Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M25/00—Catheters; Hollow probes

Definitions

• the present invention relates to a coronary catheter.
• Coronary artery catheters are known that are used for coronary angiography and various procedures in coronary arteries.
• Coronary artery catheters are available in various shapes and structures, such as the Judkins type and the Amplatz type.
• Patent Document 1 proposes a coronary artery catheter for right arm access that enables introduction and engagement of the catheter tip from an artery located in the patient's right arm (for example, the radial artery) to the left coronary artery ostium or the right coronary artery ostium. ing.
• the coronary artery catheter for right arm access is introduced from an artery located in the patient's right arm, sequentially passed through the innominate artery and the aorta, and then Introduce the tip of the coronary artery catheter for right arm access into the left or right coronary artery ostium.
• the distal end and the distal end are designed to prevent the distal end of the right arm access coronary artery catheter from being inadvertently disengaged from the left coronary artery ostium and the right coronary artery ostium.
• the angle (bending angle) formed by the bent part formed between the bent part and the straight part located on the proximal end side of the part is set to a predetermined size.
• a left coronary artery catheter and a right coronary artery catheter are proposed that have different external shapes and the above-mentioned bending angles. There is.
• the operator may introduce a coronary artery catheter from the radial artery located in the patient's left arm in order to preserve the radial artery located in the patient's right arm. Therefore, there is currently a need for a coronary artery catheter for left arm access that can be used in combination with both the left coronary artery ostium and the right coronary artery ostium, which can accommodate various blood vessel routes.
• the existing coronary artery catheter for left arm access which can be used in combination with both the left coronary artery ostium and the right coronary artery ostium, may have reduced operability depending on the course of the patient's blood vessels.
• the surgeon prepares a catheter shaped for the left coronary artery and a catheter shaped for the right coronary artery, and uses each catheter properly.
• preparing multiple types of catheters for a procedure and using multiple types of catheters depending on the content of the procedure creates problems such as an increase in the cost of the procedure and an increase in the patient's radiation exposure.
• the existing coronary artery catheter for right arm access which can be used for both the left and right coronary artery ostia and can accommodate various blood vessel routes, can be used for introduction from the left arm artery. It is possible that
• the present invention has been made to solve the above-mentioned problems, and is also excellent in selectively accessing the left coronary artery ostium and the right coronary artery ostium from the left arm artery for patients with various blood vessel routes.
• the purpose of the present invention is to provide a coronary artery catheter that exhibits operability.
• the coronary artery catheter according to the present invention is a coronary artery catheter whose distal end can be introduced from the left arm artery into both the left coronary artery ostium and the right coronary artery ostium, and has a tubular body communicating from the proximal end to the distal end, In its natural state, the tubular body has a substantially linear main body portion and a shaped portion that is bent and shaped at a plurality of locations on substantially the same plane, and the shaped portion is shaped like the main body portion.
• the tubular body has a fourth bent portion and the most distal end portion disposed on the distal side of the fourth bent portion, and in the tubular body, an axis passing through the center line of the main body portion is a first axis.
• a bending start point that is located at the boundary between the first bending part and the tip of the main body part and starts inclining from the first axis toward the second bending part, and the radius of curvature is the largest at the second bending part.
• An axis passing through the small second bending point is a second axis
• an axis passing through the second bending point and a third bending point having the smallest radius of curvature in the third bending part is a third axis
• the third bending point is a third axis.
• An axis passing through the point and a fourth bending point having the smallest radius of curvature in the fourth bending part is defined as a fourth axis
• a line perpendicular to the first axis and passing through the bending start point is defined as a first perpendicular line
• a line perpendicular to the first axis and passing through the second bending point is a second perpendicular
• a line perpendicular to the first axis and passing through the third bending point is a third perpendicular
• the fourth axis is It intersects with the first axis, and the angle between the fourth axis and the third perpendicular is more acute than the angle between the third axis and the second perpendicular, and is in the range of 1° to 30°.
• the longitudinal width of the shaped part in the major axis direction is in the range of 70 mm to 160 mm
• the second perpendicular line is (vertical width of the shaped part in the major axis direction - the second perpendicular line and the first perpendicular line). (distance between the second perpendicular line and the first perpendicular line)/(distance between the second perpendicular line and the first perpendicular line) is located at a position in the range of 1/1 to 1/7.
• the second bending point of the coronary artery catheter bends the shaped portion in the direction opposite to the direction in which the bending start point located near the distal end of the main body bends the shaped portion. Therefore, the second bending point does not overlap the first axis and is located on one side of the shaped portion in the width direction than the first axis.
• the above-mentioned coronary artery catheter is introduced from the left arm artery, and when introduced and engaged into the left coronary artery ostium via the left subclavian artery, the second axis is located on one side in the width direction of the first axis and the shaped part. A predetermined distance can be provided between the bending point and the bending point.
• the above-mentioned coronary artery catheter can prevent the tubular body from interfering with the blood vessel wall of the ascending aorta when the distal end portion is introduced into and engaged with the left coronary artery ostium. Therefore, the above-mentioned coronary artery catheter has excellent operability when introducing and engaging the most distal end into the left coronary artery ostium.
• the second bending point is located on one side in the width direction of the shaped portion rather than the first axis. Therefore, when the above coronary catheter is rotated, the center of rotation is located on the first axis side, which is closer to the center position in the width direction of the shaped portion than the second bending point. Therefore, when the above-mentioned coronary artery catheter is rotated, the operating force applied on the proximal side can be efficiently transmitted to the shaped portion side located on the distal end side of the main body portion.
• the above-mentioned coronary artery catheter has excellent operability when introducing and engaging the most distal end into the left coronary artery ostium and when introducing and engaging the most distal end into the right coronary artery ostium. .
• the third bending point is located between the second bending point and the fourth bending point. Therefore, the above-mentioned coronary artery catheter has a two-stage bending structure in which two intermediate parts, a second intermediate part and a third intermediate part, are formed between the second bending point and the fourth bending point. Therefore, when the above-mentioned coronary artery catheter is introduced from the left arm artery and introduced and engaged into the left coronary ostium via the left subclavian artery, the third bending point causes the shape part to move away from the left blood vessel wall of the ascending aorta. They are arranged in a bent state so that they are spaced apart. Therefore, the above coronary artery catheter can effectively prevent the tubular body from coming into contact with the left blood vessel wall of the ascending aorta when the distal end portion is introduced into and engaged with the left coronary artery ostium.
• the third bending point of the coronary artery catheter bends the shaped portion to the same side as the second bending point at a position on the distal side of the second bending point.
• the third bending point does not overlap the first axis, and is located on one side of the shape portion in the width direction than the first axis.
• the second intermediate portion located between the second bending point and the third bending point is also located on one side in the width direction of the shaped portion with respect to the first axis. Therefore, the above-mentioned coronary artery catheter can prevent the second intermediate portion from coming into contact with the left blood vessel wall of the ascending aorta when the distal end portion is introduced into and engaged with the left coronary artery ostium.
• the angle between the fourth axis and the third perpendicular is more acute than the angle between the third axis and the second perpendicular, and is in the range of 1° to 30°.
• the angle between the third axis and the second perpendicular line is larger than the angle between the fourth axis and the third perpendicular line, so it is introduced from the left arm artery and passes through the left subclavian artery.
• the second intermediate portion located between the second and third inflection points can be positioned to be spaced apart from the left vessel wall of the ascending aorta when introduced and engaged into the left coronary artery ostium via the second inflection point and the third inflection point.
• the above-mentioned coronary artery catheter can effectively prevent the tubular body from coming into contact with the left side blood vessel wall of the ascending aorta when the distal end portion is introduced into and engaged with the left coronary artery ostium.
• the angle between the fourth axis and the third perpendicular line is more acute than the angle between the third axis and the second perpendicular line, and is in the range of 1° to 30°. While preventing the tubular body from coming into contact with the left side blood vessel wall of the ascending aorta, the most distal end located on the distal side of the fourth bending point can be placed toward the left coronary artery ostium. Therefore, the above-mentioned coronary artery catheter can more reliably maintain a state in which the distal end portion is engaged with the left coronary artery ostium.
• the coronary artery catheter since the angle between the fourth axis and the third perpendicular line is in the range of 1° to 30°, it is introduced from the left arm artery and then passes through the left subclavian artery to the right coronary artery.
• the distal end portion located on the distal side of the fourth bending point can be prevented from expanding excessively in the width direction of the shaped portion. Therefore, even when a relatively narrow access route from the left subclavian artery to the right coronary artery ostium is selected, the coronary artery catheter described above can smoothly introduce and engage the distal end at the right coronary artery ostium. .
• the longitudinal width of the shaped part in the longitudinal direction is in the range of 70 mm to 160 mm, when the shaped part is placed in the ascending aorta and the distal end part is engaged with the left coronary artery ostium, It is possible to suitably prevent the shaped portion from coming into contact with the left blood vessel wall of the ascending aorta.
• the second perpendicular line is (vertical width in the long axis direction of the shaped part - distance between the second perpendicular line and the first perpendicular line)/(distance between the second perpendicular line and the first perpendicular line).
• FIG. 1 is a front view of a coronary artery catheter according to an embodiment.
• FIG. 2 is a rear view of the coronary artery catheter according to the embodiment.
• FIG. 1 is a left side view of a coronary artery catheter according to an embodiment.
• FIG. 2 is a right side view of the coronary artery catheter according to the embodiment.
• FIG. 1 is a plan view of a coronary artery catheter according to an embodiment.
• FIG. 2 is a bottom view of the coronary artery catheter according to the embodiment.
• FIG. 1 is an enlarged front view of a coronary catheter according to an embodiment.
• FIG. 1 is an enlarged front view of a coronary catheter according to an embodiment.
• FIG. 1 is an enlarged front view of a coronary catheter according to an embodiment.
• FIG. 1 is an enlarged front view of a coronary catheter according to an embodiment.
• FIG. 1 is an enlarged front view of a coronary catheter according to an embodiment.
• FIG. 1 is an enlarged
• FIG. 1 is an enlarged perspective view of a coronary catheter according to an embodiment.
• 1 is a diagram schematically showing an example of use of a coronary catheter according to an embodiment.
• FIG. 1 is a diagram schematically showing an example of use of a coronary catheter according to an embodiment.
• FIG. 3 is a front view of a coronary artery catheter according to Modification 1.
• FIG. 7 is a rear view of a coronary artery catheter according to Modification 1.
• FIG. 3 is a left side view of a coronary catheter according to Modification 1.
• FIG. FIG. 7 is a right side view of a coronary artery catheter according to Modification 1.
• FIG. 3 is a plan view of a coronary artery catheter according to Modification 1.
• FIG. 7 is a bottom view of a coronary catheter according to Modification 1.
• FIG. 7 is a front view of a coronary artery catheter according to a second modification.
• FIG. 7 is a rear view of a coronary artery catheter according to Modification 2.
• FIG. 7 is a left side view of a coronary artery catheter according to a second modification.
• FIG. 7 is a right side view of a coronary catheter according to Modification 2.
• FIG. FIG. 7 is a plan view of a coronary artery catheter according to a second modification.
• FIG. 7 is a bottom view of a coronary artery catheter according to a second modification.
• FIG. 7 is a front view of a coronary artery catheter according to Modification 3.
• FIG. 7 is a front view of a coronary artery catheter according to Modification 3.
• FIG. 7 is a rear view of a coronary artery catheter according to Modification 3.
• FIG. 7 is a left side view of a coronary catheter according to Modification 3.
• FIG. 7 is a right side view of a coronary catheter according to Modification 3.
• FIG. 7 is a plan view of a coronary catheter according to Modification 3.
• FIG. 7 is a bottom view of a coronary catheter according to Modification 3.
• the range “X to Y” means “more than or equal to X and less than or equal to Y.” Moreover, the range “greater than X and less than Y” shown in this specification does not include X and Y.
• FIG. 1 to 6 are six-sided views of the coronary artery catheter 1 according to the present embodiment.
• FIG. 1 is a front view of a coronary artery catheter 1.
• FIG. 2 is a rear view of the coronary artery catheter 1.
• FIG. 3 is a left side view of the coronary artery catheter 1.
• FIG. 4 is a right side view of the coronary artery catheter 1.
• FIG. 5 is a plan view of the coronary artery catheter 1.
• FIG. 6 is a bottom view of the coronary artery catheter 1. Note that in FIGS. 1 to 6, the parts indicated by solid lines illustrate the design features of the tubular body 10 of the coronary artery catheter 1, and the parts indicated by broken lines illustrate other parts.
• FIGS. 8 and 9 are substantially the same drawings, they are attached to show examples of dimensions of each drawing of the coronary artery catheter 1.
• FIG. 10 is a schematic perspective view showing a part of the distal end side of the coronary artery catheter 1.
• Arrows X1-X2 shown in FIGS. 1 to 10 indicate the longitudinal direction of the tubular body 10.
• the distal end side (the side to be introduced into the living body) of the tubular body 10 is the side shown by arrow X1
• the proximal end side of the tubular body 10 is the side shown by arrow X2.
• arrows Y1-Y2 shown in FIGS. 1 to 10 indicate the width direction of the tubular body 10.
• FIG. 11 and 12 are diagrams for explaining the effects of the coronary artery catheter 1.
• FIG. 11 shows an example of use in which the coronary artery catheter 1 is applied to a procedure for introducing and engaging the left coronary artery ostium B8i.
• FIG. 12 shows an example of use in which the coronary artery catheter 1 is applied to a procedure for introducing and engaging the right coronary artery ostium B9i.
• 11 and 12 schematically show a part of the patient's body together with the coronary artery catheter 1.
• Symbol B1 indicates the left common carotid artery.
• Symbol B2 indicates the left subclavian artery.
• Symbol B3 indicates the right common carotid artery.
• Symbol B4 indicates the right subclavian artery.
• Reference numeral B5 indicates the innominate artery.
• Reference numeral B6 indicates the ascending aorta.
• Reference numeral B7 indicates the descending aorta.
• Reference numeral B8 indicates the left coronary artery.
• Symbol B8i indicates the left coronary artery ostium.
• Symbol B9 indicates the right coronary artery.
• Symbol B9i indicates the right coronary artery ostium.
• the symbol Aa indicates the aortic arch.
• the symbol Lv indicates the left ventricle.
• the symbol Bw1 indicates the left blood vessel wall of the ascending aorta B6.
• the symbol Bw2 indicates the right blood vessel wall of the ascending aorta B6.
• Reference numeral Bw3 indicates the blood vessel wall of the left subclavian artery B2.
• the coronary artery catheter 1 can be applied to any patient having a Type I, Type II, or Type III aortic arch Aa, which is classified based on the relative positional relationship of the left common carotid artery B1, right subclavian artery B4, and brachiocephalic artery B5. It can also be applied to
• Coronary artery catheter 1 is configured such that the most distal end portion 280 can be selectively introduced into both the left coronary artery ostium B8i and the right coronary artery ostium B9i from the artery of the patient's left arm (for example, the radial artery). (See Figures 11 and 12). Coronary artery catheter 1 has its most distal end 280 connected to left coronary artery ostium B8i and right coronary artery ostium B9i via, for example, the radial artery, brachial artery, axillary artery, left subclavian artery B2, and ascending aorta B6 located in the patient's left arm. Can be introduced selectively.
• the coronary artery catheter 1 includes a tubular body 10 communicating from the proximal end to the distal end, and a hub 300 located on the proximal end side of the tubular body 10.
• a lumen 20 is formed inside the tubular body 10.
• a distal end opening 281 communicating with the lumen 20 is formed at the distal end 280 of the tubular body 10 .
• the hub 300 is connected to the base end 110 of the main body 100, as shown in FIGS. 1 and 2.
• the hub 300 can be configured to function as an injection port for injecting a contrast agent or the like into the lumen 20 or an insertion port for inserting a therapeutic device or the like into the lumen 20.
• the tubular body 10 is shaped by bending at multiple locations on substantially the same plane (plane P1 shown in FIG. 10) as the substantially linear main body 100. It has a shaped part 200 attached thereto.
• the above-mentioned "natural state” means an unloaded state in which no external force is applied to the tubular body 10. 1 to 10 show the tubular body 10 in its natural state.
• the tubular body 10 can be constructed of a tubular member having a three-layer structure, for example, an inner layer, a middle layer, and an outer layer.
• the constituent materials of each layer include polyamide resin (for example, nylon 11, nylon 12, nylon 6), polyester polyamide resin, polyether polyamide resin, polyurethane, ABS resin, polyester elastomer resin, polyurethane elastomer resin, and fluorine-based resin. Resins (PFA, PTFE, ETFE, etc.) can be used. In particular, by using ABS resin or nylon as the constituent material of the inner layer, middle layer, and outer layer, appropriate strength can be imparted to each part of the tubular body 10.
• the operability of the guide wire or treatment catheter inserted into the lumen 20 can be improved.
• the tubular body 10 can contain an X-ray opaque material such as barium sulfate, bismuth oxide, or tungsten.
• various reinforcing members such as braid wire, etc.
• a distal tip having higher flexibility than the tubular body 10 can be attached to the distal end portion 280 .
• the outer diameter of the tubular body 10 can be, for example, 1.0 mm to 3.8 mm. Further, the inner diameter of the tubular body 10 can be, for example, 0.8 mm to 3.6 mm.
• tubular body 10 is not limited to the materials and structures exemplified above, and any structure of coronary artery catheters known in the medical field can be adopted.
• the shaped portion 200 includes a first bent portion 210 bent at a position closer to the distal end than the main body portion 100, and a first intermediate portion located closer to the distal end than the first bent portion 210. 220, a second bent part 230 bent toward the opposite side of the first bent part 210 at a position on the distal side of the first intermediate part 220, and a second intermediate part 240 located on the distal side of the second bent part 230. and a third bent part 250 that is bent toward the same side as the second bent part 230 at a position closer to the distal end than the second intermediate part 240, and a third intermediate part 260 that is located closer to the distal end than the third bent part 250.
• a fourth bent part 270 that is bent toward the same side as the third bent part 250 at a position on the distal side of the third intermediate part 260, and a distal end part 280 that is disposed on the distal side of the fourth bent part 270; has.
• bending to the opposite side means bending to the opposite side (same side) when looking at the front end side from each bent part in the front view shown in FIG.
• the second bent part 230, the third bent part 250, and the fourth bent part 270 are each curved in the same direction so that the shaped part 200 draws an arc clockwise, and the first bent part 210 is curved in the opposite direction to each of the bent portions 230, 250, and 270.
• each position of the tubular body 10 is defined as follows (see FIGS. 7, 8, and 9).
• An axis passing through the center line of the main body portion 100 is defined as a first axis A1.
• the first bending part 210 is located at the boundary between the tip of the main body part 100 and starts inclining from the first axis A1 toward the second bending part 230, and from the bending start point Sa.
• the first bending point 210a is also located on the second bending part 230 side and is located at the position where the radius of curvature is the smallest in the first bending part 210.
• the bending start point Sa is located at a position where the first axis A1 overlaps with the outer surface of the tubular body 10 in the plan views shown in FIGS. 7, 8, and 9.
• the axis passing through the bending start point Sa of the first bending part 210 and the second bending point 230a having the smallest radius of curvature in the second bending part 230 is defined as a second axis A2.
• the axis passing through the second bending point 230a and the third bending point 250a having the smallest radius of curvature in the third bending part 250 is defined as a third axis A3.
• the axis passing through the third bending point 250a and the fourth bending point 270a having the smallest radius of curvature in the fourth bending part 270 is defined as a fourth axis A4.
• the fourth bending point 270a is located on the same plane as the bending start point Sa, the second bending point 230a, the third bending point 250a, and the fourth bending point 270a, and The axis passing through the end on the first axis A1 side is defined as a fifth axis A5.
• a line that is perpendicular to the first axis A1 and passes through the bending start point Sa is defined as a first perpendicular line H1.
• a line that is perpendicular to the first axis A1 and passes through the second bending point 230a is a second perpendicular line H2.
• a line that is orthogonal to the first axis A1 and passes through the third bending point 250a is defined as a third perpendicular line H3.
• the region located on the left side of the first axis A1 (the side indicated by the arrow Y1) of the shaped portion 200 is defined as "one side in the width direction.”
• the coronary artery catheter 1 is arranged so that the fourth axis A4 intersects the first axis A1 when each position of the shaped portion 200 is defined as described above (see FIGS. 7 and 8).
• the angle ⁇ a between the fourth axis A4 and the third perpendicular H3 is more acute than the angle ⁇ b between the third axis A3 and the second perpendicular H2, and is within a range of 1° to 30°. (See Figure 8).
• the longitudinal width L1 of the shaped portion 200 in the long axis direction is in the range of 70 mm to 160 mm (see FIG. 7).
• the second perpendicular line H2 is (vertical width L1 in the long axis direction of the shaped portion 200 - distance L3 between the second perpendicular line H2 and first perpendicular line H1.
• vertical width L1 - distance L3 is defined as “distance L2.” (See Figure 7).
• the distance L2/distance L3 is more preferably in the range of 1/1.5 to 1/4.
• the angle ⁇ a is 5° to 25°. In the coronary artery catheter 1 of this embodiment, the angle ⁇ a is 21°.
• the angle ⁇ b is preferably 60° to 75°. In the coronary artery catheter 1 of this embodiment, the angle ⁇ b is 70°. Note that the size of the angle ⁇ b is not particularly limited as long as the angle ⁇ a is more acute than the angle ⁇ b.
• the vertical width L1 is 80 mm to 122 mm.
• Distance L2 is preferably 20 mm to 35 mm on the premise that distance L2/distance L3 is in the range of 1/1 to 1/7.
• the distance L3 is preferably 40 mm to 102 mm.
• the coronary artery catheter 1 of this embodiment has a vertical width L1 of 112 mm, a distance L2 of 33 mm, and a distance L3 of 79 mm.
• the coronary artery catheter 1 has a two-stage bending structure in which two intermediate parts, the second intermediate part 240 and the third intermediate part 260, are formed between the second bending point 230a and the fourth bending point 270a.
• the width W1 of the shaped portion 200 shown in FIG. 7 is 41 mm to 58 mm.
• the ratio (W2/W1) of the maximum width W2 from the first axis A1 to the second bending portion 230 on the second perpendicular line H2 to the width W1 of the shaped portion 200 is 1/2 to 1/2. It is preferable that it is 4.
• the width W1 is 44 mm to 50 mm.
• the coronary artery catheter 1 of this embodiment has a width W1 of 44 mm. Note that the width W1 means the maximum width of the shaped portion 200 in the front view shown in FIG.
• the maximum width W2 is preferably 11 mm to 29 mm, assuming that the ratio (W2/W1) is 1/2 to 1/4 when the width W1 is 41 mm to 58 mm.
• the coronary artery catheter 1 of this embodiment has a maximum width W2 of 20 mm.
• the angle between the first axis A1 and the second axis A2 is defined as a first angle ⁇ 1.
• the angle formed by the second axis A2 and the third axis A3 is defined as a second angle ⁇ 2.
• the angle formed by the third axis A3 and the fourth axis A4 is defined as a third angle ⁇ 3.
• the angle formed by the fourth axis A4 and the fifth axis A5 is defined as a fourth angle ⁇ 4.
• the coronary artery catheter 1 is configured such that the fourth angle ⁇ 4 is smaller than the third angle ⁇ 3, the third angle ⁇ 3 is smaller than the second angle ⁇ 2, and the second angle ⁇ 2 is smaller than the first angle ⁇ 1. I can do it. Furthermore, when the magnitude relationship of the first angle ⁇ 1, the second angle ⁇ 2, the third angle ⁇ 3, and the fourth angle ⁇ 4 is defined as described above, the coronary artery catheter 1 is aligned with the fourth axis A4 shown in FIG.
• the straight line distance L4 between the third bending point 250a and the fourth bending point 270a along the third axis A3 is one or more times the straight line distance L5 between the second bending point 230a and the third bending point 250a along the third axis A3. It can be configured so that it is less than
• the first angle ⁇ 1 is preferably greater than 155° and less than 175°. Further, the first angle ⁇ 1 is more preferably 160° or more and 173° or less. In the coronary artery catheter 1 of this embodiment, the first angle ⁇ 1 is 168°.
• the second intermediate portion 240 comes into contact with the left blood vessel wall Bw1 of the ascending aorta B6. It becomes easier to do.
• the first angle ⁇ 1 is 175° or more
• the bending of the first bending portion 210 becomes excessively tight, making it difficult to cause the distal end portion 280 to reach the left coronary artery ostium B8i.
• the second angle ⁇ 2 is preferably greater than 120° and less than 160°. Moreover, it is more preferable that the second angle ⁇ 2 is 130° or more and 155° or less. In the coronary artery catheter 1 of this embodiment, the second angle ⁇ 2 is 148°.
• the third angle ⁇ 3 formed by the third bending portion 250 located on the distal side of the second bending portion 230 becomes sharp, and the third angle ⁇ 3 at the third bending portion 250 becomes sharp.
• the degree of bending becomes too large. Therefore, when the most distal end portion 280 of the coronary artery catheter 1 is engaged with the right coronary artery ostium B9i, the range in which the most distal end portion 280 is engaged with the right coronary artery ostium B9i becomes narrower. It becomes easier to get out of it.
• the second angle ⁇ 2 is 120° or less
• the distal end portion 280 is engaged with the left coronary artery ostium B8i
• the second intermediate portion 240 comes into contact with the left blood vessel wall Bw1 of the ascending aorta B6. It becomes easier to do.
• the range in which the most distal end portion 280 is engaged with the left coronary artery ostium B8i becomes narrower, so that the most distal end portion 280 easily slips out from the left coronary artery ostium B8i.
• the third angle ⁇ 3 is preferably greater than 112° and less than 155°. Further, the third angle ⁇ 3 is more preferably 120° or more and 140° or less. In the coronary artery catheter 1 of this embodiment, the third angle ⁇ 3 is 131°.
• the third intermediate portion 260 is largely separated from the left blood vessel wall Bw1 of the ascending aorta B6 when the distal end portion 280 is introduced into the right coronary artery ostium B9i. It will be arranged like this. Therefore, in the coronary artery catheter 1, when the third angle ⁇ 3 is 155° or more, it becomes difficult to introduce the most distal end portion 280 into the left coronary artery ostium B8i. Further, in the coronary artery catheter 1, when the third angle ⁇ 3 is 112° or less, the angle of the third bending portion 250 becomes too small.
• the range in which the most distal end portion 280 is engaged with the right coronary artery ostium B9i becomes narrower, and the most distal end portion 280 is separated from the right coronary artery ostium B9i. It becomes easier to get out.
• the fourth angle ⁇ 4 is preferably greater than 50° and less than 130°. Moreover, it is more preferable that the fourth angle ⁇ 4 is 70° or more and 115° or less. In the coronary artery catheter 1 of this embodiment, the fourth angle ⁇ 4 is 96°.
• the coronary artery catheter 1 When the fourth angle ⁇ 4 is 130° or more, the coronary artery catheter 1 is placed so that the most distal end portion 280 is separated from the left coronary artery ostium B8i when the most distal end portion 280 is introduced into the left coronary artery ostium B8i. Therefore, in the coronary artery catheter 1, when the fourth angle ⁇ 4 is 130° or more, it becomes difficult to introduce the most distal end portion 280 into the left coronary artery ostium B8i. Further, in the coronary artery catheter 1, when the fourth angle ⁇ 4 is 50° or less, the angle of the fourth bending portion 270 becomes too small.
• the range in which the most distal end portion 280 is engaged with the right coronary artery ostium B9i becomes narrower, and the most distal end portion 280 is separated from the right coronary artery ostium B9i. It becomes easier to get out.
• the straight line distance L4 shown in FIG. 8 is preferably 20 mm to 40 mm, on the premise that it is at least one time and less than twice the straight line distance L5.
• the straight-line distance L4 is 30 mm.
• the straight line distance L5 shown in FIG. 8 is preferably 11 mm to 35 mm. In the coronary artery catheter 1 of this embodiment, the straight-line distance L5 is 22 mm.
• the most extreme portion 280 can be arranged to be located closer to the fourth bent portion 270 than the third perpendicular H3 in the longitudinal direction of the shaped portion 200. That is, the most distal end portion 280 can be disposed closer to the distal end in the longitudinal direction than the third perpendicular line H3.
• the first intermediate portion 220 is curved toward the side away from the first axis A1 (the side indicated by the arrow Y1). Further, the second intermediate portion 240 is curved toward the side closer to the first axis A1 (the side indicated by the arrow Y2).
• the third intermediate portion 260 is curved toward the fourth bent portion 270 located on the distal side of the third bent portion 250.
• the most distal end portion 280 is curved so as to be folded back toward the proximal end side at a fourth bending point 270a.
• the third intermediate portion 260 may extend substantially linearly between the third bent portion 250 and the fourth bent portion 270.
• the first intermediate portion 220 intersects with the second axis A2, which is a straight line connecting the bending start point Sa and the second bending point 230a. Further, a part of the first intermediate portion 220 on the bending start point Sa side is located closer to the first axis A1 than the second axis A2.
• the first bending point 210a of the first bending portion 210 is located between the first axis A1 and the second axis A2. Therefore, in the region between the bending start point Sa and the second bending point 230a, the shaped part 200 has a part of the first bending part 210 and the first intermediate part 220 between the first axis A1 and the second axis A2. configured to be located. Therefore, as shown in FIG.
• the coronary artery catheter 1 when the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2 and the distal end portion 280 is introduced into the left coronary artery ostium B8i, the coronary artery catheter 1 has a shape that The section 200 can be oriented toward the ascending aorta B6 side. Thereby, the coronary artery catheter 1 can be configured so that the second bending part 230 and the third bending part 250 do not come into contact with the blood vessel walls Bw1 and Bw2 of the ascending aorta B6.
• FIG. 11 shows the state when the distal end portion 280 of the coronary artery catheter 1 is introduced and engaged into the left coronary artery ostium B8i.
• FIG. 12 shows the state when the distal end portion 280 of the coronary artery catheter 1 is introduced and engaged into the right coronary artery ostium B9i.
• the second bending point 230a of the coronary artery catheter 1 bends the shaped part 200 in the direction opposite to the direction in which the bending start point Sa located near the distal end of the main body part 100 bends the shaped part 200 (FIG. 7, (see Figure 8). Therefore, the second bending point 230a does not overlap with the first axis A1, and is located on one side of the width direction of the shaped portion 200 (the first axis A1 shown in FIGS. 7, 8, and 9) than the first axis A1. located on the left side). As shown in FIG.
• the coronary artery catheter 1 is introduced from the left arm artery, and when introduced and engaged into the left coronary artery ostium B8i via the left subclavian artery B2, the first axis A1 and the width of the shaped portion 200 A predetermined distance may be provided between the second bending point 230a located on one side of the direction.
• the coronary artery catheter 1 can suppress the tubular body 10 from coming into contact with the blood vessel walls Bw1 and Bw2 of the ascending aorta B6 when the distal end portion 280 is introduced and engaged into the left coronary artery ostium B8i. Therefore, the coronary artery catheter 1 has excellent operability when introducing and engaging the distal end portion 280 into the left coronary artery ostium B8i.
• the second bending point 230a is located on one side in the width direction of the shaped portion 200 than the first axis A1 (see FIGS. 7 and 8). Therefore, when the coronary artery catheter 1 is rotated with respect to the first axis A1, the coronary artery catheter 1 is rotated near the first axis A1, which is located closer to the center position in the width direction of the shaped portion 200 than the second bending point 230a. The center is located. Therefore, when the coronary artery catheter 1 is rotated, the operating force applied on the proximal side can be efficiently transmitted to the shaped part 200 side located on the distal end side of the main body part 100.
• the coronary artery catheter 1 has excellent operability when introducing and engaging the most distal end 280 into the left coronary artery ostium B8i and when introducing and engaging the most distal end 280 into the right coronary artery ostium B9i. Become something.
• the coronary artery catheter 1 has a two-stage bending structure in which two intermediate parts, the second intermediate part 240 and the third intermediate part 260, are formed between the second bending point 230a and the fourth bending point 270a.
• the coronary artery catheter 1 is introduced from the left arm artery and is introduced and engaged into the left coronary artery ostium B8i via the left subclavian artery B2, the shaped portion 200 is bent by the third bending point 250a.
• the coronary artery catheter 1 can effectively prevent the tubular body 10 from coming into contact with the left blood vessel wall Bw1 of the ascending aorta B6 when the distal end portion 280 is introduced into and engaged with the left coronary artery ostium B8i.
• the third bending point 250a of the coronary artery catheter 1 bends the shaped portion 200 to the same side as the second bending point 230a at a position on the distal side of the second bending point 230a.
• the third bending point 250a like the second bending point 230a, does not overlap with the first axis A1 and is located on one side of the shape portion 200 in the width direction than the first axis A1.
• the second intermediate portion 240 located between the second bending point 230a and the third bending point 250a is also located on one side in the width direction of the shaped portion 200 with respect to the first axis A1. Therefore, as shown in FIG.
• the coronary artery catheter 1 prevents the second intermediate portion 240 from coming into contact with the left blood vessel wall Bw1 of the ascending aorta B6 when the distal end portion 280 is introduced and engaged into the left coronary artery ostium B8i. can be suppressed.
• the angle ⁇ a between the fourth axis A4 and the third perpendicular H3 is more acute than the angle ⁇ b between the third axis A3 and the second perpendicular H2, and is within a range of 1° to 30°. (See Figure 8).
• the angle ⁇ a between the third axis A3 and the second perpendicular H2 is larger than the angle ⁇ b between the fourth axis A4 and the third perpendicular H3, so as shown in FIG.
• the ascending aorta B6 passes through the second intermediate portion 240 located between the second bending point 230a and the third bending point 250a. It can be arranged so as to be spaced apart from the left blood vessel wall Bw1. Therefore, the coronary artery catheter 1 can effectively prevent the tubular body 10 from coming into contact with the left blood vessel wall Bw1 of the ascending aorta B6 when the distal end portion 280 is introduced into the left coronary artery ostium B8i.
• the angle ⁇ a between the fourth axis A4 and the third perpendicular line H3 is more acute than the angle ⁇ b between the third axis A3 and the second perpendicular line H2, and the angle ⁇ a is between 1° and 30°.
• the most extreme part 280 is located on the distal side of the fourth bending point 270a while preventing the tubular body 10 from coming into contact with the left blood vessel wall Bw1 of the ascending aorta B6. can be placed toward the left coronary artery ostium B8i. Therefore, the coronary artery catheter 1 can more reliably maintain the state in which the distal end portion 280 is engaged with the left coronary artery ostium B8i.
• the coronary artery catheter 1 is introduced from the left arm artery and then passed through the left subclavian artery B2.
• the distal end portion 280 located on the distal side of the fourth bending point 270a can be prevented from expanding excessively in the width direction of the shaped portion 200. That is, the width W' formed when approaching the right coronary artery ostium B9i shown in FIG. 12 can be suppressed within a predetermined range.
• the coronary artery catheter 1 smoothly introduces and engages the most distal end portion 280 into the right coronary artery ostium B9i. be able to.
• the longitudinal width L1 of the shaped portion 200 in the longitudinal direction is in the range of 70 mm to 160 mm (see FIG. 7). Therefore, as shown in FIG. 11, when the coronary artery catheter 1 places a part of the shaped portion 200 in the ascending aorta B6 and introduces and engages the distal end portion 280 into the left coronary artery ostium B8i, the left subclavian artery B2 The vertical distance L' of the shaped portion 200 located between the left coronary artery ostium B8i and the left coronary artery ostium B8i can be maintained at a predetermined value.
• the coronary artery catheter 1 can suitably prevent the shaped portion 200 from coming into contact with the left blood vessel wall Bw1 of the ascending aorta B6. Furthermore, in the coronary artery catheter 1, the second perpendicular line H2 is located at a position where the distance L2/distance L3 is in the range of 1/1 to 1/7 (see FIG. 7). Therefore, when the coronary artery catheter 1 places the shaped portion 200 in the ascending aorta B6 and introduces and engages the distal end portion 280 into the left coronary artery ostium B8i, the second bent portion 230 and the third bent portion 250 are arranged in the ascending aorta B6. It is possible to suitably prevent contact with the left side blood vessel wall Bw1.
• the coronary artery catheter 1 is configured as a coronary artery catheter in which the distal end portion 280 can be introduced from the left arm artery into both the left coronary artery ostium B8i and the right coronary artery ostium B9i.
• Coronary artery catheter 1 has a tubular body 10 that communicates from the proximal end to the distal end. In its natural state, the tubular body 10 has a substantially linear main body portion 100 and a shaped portion 200 that is bent and shaped at a plurality of locations on substantially the same plane P1.
• the shaped portion 200 includes a first bent portion 210 bent at a position closer to the distal end than the main body portion 100 , a first intermediate portion 220 located closer to the distal end than the first bent portion 210 , and a first intermediate portion 220 bent at a position closer to the distal end than the first bent portion 210 .
• a second bent part 230 bent toward the opposite side of the first bent part 210 at a position on the distal side; a second intermediate part 240 located on the distal side of the second bent part 230; a third bent portion 250 bent toward the same side as the second bent portion 230 at a side position; a third intermediate portion 260 located on the distal side of the third bent portion 250; It has a fourth bent part 270 that is bent toward the same side as the third bent part 250 at the position, and a most distal end part 280 that is disposed on the distal side of the fourth bent part 270.
• the first axis A1 is an axis passing through the center line of the main body 100, and is located at the boundary with the tip of the main body 100 at the first bent part 210, and extends from the first axis A1 to the second bent part 230.
• the second axis A2 is an axis passing through the bending start point Sa where the inclination starts towards the direction and the second bending point 230a with the smallest radius of curvature in the second bending part 230.
• the axis passing through the third bending point 250a with the smallest radius of curvature is called a third axis A3
• the axis passing between the third bending point 250a and the fourth bending point 270a with the smallest radius of curvature in the fourth bending part 270 is called a fourth axis.
• a line perpendicular to the first axis A1 and passing through the bending start point Sa is the first perpendicular H1
• a line perpendicular to the first axis A1 and passing through the second bending point 230a is the second perpendicular H2
• the third perpendicular line H3 is a line that is orthogonal to the first axis A1 and passes through the third bending point 250a
• the fourth axis A4 intersects the first axis A1
• the fourth axis A4 and the third perpendicular line H3 are The angle ⁇ a formed is more acute than the angle ⁇ b formed between the third axis A3 and the second perpendicular line H2, and is in the range of 1° to 30°
• the longitudinal width L1 of the shaped portion 200 in the long axis direction is 70 mm to 30°.
• the range is 160 mm
• the second perpendicular line H2 is located at a position where distance L2/distance L3 is
• the coronary artery catheter 1 configured as described above is introduced from the left arm artery, and the distal end portion 280 is introduced and engaged into the left coronary artery ostium B8i and the right coronary artery ostium B9i via the left subclavian artery B2 and the ascending aorta B6.
• This provides superior operability in procedures.
• excellent operability means that the distal end portion 280 can be smoothly introduced and engaged into the left coronary artery ostium B8i and the right coronary artery ostium B9i by a simple operation such as pushing and pulling the tubular body 10.
• the torque transmission performance to the leading edge portion 280 is high.
• the torque transmission performance to the leading edge portion 280 is high.
• the tubular body 10 is inserted into the other right coronary artery ostium B9i.
• Angiography may be performed by engaging the most distal end 280 and injecting a contrast agent from the most distal end 280.
• the operator grasps the hub 300 with the shaped portion 200 located in the ascending aorta B6 and descending aorta B7.
• the shaped portion 200 is rotated and the distal end portion 280 is moved.
• the coronary artery catheter 1 configured as described above, when the shaped part 200 rotates, the shaped part 200 and the left blood vessel wall Bw1 of the ascending aorta B6 and the right blood vessel wall Bw2 of the ascending aorta B6.
• the coronary artery catheter 1 Since the contact (friction) with the hub 300 is small, the rotation of the hub 300 can be efficiently transmitted to the distal end portion 280.
• the coronary artery catheter 1 has excellent operability, so that it is possible to shorten the procedure time and reduce the patient's radiation exposure and stress.
• an existing coronary artery catheter (hereinafter referred to as a "dual catheter") that has a shape that can be introduced into the left coronary artery ostium B8i and the right coronary artery ostium B9i by access from the right arm is introduced from the left arm artery and left
• a portion of the dual-use catheter may unintentionally interfere with the blood vessel wall or the like. If a portion of the dual-purpose catheter unintentionally interferes with a blood vessel wall or the like, frictional resistance during operation of the dual-purpose catheter increases.
• the width W1 of the shaped portion 200 is in the range of 41 mm to 58 mm. Further, the ratio (W2/W1) of the maximum width W2 from the first axis A1 to the second bent portion 230 on the second perpendicular line H2 to the width W1 of the shaped portion 200 is 1/2 to 1/4. Since the width W1 of the coronary artery catheter 1 is in the range of 41 mm to 58 mm, when the distal end portion 280 is introduced and engaged into the left coronary artery ostium B8i as shown in FIG. 11, the shaped portion 200 is separated from the ascending aorta B6. It has a curved shape.
• the ratio (W2/W1) is 1/2 to 1/4, the widthwise expansion of the shaped portion 200 can be suppressed within a predetermined range based on the first axis A1. Therefore, when introducing and engaging the most distal end 280 into the left coronary artery ostium B8i, as shown in FIG. can be directed toward the left coronary artery ostium B8i. This allows the coronary artery catheter 1 to more smoothly introduce and engage the distal end portion 280 into the left coronary artery ostium B8i.
• the angle between the first axis A1 and the second axis A2 is a first angle ⁇ 1
• the angle between the second axis A2 and the third axis A3 is a second angle ⁇ 2.
• the angle formed by the third axis A3 and the fourth axis A4 is a third angle ⁇ 3, and the fourth axis A4, the bending start point Sa, the second bending point 230a, the third bending point 250a, and the fourth bending point 270a
• the angle formed by the fifth axis A5 which is located on the same plane as the tip of the tip and passes through the end of the tip end position 280a of the tip end portion 280 on the first axis A1 side, is the fourth angle ⁇ 4, then The angle ⁇ 4 is smaller than the third angle ⁇ 3, the third angle ⁇ 3 is smaller than the second angle ⁇ 2, and the second angle ⁇ 2 is smaller than the first angle ⁇ 1.
• the bending of the shaped portion 200 becomes tighter toward the distal end portion 280. Therefore, when the coronary artery catheter 1 introduces and engages the most distal end portion 280 into the left coronary artery ostium B8i, the first bent portion 210, the first intermediate portion 220, the second bent portion 230, the second intermediate portion 240, the third While suppressing the bending part 250 and the third intermediate part 260 from coming into contact with the ascending aorta B6, the distal end part 280, which is bent at the most acute angle than the other bending parts, can be arranged so as to be hooked on the left coronary artery ostium B8i.
• the shaped portion 200 becomes more curved toward the most distal end 280, the return stress (stress that attempts to restore the shape to its natural state) when the shaped portion 200 is stretched into a substantially straight line is applied to the most distal end. It gets bigger as you go to 280. Therefore, in the coronary artery catheter 1, the backup force for maintaining the state in which the distal end portion 280 is engaged with the left coronary artery ostium B8i is improved.
• the linear distance L4 between the third bending point 250a and the fourth bending point 270a along the fourth axis A4 is the same as that between the second bending point 230a and the third bending point 250a along the third axis A3.
• the straight line distance L5 is at least 1 time and less than 2 times. Therefore, while suppressing the second intermediate portion 240 located between the second bending point 230a and the third bending point 250a from coming into contact with the ascending aorta B6, the third intermediate portion located on the distal side of the third bending point 250a is suppressed. While moving the intermediate portion 260 closer to the left coronary artery ostium B8i based on the third bending point 250a, the distal end portion 280 located on the distal side of the third intermediate portion 260 is engaged to a deeper position of the left coronary artery ostium B8i. becomes possible. Thereby, in the coronary artery catheter 1, since the distal end portion 280 contacts the left coronary artery ostium B8i over a wider range, the backup force against the left coronary artery ostium B8i is improved.
• the fourth angle ⁇ 4 is greater than 50° and less than 130°. Therefore, as shown in FIG. 11, the coronary artery catheter 1 preferably maintains the state in which the most distal end portion 280 is hooked to the left coronary artery ostium B8i when the distal end portion 280 is introduced into and engaged with the left coronary artery ostium B8i. be able to. Further, the coronary artery catheter 1 can be arranged so that the most distal end portion 280 remains coaxial with the left coronary artery ostium B8i when the most distal end portion 280 is introduced into and engaged with the left coronary artery ostium B8i.
• the coronary artery catheter 1 effectively prevents the distal end portion 280 from slipping out from the left coronary artery ostium B8i when the contrast agent is discharged with the distal end portion 280 introduced into the left coronary artery ostium B8i and engaged. can. Furthermore, since the fourth angle ⁇ 4 is greater than 50° and less than 130°, as shown in FIG. Therefore, the most distal end portion 280 located on the distal side of the fourth bending point 270a can be appropriately positioned toward the right coronary artery ostium B9i side.
• the distal end portion 280 is located closer to the fourth bent portion 270 than the third perpendicular line H3 in the longitudinal direction of the shaped portion 200. Therefore, when introducing the tubular body 10 from the left subclavian artery B2, as shown in FIG. By a simple operation of moving the tubular body 10 upward and then pulling it upward, it becomes possible to introduce and engage the distal end portion 280 into the left coronary artery ostium B8i.
• the coronary artery catheter 1 is bent at the second bend.
• the portion 230 and the third bent portion 250 may be configured so as not to contact the blood vessel walls Bw1 and Bw2 of the ascending aorta B6.
• the coronary artery catheter 1 is such that when the most distal end portion 280 is introduced into the left coronary artery ostium B8i, the second bent portion 230 and the third bent portion 250 come into contact with the ascending aorta B6.
• the coronary artery catheter 1 is configured such that when the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2 and the distal end portion 280 is introduced into the right coronary artery ostium B9i,
• the second bending portion 230 may be configured to contact the left blood vessel wall Bw1 of the ascending aorta B6.
• the second bending portion 230 is supported by the left blood vessel wall Bw1 of the ascending aorta B6 in a state in which the most distal end portion 280 is introduced into and engaged with the right coronary artery ostium B9i. Therefore, the backup force of the distal end portion 280 against the right coronary artery ostium B9i can be increased.
• the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2, and the distal end portion 280 is inserted into the left coronary artery ostium B8i or the right coronary artery ostium B9i.
• the first bent portion 210 can be configured to be located at a position where it contacts the blood vessel wall Bw3 of the left subclavian artery B2 or at the aortic arch Aa.
• Coronary artery catheter 1 is configured such that when the most distal end portion 280 is introduced into left coronary artery ostium B8i or right coronary artery ostium B9i, first bent portion 210 comes into contact with blood vessel wall Bw3 of left subclavian artery B2.
• first bent portion 210 comes into contact with blood vessel wall Bw3 of left subclavian artery B2.
• the operating force applied on the proximal side for example, the rotational force during rotational operation
• the distal side of the main body portion 100 It becomes possible to transmit the information satisfactorily to the side of the shaped portion 200.
• the coronary artery catheter 1 can smoothly introduce and engage the most distal end portion 280 into the left coronary artery ostium B8i or the right coronary artery ostium B9i.
• the first intermediate portion 220 intersects with the second axis A2, which is a straight line connecting the bending start point Sa and the second bending point 230a. Further, a part of the first intermediate portion 220 on the bending start point Sa side is located closer to the first axis A1 than the second axis A2. Therefore, as shown in FIG. 11, when the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2 and the distal end portion 280 is introduced into the left coronary artery ostium B8i, the coronary artery catheter 1 has a shape that The section 200 can be directed toward the ascending aorta B6.
• the second bending part 230 and the third bending part 250 can be configured so as not to contact the blood vessel walls Bw1 and Bw2 of the ascending aorta B6. Therefore, in the coronary artery catheter 1 configured as described above, when the operation of introducing the distal end portion 280 into the left coronary artery ostium B8i is performed, the second bending portion 230 and the third bending portion 250 are connected to the ascending aorta B6. Deterioration of operability due to contact can be suppressed.
• the coronary artery catheters 1A, 1B, and 1C according to the modified examples have a shape portion 200 different from the coronary artery catheter 1 according to the embodiment described above. In other respects, it is substantially the same as the coronary artery catheter 1. In each modification, explanations other than the differences in shape will be omitted as appropriate.
• Coronary artery catheters 1A, 1B, and 1C according to each modified example have the fourth axis A4 that intersects the first axis A1, and the fourth axis A4 and the third axis of the coronary artery catheter 1 according to the embodiment described above.
• the angle ⁇ a formed by the perpendicular line H3 is more acute than the angle ⁇ b formed by the third axis A3 and the second perpendicular line H2, and is in the range of 1° to 30°
• the longitudinal width L1 of the shaped portion 200 in the longitudinal direction is in the range of 70 mm to 160 mm
• the second perpendicular line H2 is located at a position where distance L2/distance L3 is in the range of 1/1 to 1/7.
• Coronary artery catheters 1A, 1B, and 1C according to each modification have the above-described structure, so that the distal end portion 280 can be introduced and engaged from the left arm artery to both the left coronary artery ostium B8i and the right coronary artery ostium B9i. .
• the coronary artery catheter 1 has the advantages described in the embodiment described above when introducing and engaging the distal end portion 280 from the left arm artery to the left coronary artery ostium B8i and the right coronary artery ostium B9i. It is possible to demonstrate excellent operability.
• FIG. 13 is a front view of a coronary catheter 1A according to modification 1.
• FIG. 14 is a rear view of a coronary catheter 1A according to Modification 1.
• FIG. 15 is a left side view of a coronary catheter 1A according to modification 1.
• FIG. 16 is a right side view of a coronary catheter 1A according to Modification 1.
• FIG. 17 is a plan view of a coronary artery catheter 1A according to modification 1.
• FIG. 18 is a bottom view of a coronary catheter 1A according to Modification 1.
• the parts indicated by solid lines illustrate the design characteristic parts of the tubular body 10 of the coronary artery catheter 1A according to Modification Example 1, and the parts indicated by broken lines illustrate other parts. are doing.
• the coronary artery catheter 1A has an angle ⁇ a of 19°, an angle ⁇ b of 69°, a vertical width L1 of 117 mm, a distance L2 of 33 mm, a distance L3 of 84 mm, and a horizontal width W1 of 47 mm.
• the maximum width W2 is 17 mm
• the first angle ⁇ 1 is 170°
• the second angle ⁇ 2 is 150°
• the third angle ⁇ 3 is 132°
• the fourth angle ⁇ 4 is 108°
• the distance L4 is 31 mm
• the straight line distance L5 is 23 mm.
• FIG. 19 is a front view of a coronary artery catheter 1B according to a second modification.
• FIG. 20 is a rear view of a coronary artery catheter 1B according to a second modification.
• FIG. 21 is a left side view of a coronary artery catheter 1B according to a second modification.
• FIG. 22 is a right side view of a coronary artery catheter 1B according to a second modification.
• FIG. 23 is a plan view of a coronary artery catheter 1B according to a second modification.
• FIG. 24 is a bottom view of a coronary artery catheter 1B according to a second modification.
• the parts indicated by solid lines illustrate the design characteristic parts of the tubular body 10 of the coronary catheter 1B according to Modification 2
• the parts indicated by broken lines illustrate other parts. are doing.
• the coronary artery catheter 1B has an angle ⁇ a of 9°, an angle ⁇ b of 67°, a vertical width L1 of 110 mm, a distance L2 of 33 mm, a distance L3 of 77 mm, and a horizontal width W1 of 50 mm.
• the maximum width W2 is 20 mm
• the first angle ⁇ 1 is 167°
• the second angle ⁇ 2 is 144°
• the third angle ⁇ 3 is 122°
• the fourth angle ⁇ 4 is 105°
• the distance L4 is 31 mm
• the straight line distance L5 is 28 mm.
• FIG. 25 is a front view of a coronary artery catheter 1C according to modification 3.
• FIG. 26 is a rear view of a coronary artery catheter 1C according to modification 3.
• FIG. 27 is a left side view of a coronary catheter 1C according to modification 3.
• FIG. 28 is a right side view of a coronary catheter 1C according to modification 3.
• FIG. 29 is a plan view of a coronary catheter 1C according to modification 3.
• FIG. 30 is a bottom view of a coronary artery catheter 1C according to modification 3.
• the parts indicated by solid lines illustrate the design characteristic parts of the tubular body 10 of the coronary artery catheter 1C according to Modification 3, and the parts indicated by broken lines illustrate other parts. are doing.
• Coronary artery catheter 1C has an angle ⁇ a of 11°, an angle ⁇ b of 67°, a vertical width L1 of 88 mm, a distance L2 of 29 mm, a distance L3 of 59 mm, and a horizontal width W1 of 49 mm.
• the maximum width W2 is 17 mm
• the first angle ⁇ 1 is 166°
• the second angle ⁇ 2 is 144°
• the third angle ⁇ 3 is 125°
• the fourth angle ⁇ 4 is 107°
• the straight line The distance L4 is 32 mm
• the straight line distance L5 is 21 mm.

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