WO2022249412A1 - Cathéter - Google Patents

Cathéter Download PDF

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Publication number
WO2022249412A1
WO2022249412A1 PCT/JP2021/020289 JP2021020289W WO2022249412A1 WO 2022249412 A1 WO2022249412 A1 WO 2022249412A1 JP 2021020289 W JP2021020289 W JP 2021020289W WO 2022249412 A1 WO2022249412 A1 WO 2022249412A1
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WO
WIPO (PCT)
Prior art keywords
core wire
mesh member
distal
lumen
catheter
Prior art date
Application number
PCT/JP2021/020289
Other languages
English (en)
Japanese (ja)
Inventor
雄太 中川
Original Assignee
朝日インテック株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 朝日インテック株式会社 filed Critical 朝日インテック株式会社
Priority to PCT/JP2021/020289 priority Critical patent/WO2022249412A1/fr
Publication of WO2022249412A1 publication Critical patent/WO2022249412A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00—Dilators with or without means for introducing media, e.g. remedies

Definitions

  • the present invention relates to catheters.
  • CTO chronic total occlusion
  • Patent Literature 1 by providing a membrane body made of a flexible material that partially covers the gap of the expansion part, the guide wire inserted into the internal space of the expansion part is prevented from protruding outside the expansion part. A technique for doing so is disclosed.
  • the guide wire (retrograde guide wire) from the opposite side of the obstructing lesion is suppressed by the membrane body from protruding outside the extension portion, and the guide wire is attached to the shaft portion. can lead.
  • the guide wire can be guided to the shaft portion, there is a possibility that the guide wire cannot be properly guided to the proximal end side if the guide wire comes into contact with the core wire or parts inside the shaft portion.
  • the present invention has been made based on the circumstances as described above, and its purpose is to provide a technique capable of appropriately guiding a retrograde guidewire to the proximal side.
  • a catheter in order to achieve such an object, includes a radially expandable and contractible tubular mesh member, a hollow shaft connected to the proximal end of the mesh member, and a distal end of the mesh member. a connected hollow distal tip, the mesh member such that the distal end is connected to the distal end of the mesh member and/or the distal tip, and the proximal end is positioned proximally relative to the proximal end of the hollow shaft; and a core wire extending through the interior of the hollow shaft, wherein the hollow shaft has an inner side having a core wire lumen through which the core wire passes and a guide wire lumen through which a retrograde guide wire guided from the distal side passes.
  • a shaft is provided, and the core wire has a strand extending from a position on the distal side of the inlet on the distal side of the core wire lumen to the proximal side of the inlet when the mesh member is in an expanded state.
  • a coil portion is formed by winding the .
  • the coil portion may be provided to a range that is closer to the proximal side than the inlet of the core wire lumen when the mesh member is in a diameter-reduced state.
  • the core wire lumen may be formed so that the inner diameter of the core wire lumen becomes smaller toward the distal end within a predetermined range on the distal end side.
  • the retrograde guidewire can be appropriately guided to the proximal side.
  • FIG. 1 is a schematic cross-sectional view of a catheter according to the first embodiment.
  • FIG. 2 is a cross-sectional view of the catheter according to the first embodiment taken along line AA.
  • FIG. 3 is a cross-sectional view enlarging a part of the catheter according to the first embodiment.
  • FIG. 4 is a schematic cross-sectional view of a state in which the mesh member of the catheter according to the first embodiment is expanded.
  • FIG. 5 is a partially enlarged cross-sectional view of the catheter according to the first embodiment in which the mesh member is expanded.
  • FIG. 6 is a schematic cross-sectional view of a catheter according to a second embodiment.
  • FIG. 7 is a cross-sectional view of the catheter according to the second embodiment taken along line BB.
  • FIG. 8 is a cross-sectional view enlarging a part of the catheter according to the second embodiment.
  • FIG. 9 is a schematic cross-sectional view of a catheter according to a third embodiment;
  • FIG. 10 is a cross-sectional view of the catheter according to the third embodiment taken along line CC.
  • FIG. 11 is a cross-sectional view enlarging a part of the catheter according to the third embodiment.
  • FIG. 12 is a schematic cross-sectional view of a catheter according to a fourth embodiment;
  • FIG. 13 is a schematic cross-sectional view showing a state in which the mesh member of the catheter according to the fourth embodiment is expanded.
  • FIG. 14 is a partially enlarged cross-sectional view of the catheter according to the fourth embodiment.
  • FIG. 15 is a partially enlarged cross-sectional view of the catheter according to the fourth embodiment in which the mesh member is expanded.
  • FIG. 16 is a schematic cross-sectional view of a catheter according to a fifth embodiment;
  • FIG. 17 is a schematic cross-sectional view showing a state in which the mesh member of the catheter according to the fifth embodiment is expanded.
  • FIG. 18 is a cross-sectional view enlarging a portion of the catheter according to the fifth embodiment.
  • FIG. 19 is a partially enlarged cross-sectional view of the catheter according to the fifth embodiment in which the mesh member is expanded.
  • guide wire refers to a medical guide wire that is pushed into a surgical site in a body cavity such as a blood vessel and used for guiding a catheter to the surgical site or for penetrating an obstruction.
  • distal side means the direction along the longitudinal direction of the catheter (the direction along the axial direction of the catheter), which is the direction in which the distal tip is located with respect to the mesh member.
  • proximal side means a direction along the longitudinal direction of the catheter, 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.
  • maximum expansion diameter means the outer diameter of a portion where the outer diameter of the mesh member perpendicular to the axial direction is the maximum when the mesh member is expanded (also referred to as “diameter expansion”).
  • the term “anterograde guidewire” refers to a guidewire that is pushed to an operation site such as an obstruction site in a blood vessel prior to a catheter, and is referred to as a "retrograde guidewire.”
  • guide wire refers to a guide wire that is advanced from the distal end side of a catheter toward the catheter in a blood vessel, for example.
  • FIG. 1 is a schematic cross-sectional view of a catheter according to the first embodiment.
  • FIG. 1 shows a state in which the diameter of the mesh member is reduced in the catheter.
  • FIG. 2 is a cross-sectional view of the catheter according to the first embodiment taken along line AA.
  • FIG. 3 is a cross-sectional view enlarging a part of the catheter according to the first embodiment.
  • FIG. 4 is a schematic cross-sectional view of a state in which the mesh member of the catheter according to the first embodiment is expanded.
  • FIG. 5 is a partially enlarged cross-sectional view of the catheter according to the first embodiment in which the mesh member is expanded.
  • the catheter 1 generally comprises a mesh member 110, a hollow shaft 120, a distal tip 130, a core wire 150, a guiding membrane 160 and a connector 170.
  • the mesh member 110 is a radially expandable tubular member. When the core wire 150 is pulled proximally, the mesh member 110 expands by deforming out of plane and bulging radially outward as shown in FIG. to receive retrograde guidewire W 2 within mesh member 110 .
  • the mesh member 110 has a plurality of first strands 111 and a plurality of second strands 112, and the first strands 111 and the second strands 112 are woven in a grid pattern. It is rarely formed to be tubular as a whole.
  • the mesh member 110 is formed with apertures m between adjacent braided strands and receives a retrograde guidewire through the enlarged apertures m when expanded.
  • a distal end portion of each wire constituting mesh member 110 is joined to distal tip 130 , and a proximal end portion of each wire is joined to hollow shaft 120 .
  • Each of the wires 111 and 112 may be a single wire, or may be a twisted wire obtained by twisting a plurality of single wires.
  • a metal material or a resin material can be used as a material for forming the wires 111 and 112 of the mesh member 110 .
  • metal materials include stainless steel such as SUS304, nickel-titanium alloys, cobalt-chromium alloys, and the like.
  • resin materials include polyamide, polyester, polyacrylate, polyetheretherketone, and the like. Among these materials, metal materials may be used from the viewpoint of improving strength and flexibility.
  • the wires 111 and 112 may be made of the same material, or may be made of different materials.
  • a radiopaque material may be included as a material for forming the strands 111 and 112 of the mesh member 110.
  • radiopaque materials include gold, platinum, tungsten, or alloys containing these elements (eg, platinum-nickel alloys, etc.).
  • the surface of each strand 111, 112 may be coated with a radiopaque material.
  • the hollow shaft 120 is connected to the proximal end of the mesh member 110.
  • the hollow shaft 120 includes a hollow distal shaft 121 whose distal end is connected to the proximal end of the mesh member 110, and a hollow central shaft 121 whose distal end is connected to the proximal side of the distal shaft 121. It has a shaft 123 and a hollow proximal shaft 127 whose distal end is connected to the proximal end of central shaft 123 .
  • the distal shaft 121 has a single lumen 122 through which the retrograde guidewire W2 and the core wire 150 can be passed.
  • the central shaft 123 is an example of an inner shaft, has an outer diameter corresponding to the inner diameter of the distal shaft 121, and, as shown in FIGS. is connected to the inner circumference of the
  • the central shaft 123 has a guidewire lumen 124 through which a retrograde guidewire can be passed, and a corewire lumen 125 through which a corewire 150 can be passed.
  • the guide wire lumen 124 has a circular front surface that is partially cut away, and the core wire lumen 125 has a circular front surface.
  • the core wire lumen 125 through which the core wire 150 can be inserted is provided, the operability of expanding and contracting the mesh member 110 by the core wire 150 can be improved.
  • An opening 126 that opens toward the proximal side is formed on the proximal side of the guide wire lumen 124 of the central shaft 123 , and the retrograde guide wire is delivered to the outside of the catheter 1 through the opening 126 . be.
  • the tip surface 123a on the tip side of the central shaft 123 is arranged at a position closer to the proximal side than the tip side of the tip side shaft 121, as shown in FIGS.
  • a tip surface 123 a of the central shaft 123 is a surface that is inclined with respect to the axis of the hollow shaft 120 .
  • the distal end surface 123 a is positioned so that the surface surrounding the core wire lumen 125 is closer to the distal end than the surface surrounding the guide wire lumen 124 .
  • the tip surface 123a is a flat surface. With this configuration, the central shaft 123 can be easily produced by cutting the tip side from a cylindrical state with a plane inclined with respect to the axis. Note that the tip surface 123a is not limited to a flat surface, and may be a curved surface.
  • the guide wire lumen 124 is positioned in a plane perpendicular to the axis of the hollow shaft 120 on the distal side.
  • a part of the periphery can be made absent, and the ratio of the area of the part connected to the guide wire lumen 124 to the lumen 122 in the plane perpendicular to the axis of the hollow shaft 120 is increased. and effectively guide a retrograde guidewire into the guidewire lumen 124 .
  • a retrograde guidewire can also be effectively guided into the guidewire lumen 124 by an inclination around the guidewire lumen 124 .
  • the slope around corewire lumen 125 can also effectively guide a retrograde guidewire into guidewire lumen 124 .
  • the proximal side shaft 127 is connected to the proximal side of the central shaft 123 .
  • the proximal shaft 127 internally communicates with the core wire lumen 125 of the central shaft 123 and has a lumen 128 through which the core wire 150 can be inserted.
  • the hollow shaft 120 since the hollow shaft 120 is inserted into the blood vessel, it may have antithrombotic properties, flexibility, and biocompatibility, and a resin material and a metal material are adopted. be able to. Since the distal shaft 121 and the central shaft 123 are required to be flexible, resin materials such as polyamide resin, polyolefin resin, polyester resin, polyurethane resin, silicone resin, and fluorine resin may be used. As the base end side shaft 127, a metal tube such as a hypotube may be adopted because it is required to have pushability.
  • the distal tip 130 is a member connected to the distal end of the mesh member 110 . Specifically, the tip 130 is sharpened toward the distal side so that the catheter 1 can easily advance through the blood vessel. Each tip is embedded.
  • the material forming the distal tip 130 may be flexible because the catheter 1 is advanced through the blood vessel.
  • Materials having such flexibility include, for example, resin materials such as polyurethane and polyurethane elastomer.
  • the core wire 150 is connected at its distal end to the distal end of the mesh member 110 and/or the distal tip 130, and extends through the interior of the mesh member 110 and the hollow shaft 120 such that its proximal end is positioned proximally relative to the proximal end of the hollow shaft 120. extends through. Specifically, the core wire 150 passes through the space inside the mesh member 110, the inside of the hollow shaft 120 (the lumen 122 of the distal shaft 121, the core wire lumen 125 of the central shaft 123, and the lumen 128 of the proximal shaft 127). , and through a through hole 171 of the connector 170 to the outside. By manipulating the core wire 150 outside the connector 170, the core wire 150 advances and retreats in the axial direction, and the mesh member 110 expands and contracts in the radial direction.
  • the core wire 150 includes a distal end portion 151 whose distal end is connected to the distal end of the mesh member 110 and/or the distal tip 130, a coil portion 152 connected to the proximal end side of the distal end portion 151, and a coil portion 152 connected to the proximal end side of the coil portion 152. It has a proximal end 153 to which it is connected.
  • the tip portion 151 is composed of, for example, one metal wire.
  • the coil part 152 has, for example, a cylindrical hollow shape wound with one or more metal wires.
  • the outer diameter of the coil portion 152 is larger than the outer diameter of the tip portion 151 .
  • the gap between the core wire lumen 125 and the outside of the coil portion 152 can be reduced.
  • the outer diameter of the coil portion 152 is preferably, for example, substantially the same as or close to the inner diameter of the core wire lumen 125 . With this configuration, the outer diameter of the core wire 150 can be increased while maintaining the bendability of the core wire 150, and the gap between the core wire lumen 125 and the core wire lumen 125 can be reduced.
  • the coil portion 152 extends at least on the distal side of the core wire lumen 125. It is provided in a range from a position on the distal side of the inlet to the proximal side of the core wire lumen 125 on the distal side. Further, as shown in FIG. 5, the coil portion 152 is at least on the distal side of the core wire lumen 125 even when the mesh member 110 is in an expanded state, that is, when the core wire 150 is pulled to the proximal side.
  • the coil portion 152 is positioned at the entrance of the core wire lumen 125, and the gap between the core wire lumen 125 and the coil portion 152 is provided. can be made smaller. This can prevent the end of the retrograde guidewire from straying into the core wire lumen 125 . As a result, breakage of the retrograde guidewire can be prevented.
  • the material constituting the core wire 150 may have sufficient tensile strength and rigidity from the viewpoint of preventing the core wire 150 itself from being cut and expanding and contracting the mesh member 110 reliably.
  • Examples of such materials include stainless steel such as SUS304, metal materials such as nickel-titanium alloys, and cobalt-chromium alloys.
  • the connector 170 is a member for gripping the catheter 1 by the operator.
  • the connector 170 is connected to the proximal end of the hollow shaft 120 and connects the lumen 122 of the distal shaft 121 of the hollow shaft 120, the core wire lumen 125 of the central shaft 123, and the proximal end so that the core wire 150 can be exposed to the outside. It has a through hole 171 communicating with the lumen 128 of the side shaft 127 and an opening 172 formed at the proximal end of the through hole 171 .
  • the shape of the connector 170 is not particularly limited, and may be any shape as long as the operator can easily hold it.
  • the guide membrane 160 is arranged on the mesh member 110 , and the tip of the guide membrane 160 is positioned between the proximal end of the distal tip 130 and the tip of the hollow shaft 120 .
  • Guiding membrane 160 acts to smoothly guide a retrograde guidewire received through opening m of mesh member 110 toward hollow shaft 120 .
  • the guiding membrane 160 of the present embodiment extends from the substantially central portion in the axial direction of the mesh member 110 where the tip is located (for example, the maximum expanded diameter portion of the mesh member 110) to the tip of the hollow shaft 120 where the proximal end of the guiding membrane 160 is located. It is formed in the mesh member 110 in a region spanning
  • Retrograde guidewire W2 is received within mesh member 110 through opening m of mesh member 110 and is directed into hollow shaft 120 against, for example, funneled guide membrane 160 .
  • the induction film 160 is made of a stretchable material.
  • materials forming the guide film 160 include resin materials such as polyurethane, polyurethane elastomer, polyamide, polyamide elastomer, and copolymers thereof.
  • Catheter 1 is used to receive retrograde guidewire W2.
  • an antegrade guide wire W1 (not shown) into, for example, a blood vessel, it is advanced along the blood vessel to a site where an obstruction exists (hereinafter also referred to as "occlusion site").
  • the proximal end of the antegrade guidewire W1 is inserted into the distal end of the distal tip 130 and the lumen of the hollow shaft 120 (lumen 122, guidewire lumen 124).
  • the distal end of the catheter 1 is advanced in the blood vessel to the occlusion site.
  • the mesh member 110 is inserted into the blood vessel in a diameter-reduced state, and the diameter-reduced state is maintained until the tip of the catheter 1 reaches the occlusion site.
  • the antegrade guide wire W1 is pulled out from the catheter 1 by pulling the antegrade guide wire W1 toward the proximal end side. Note that the antegrade guidewire W1 may not be pulled out from the catheter 1.
  • the mesh member 110 faces radially outward. Transform and expand.
  • the opening m is also expanded, so that the retrograde guidewire W2 can be easily received.
  • the tip of the induction film 160 is joined to the substantially central portion in the axial direction of the mesh member 110, the induction film 160 is expanded following the expansion of the mesh member 110, and the induction film 160 is expanded as a whole. becomes a funnel shape.
  • the coil portion 152 of the core wire 150 is positioned at the entrance of the core wire lumen 125, and the gap between the core wire lumen 125 and the coil portion 152 is small.
  • the catheter 1 receives the retrograde guidewire W2 coming from the distal end side.
  • the path through which the retrograde guidewire W2 is directed for example, a false lumen in the blood vessel wall surrounding the occlusion site, a through hole passing through the occlusion site, etc. are assumed, but any path may be used.
  • retrograde guide wire W2 is guided by guide membrane 160 of mesh member 110 and is guided from opening 120a of hollow shaft 120 to the distal end. It is inserted through the lumen 122 of the side shaft 121 .
  • the retrograde guidewire W2 is effectively guided from the lumen 122 of the distal shaft 121 to the guidewire lumen 124 due to the shape of the distal side of the central shaft 123 without straying into the guidewire lumen 125, and is guided to the opening 126. is delivered to the outside of the catheter 1 via the Next, the retrograde guidewire W2 delivered from the opening 126 is delivered outside the body after passing through the blood vessel. As a result, it is possible to create a state in which the retrograde guide wire W2 passes through the obstructed site and both ends of the retrograde guide wire W2 are exposed to the outside of the body.
  • the catheter 1 can receive the retrograde guidewire W2 and guide the end portion out of the body, so it can be suitably used as a medical device in combination with the retrograde guidewire W2.
  • the catheter 1 since the catheter 1 has the above-described configuration, it is possible to prevent the retrograde guide wire W2 guided through the lumen 122 of the distal shaft 121 from straying into the core wire lumen 125. Wire W2 can be effectively guided into guidewire lumen 124 and delivered to the outside through opening 126 .
  • FIG. 6 is a schematic cross-sectional view of a catheter according to a second embodiment.
  • FIG. 7 is a cross-sectional view of the catheter according to the second embodiment taken along line BB.
  • FIG. 8 is a cross-sectional view enlarging a part of the catheter according to the second embodiment.
  • symbol is attached
  • a catheter 1A according to the second embodiment includes a hollow shaft 220 instead of the hollow shaft 120 of the catheter 1 according to the first embodiment, and a core wire 250 instead of the core wire 150.
  • the core wire 250 is made of, for example, one metal wire.
  • the outer diameter of the tip portion of the core wire 250 is formed, for example, so as to decrease toward the tip.
  • the material comprising core wire 250 may be similar to core wire 150 .
  • the hollow shaft 220 further has a coil portion 129 connected to the inner periphery of the core wire lumen 125 in addition to the configuration of the hollow shaft 120 .
  • the coil portion 129 has, for example, a cylindrical hollow shape wound with one or more metal wires.
  • the coil portion 129 may be provided over the entire core wire lumen 125 in the axial direction, or may be provided in a portion of the core wire lumen 125 on the distal end side. According to the coil portion 129, for example, as shown in FIGS. 7 and 8, the gap between the core wire lumen 125 and the core wire 250 can be reduced.
  • the inner diameter of the coiled portion 129 may be, for example, the same as or slightly larger than the maximum outer diameter of the portion of the core wire 250 that passes through that portion of the coiled portion 129 when the mesh member 110 is expanded or contracted.
  • the outer diameter of the core wire 250 can be reduced to maintain flexibility, the gap between the core wire 250 and the core wire lumen 125 can be reduced, and the core wire lumen 125 can be retrograde. It is possible to appropriately prevent the guide wire from getting into the wrong place.
  • FIG. 9 is a schematic cross-sectional view of a catheter according to a third embodiment
  • FIG. 10 is a cross-sectional view of the catheter according to the third embodiment taken along line CC
  • FIG. 11 is a cross-sectional view enlarging a part of the catheter according to the third embodiment. Parts similar to those of the catheters according to the first and second embodiments are denoted by the same reference numerals.
  • a catheter 1B according to the third embodiment includes a hollow shaft 320 instead of the hollow shaft 120 of the catheter 1A according to the second embodiment.
  • the hollow shaft 320 is connected to the proximal end of the mesh member 110.
  • the hollow shaft 320 includes a distal shaft 121 , a hollow central shaft 323 whose distal end is connected to the proximal side of the distal shaft 121 , and a distal end connected to the proximal end of the central shaft 323 . and a hollow proximal shaft 127 .
  • the central shaft 323 is an example of an inner shaft, has an outer diameter corresponding to the inner diameter of the distal shaft 121, and, as shown in FIGS. connected inside the
  • the central shaft 323 has a guidewire lumen 324 through which a retrograde guidewire can be passed and a corewire lumen 325 through which a corewire 250 can be passed.
  • the guide wire lumen 324 has a circular front surface with a part cut away, and the core wire lumen 325 has a circular front surface.
  • An opening 326 that opens toward the proximal side is formed on the proximal side of the guidewire lumen 324 of the central shaft 323, and the retrograde guidewire is delivered to the outside of the catheter 1B through the opening 326.
  • the tip surface 323a on the tip side of the central shaft 323 is arranged at a position closer to the proximal side than the tip side of the tip side shaft 121, as shown in FIGS.
  • a tip surface 323 a of the central shaft 323 is a surface that is inclined with respect to the axis of the hollow shaft 320 .
  • the distal surface 323 a has a surface surrounding the core wire lumen 325 that is closer to the distal side than a surface surrounding the guide wire lumen 324 .
  • the tip surface 323a is a flat surface. With this configuration, the central shaft 323 can be easily produced by cutting the tip side from a cylindrical state with a plane inclined with respect to the axis. Note that the tip surface 323a is not limited to a flat surface, and may be a curved surface.
  • the core wire lumen 325 is formed so that the inner diameter becomes smaller toward the distal end.
  • the inner diameter of each portion of core wire lumen 325 is, for example, equal to or slightly larger than the maximum outer diameter of the portion of core wire 250 that passes through core wire lumen 325 when mesh member 110 is expanded or contracted. good too. With this configuration, the outer diameter of the core wire 250 can be reduced to maintain flexibility, and the gap on the distal side between the core wire 250 and the core wire lumen 325 can be reduced. It is possible to adequately prevent the erroneous insertion of the guidewire.
  • the guide wire lumen 324 is positioned in a plane perpendicular to the axis of the hollow shaft 320 on the distal side.
  • a portion of the peripheral surface can be absent, and the ratio of the area leading to the guidewire lumen 324 to the lumen 122 in the plane perpendicular to the axis of the hollow shaft 320 can be increased to provide a retrograde guide.
  • a wire can be effectively guided to the guidewire lumen 324 .
  • a retrograde guidewire can also be effectively guided into the guidewire lumen 324 by an inclination around the guidewire lumen 324 .
  • the slope around corewire lumen 325 can also effectively guide a retrograde guidewire into guidewire lumen 324 .
  • the hollow shaft 320 since the hollow shaft 320 is inserted into the blood vessel, it may have antithrombotic properties, flexibility, and biocompatibility, and a resin material or a metal material is adopted. be able to. Since the distal shaft 121 and the central shaft 323 are required to be flexible, resin materials such as polyamide resin, polyolefin resin, polyester resin, polyurethane resin, silicone resin, and fluorine resin may be used. As the base end side shaft 127, a metal tube such as a hypotube may be adopted because it is required to have pushability.
  • FIG. 12 is a schematic cross-sectional view of a catheter according to a fourth embodiment
  • FIG. 13 is a schematic cross-sectional view showing a state in which the mesh member of the catheter according to the fourth embodiment is expanded.
  • FIG. 14 is a partially enlarged cross-sectional view of the catheter according to the fourth embodiment.
  • FIG. 15 is a partially enlarged cross-sectional view of the catheter according to the fourth embodiment in which the mesh member is expanded. Parts similar to those of the catheters according to the first to third embodiments are denoted by the same reference numerals.
  • a catheter 1C according to the fourth embodiment includes a core wire 350 instead of the core wire 150 of the catheter 1 according to the first embodiment.
  • the core wire 350 is made of, for example, one metal wire.
  • the outer diameter of the tip portion of the core wire 350 is formed, for example, so as to decrease toward the tip.
  • the material comprising core wire 350 may be similar to core wire 150 .
  • the core wire 350 has a protrusion 351 brazed with a metal brazing material. 12 and 14, when the mesh member 110 is in a state of reduced diameter, i.e., when the core wire 350 is not pulled to the proximal side, the convex portion 351 is positioned at the distal end of the core wire lumen 125. 13 and 15, when the mesh member 110 is in an expanded state, that is, when the core wire 350 is pulled proximally, the core wire lumen 125 is provided at a position corresponding to the entrance on the tip side of the .
  • the protrusion 351 is provided, for example, on the guide wire lumen 124 side of the core wire 350 . As shown in FIGS. 13 and 15, when the mesh member 110 is in the expanded state, the protrusion 351 is caught in the entrance of the core wire lumen 125, preventing the core wire 350 from moving further proximally. It is the size of
  • Such a configuration can prevent the core wire 350 from being excessively pulled proximally, causing the mesh member 110 to expand more than necessary or the core wire 350 to come off the distal tip 130 or the mesh member 110. It can prevent you from getting tired.
  • the protrusion 351 closes at least part of the gap between the core wire lumen 125 and the core wire 350 , it is possible to prevent the end of the retrograde guidewire from entering the core wire lumen 125 . As a result, breakage of the retrograde guidewire can be prevented.
  • FIG. 16 is a schematic cross-sectional view of a catheter according to a fifth embodiment
  • FIG. 17 is a schematic cross-sectional view showing a state in which the mesh member of the catheter according to the fifth embodiment is expanded.
  • FIG. 18 is a cross-sectional view enlarging a portion of the catheter according to the fifth embodiment.
  • FIG. 19 is a partially enlarged cross-sectional view of the catheter according to the fifth embodiment in which the mesh member is expanded. Parts similar to those of the catheters according to the first to fourth embodiments are denoted by the same reference numerals.
  • a catheter 1D according to the fifth embodiment includes a core wire 450 instead of the core wire 150 of the catheter 1 according to the first embodiment.
  • the core wire 450 is connected to the distal end of the mesh member 110 and/or the distal tip 130 at its distal end, and extends through the interior of the mesh member 110 and the hollow shaft 120 such that its proximal end is positioned proximally relative to the proximal end of the hollow shaft 120 . extends through. Specifically, the core wire 450 passes through the space inside the mesh member 110, the inside of the hollow shaft 120 (the lumen 122 of the distal shaft 121, the core wire lumen 125 of the central shaft 123, and the lumen 128 of the proximal shaft 127). , and through a through hole 171 of the connector 170 to the outside. By manipulating the core wire 450 outside the connector 170, the core wire 450 advances and retreats in the axial direction, and the mesh member 110 expands and contracts in the radial direction.
  • the core wire 450 has a distal end portion 451 whose distal end is connected to the distal end of the mesh member 110 and/or the distal tip 130 and a proximal end portion 452 connected to the proximal side of the distal end portion 451 .
  • the base end portion 452 is formed of, for example, one metal wire.
  • the tip portion 451 is, for example, cylindrical.
  • the outer diameter of the distal end portion 451 is larger than the outer diameter of the proximal end portion 452 .
  • the outer diameter of the distal end portion 451 is larger than the inner diameter of the core wire lumen 125 .
  • the distal end portion 451 is the distal end portion of the core wire lumen 125 when the mesh member 110 is in a reduced diameter state, that is, when the core wire 450 is not pulled proximally.
  • the mesh member 110 is in a predetermined expanded state, that is, when the core wire 450 is pulled proximally, as shown in FIGS.
  • the distal end portion 451 blocks the entrance of the core wire lumen 125, allowing the core wire 450 to extend proximally. don't move.
  • the material comprising core wire 450 may be similar to core wire 150 .
  • the distal end portion 451 of the core wire 450 fits into the entrance of the core wire lumen 125 on the distal side, thereby causing the core wire 450 to move excessively toward the proximal side. It is possible to prevent the mesh member 110 from being pulled excessively, and prevent the core wire 450 from being detached from the distal tip 130 or the mesh member 110 . In addition, since the distal end portion 451 fits into the entrance on the distal side of the core wire lumen 125 , it is possible to prevent the end of the retrograde guidewire from entering the core wire lumen 125 erroneously. As a result, breakage of the retrograde guidewire can be prevented.
  • the distal shafts 121, 321 and the central shafts 123, 323 are configured separately and are joined together, but the present invention does this.
  • the tip side shafts 121, 321 and the central shafts 123, 323 may be integrally formed.
  • the coil portion 152 of the core wire 150 is configured only by a coil wound with a metal wire, but the present invention is not limited to this. It is also possible to adopt a configuration in which one or more metal wires are wound around one metal wire.
  • catheters of the first embodiment and the third embodiment described above may be combined.
  • the entire front surface of the central shaft 123, 323 is a surface inclined with respect to the axis of the hollow shaft 120, 320, but the present invention is not limited to this,
  • only the distal surface of the central shaft 123, 323 around the guidewire lumen 124, 324 may be angled with respect to the axis of the hollow shaft 120, 320;
  • the wire can be effectively guided through the guidewire lumen 124,324.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Vascular Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

Le but de la présente invention est de permettre de guider de manière appropriée un fil de guidage rétrograde vers le côté d'extrémité de base. La présente invention concerne un cathéter 1 comprenant un élément de maillage 110, une tige creuse 120 reliée à la partie d'extrémité de base de l'élément de maillage 110, une pointe d'extrémité distale 130, et un fil central 150 s'étendant à travers l'élément de maillage 110 et la tige creuse 120 de telle sorte que la partie d'extrémité distale de celui-ci est reliée à la partie d'extrémité distale de l'élément de maillage 110 et l'extrémité de base de celui-ci est située plus loin du côté d'extrémité de base que l'extrémité de base de la tige creuse 120. La tige creuse 120 a un arbre central 123 qui a une lumière pour fil central 125 à travers laquelle un fil central 150 est inséré et une lumière pour fil de guidage 124 à travers laquelle un fil de guidage rétrograde est inséré. Une partie bobine 152 est formée sur le fil central 150 dans une plage sur le côté d'extrémité de base d'une position sur le côté d'extrémité distale par rapport à l'ouverture côté extrémité distale de la lumière pour fil central 125 lorsque l'élément de maille 110 est dans un état expansé.
PCT/JP2021/020289 2021-05-27 2021-05-27 Cathéter WO2022249412A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2021/020289 WO2022249412A1 (fr) 2021-05-27 2021-05-27 Cathéter

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2021/020289 WO2022249412A1 (fr) 2021-05-27 2021-05-27 Cathéter

Publications (1)

Publication Number Publication Date
WO2022249412A1 true WO2022249412A1 (fr) 2022-12-01

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2021/020289 WO2022249412A1 (fr) 2021-05-27 2021-05-27 Cathéter

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Country Link
WO (1) WO2022249412A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2017077323A (ja) * 2015-10-20 2017-04-27 朝日インテック株式会社 カテーテル
WO2018193603A1 (fr) * 2017-04-20 2018-10-25 朝日インテック株式会社 Cathéter
WO2019198210A1 (fr) * 2018-04-12 2019-10-17 朝日インテック株式会社 Cathéter
WO2020003492A1 (fr) * 2018-06-29 2020-01-02 朝日インテック株式会社 Cathéter

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2017077323A (ja) * 2015-10-20 2017-04-27 朝日インテック株式会社 カテーテル
WO2018193603A1 (fr) * 2017-04-20 2018-10-25 朝日インテック株式会社 Cathéter
WO2019198210A1 (fr) * 2018-04-12 2019-10-17 朝日インテック株式会社 Cathéter
WO2020003492A1 (fr) * 2018-06-29 2020-01-02 朝日インテック株式会社 Cathéter

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