extended to
  • the movement range of the lever 320 (the connection portion 320A and the handle portion 320B) when operated to feed out the guide wire GW is the Z-axis direction passing through the mounting position of the guide wire GW. It is on the side of the lever rotating shaft 320O with respect to the vertical plane extending vertically. Therefore, it is possible to appropriately prevent the hand or fingers gripping the handle portion 320B from contacting the guide wire GW.
  • a wire feeding device 401 according to the fifth embodiment will be described with reference to each drawing.
  • 50 is a perspective view of the wire feeding device 401
  • FIG. 51 is a bottom perspective view of the wire feeding device 401 when the ejection switch is not fixed
  • FIG. 52 is a bottom perspective view of the wire feeding device 401 when fixed.
  • Parts similar to those of the wire feeding devices according to the first to fourth embodiments are denoted by the same reference numerals, and overlapping descriptions are omitted.
  • the wire feeding device 401 further includes an operation fixing portion 403 for fixing the ejection switch 45 in a pressed state.
  • the fixed operation part 403 has a fixed switch 404 and a spring 405 that biases the fixed switch 404 toward the injection switch 45 side.
  • the fixed switch 404 has a convex portion 404A that protrudes outside the housing 2 and is operated by the operator, and a contact portion 404B that contacts the ejection switch 45 .
  • the contact portion 404B of the fixed switch 404 is in contact with the side surface of the injection switch 45 in the negative direction of the X axis, as shown in FIG. In this case, the operator can press the ejection switch 45 .
  • the contact portion 404B of the fixed switch 404 contacts the side surface of the injection switch 45 on the negative side of the Y axis and moves in the positive direction of the X axis. .
  • the ejection switch 45 cannot be rotated in the negative direction of the Y-axis by the contact portion 404B, and is maintained in the pressed state.
  • the operator moves the projection 404A of the fixed switch 404 in the negative direction of the X axis, thereby causing the ejection switch 45 to move as shown in FIG. can be returned to an unpressed state.
  • a metal spring is used as the compression spring 12, but other types of elastic bodies such as rubber cords and leaf springs may be used. It can be material.
  • the hammer 11 is also made of metal in the above-described embodiment, it may be made of a resin material like the compression spring.
  • the biasing force of the hammer 11 in the distal direction is increased.
  • An elastic body may be provided to increase the biasing force by stretching the elastic body.
  • the gripping portions 20, 220, 260 may be directly moved in the distal direction by the pressing spring 12.
  • a mechanism for adjusting the movable range in the X-axis direction of the gripping units 20, 220, and 260 for example, a mechanism for moving the position of the wall in the X-axis direction that determines the movable range may be provided. With this configuration, the amount of wire fed by the wire feeding device can be adjusted easily and appropriately.
  • a mechanism for adjusting the amount of compression of the compression spring 12 in the initial state for example, a mechanism for moving the position of the wall on the proximal end side of the compression spring 12 may be provided. By doing so, it is possible to easily and appropriately adjust the impact force applied to the gripping portions 20, 220, 260 by the hammer 11 in the wire feeding device. Further, in the above-described embodiment, it is assumed that the compression spring 12 is not compressed at all in the initial state, but the compression spring 12 may be slightly compressed in the initial state.
  • the guide wire GW is delivered by the operator manually rotating the levers 31 and 320, but it may be delivered by an electric motor.
  • the link 35 may be rotated by power of a motor.
  • the motor may be stopped when the link 35 is rotated by a predetermined angle.
  • a switch for driving the motor may be provided, and when the switch is pressed once, the motor may be driven to rotate the link 35 by a predetermined angle.
  • the gripping portion 20 in the second embodiment may be replaced with the gripping portions 220 and 260 in the third embodiment.
  • the lever 31 in the first and second embodiments may be replaced with the lever 320 in the fourth embodiment.
  • the opening/closing part 310 in the fourth embodiment may be provided in the wire feeding devices according to the first and second embodiments.
  • the operation fixing part 403 in the fifth embodiment may be provided in the wire feeding devices according to the first to third embodiments.

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PCT/JP2021/016082 2021-04-20 2021-04-20 ワイヤ送出装置 Ceased WO2022224359A1 (ja)

Priority Applications (3)

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JP2023515936A JP7603798B2 (ja) 2021-04-20 2021-04-20 ワイヤ送出装置
PCT/JP2021/016082 WO2022224359A1 (ja) 2021-04-20 2021-04-20 ワイヤ送出装置
US18/379,984 US20240032959A1 (en) 2021-04-20 2023-10-13 Wire feeding device

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PCT/JP2021/016082 WO2022224359A1 (ja) 2021-04-20 2021-04-20 ワイヤ送出装置

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JP7250947B2 (ja) * 2019-10-23 2023-04-03 朝日インテック株式会社 ワイヤ送出装置

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5749371A (en) * 1995-10-06 1998-05-12 Zadini; Filiberto P. Automatic guidewire placement device for medical catheters
JP2015510830A (ja) * 2012-03-18 2015-04-13 トラウマテック ソリューションズ ベー．フェー． 血管内アクセスおよび治療のためのデバイスおよび方法
US20160375223A1 (en) * 2015-06-23 2016-12-29 Traumatek Solutions, B.V. Vessel cannulation device and method of use
JP2018064822A (ja) * 2016-10-20 2018-04-26 株式会社ハイレックスコーポレーション ガイドワイヤ操作具および該ガイドワイヤ操作具を備えたガイドワイヤのセット

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5749371A (en) * 1995-10-06 1998-05-12 Zadini; Filiberto P. Automatic guidewire placement device for medical catheters
JP2015510830A (ja) * 2012-03-18 2015-04-13 トラウマテック ソリューションズ ベー．フェー． 血管内アクセスおよび治療のためのデバイスおよび方法
US20160375223A1 (en) * 2015-06-23 2016-12-29 Traumatek Solutions, B.V. Vessel cannulation device and method of use
JP2018064822A (ja) * 2016-10-20 2018-04-26 株式会社ハイレックスコーポレーション ガイドワイヤ操作具および該ガイドワイヤ操作具を備えたガイドワイヤのセット

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