JP2016096869A - Balloon catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a balloon catheter capable of effectively expanding a narrow section while preventing a balloon from sliding, in which an element to prevent the balloon from sliding does not interfere with a bent part of a blood vessel or other devices, or drop.SOLUTION: A balloon catheter includes an outer shaft 10, a balloon 30 connected to the tip of the outer shaft 10, an inner tube 40 inserted into a lumen of the outer shaft 10 and the inside of the balloon 30 that forms a guide wire lumen, and an element 50 to prevent the balloon from sliding fastened to the outer peripheral surface of the inner tube 40 that projects to the outside in the radial direction of the inner tube 40 and presses the inner surface of the balloon 30 when the balloon 30 is expanded.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a balloon catheter.

  For a balloon catheter used for performing angioplasty on a lesion (stenosis) in a blood vessel, it is desired to effectively expand the stenosis while preventing the balloon from slipping.

Here, as a balloon catheter for effectively expanding a stenosis, a balloon catheter (cutting balloon catheter) formed by mounting a plurality of incisors provided with cutting blades on the outer surface of the balloon is disclosed (Patent Document). 1).
According to such a balloon catheter, the stenosis portion is cut by the cutting blade when the balloon is expanded, so that the stress of the blood vessel being expanded can be relaxed and the stenosis portion can be effectively expanded.

However, the balloon catheter described in Patent Document 1 is disadvantageous in that a special mounting portion (cutting device) must be provided to fix the cutting blade to the balloon.
It is also conceivable that the cutting blade falls off the balloon.

  As a balloon catheter for angiogenesis that can solve such problems and prevent the balloon from slipping, it is a flexible catheter that extends from the rear end of the balloon to the tip while being separated from the outer surface of the balloon. An element in which a plurality of elongated elements (anti-slip elements) are provided at a plurality of (three locations) at equal angular intervals along the circumferential direction of the balloon is disclosed (Patent Document 2).

  According to such a balloon catheter, by expanding the balloon, the anti-slip element bonded to both ends of the balloon is moved in the radial direction of the balloon and meshed with the lesion, thereby longitudinally moving the lesion. An axial channel is formed, which can prevent the balloon from moving (sliding) in the axial direction when the balloon is expanded.

JP-A-5-293176 Japanese Patent No. 4309286

  However, the balloon catheter described in Patent Document 2 has the following problems.

  In other words, the anti-slip element before the balloon catheter is used (before the balloon is expanded) is covered with the balloon in a folded state. The anti-slip element, which is glued only at the end (not glued to the outer surface of the balloon other than the tip and rear ends), is loosened away from the outer surface of the balloon, expanding the balloon It is difficult to return to the previous state.

  For this reason, when the balloon catheter in such a state is inserted into the blood vessel toward the next lesion, the anti-slip element in a state of being loosened away from the outer surface of the balloon is caught by the bent portion of the blood vessel. The penetrability of the balloon catheter is significantly impaired.

  In addition, another device can be inserted into the front end of the balloon while the anti-slip element is spaced from the outer surface of the balloon, or the balloon catheter can be pulled back with another device on the rear end of the balloon. In doing so, the anti-slip element that is loosened away from the outer surface of the balloon is caught on the other device (the other device enters between the outer surface of the balloon and the anti-slip element), and the other device. Or the balloon catheter may be damaged (including slipping of the anti-slip element).

  Further, when the deflated balloon is pulled back to a lumen such as a guiding catheter, an anti-slip element may be caught in the opening of the guiding catheter.

  Furthermore, in a balloon catheter in which the anti-slip element is located outside the balloon, the risk of the anti-slip element falling off the balloon cannot be avoided.

The present invention has been made based on the above situation.
The object of the present invention is to effectively expand the constriction while preventing the balloon from sliding, and the elements for preventing the balloon from interfering with the bent part of the blood vessel or other devices. The object of the present invention is to provide a balloon catheter that does not fall off and does not fall off.

(1) The balloon catheter of the present invention includes an outer shaft,
A balloon connected to the tip of the outer shaft;
An inner tube that is inserted through the lumen of the outer shaft and the balloon to form a guide wire lumen;
An anti-slip element that is fixed to the outer peripheral surface of the inner tube or integrally formed with the inner tube, protrudes radially outward of the inner tube, and presses the inner surface of the balloon when the balloon is expanded is provided. It is characterized by that.

According to the balloon catheter having such a configuration, when the balloon is expanded, a channel can be formed in the diseased tissue by causing the anti-slip element to bite into the stenosis portion (along with the balloon wall) via the balloon wall. . Thereby, while being able to expand a stenosis part effectively, it can prevent that the balloon at the time of expansion moves (slides) to an axial direction.
In addition, unlike the conventional balloon catheter, the anti-slip element is present inside the balloon, so that the anti-slip element does not interfere with the bent part of the blood vessel or other devices, and the anti-slip element is not It will not fall off the balloon.

(2) In the balloon catheter of the present invention, it is preferable that the inner tube is eccentric from the central axis of the balloon in the protruding direction of the anti-slip element.

  According to the balloon catheter having such a configuration, the size of the anti-slip element can be reduced, and the blood vessel penetrability can be further improved.

(3) In the balloon catheter of the present invention, it is preferable that a convex portion is formed on the balloon along the shape of the anti-slip element.

  According to the balloon catheter having such a configuration, it is possible to prevent an excessive tension from being applied to the wall of the balloon (convex portion) when the balloon is expanded as the anti-slip element is pressed.

  According to the balloon catheter of the present invention, the stenosis can be effectively expanded while reliably preventing the balloon from slipping, and the anti-slip element may interfere with the bent part of the blood vessel or other devices. In addition, the anti-slip element does not fall off.

It is a side view of the balloon catheter concerning one embodiment of the present invention. It is a perspective view which shows the front-end | tip part of the balloon catheter shown in FIG. It is a side view which shows the front-end | tip part of the balloon catheter shown in FIG. FIG. 4 is a transverse cross-section (A-A cross-sectional view of FIG. 3) at the distal end portion of the balloon catheter shown in FIG. 1. It is sectional drawing which shows an example of the folding method of the balloon which comprises the balloon catheter shown in FIG. It is sectional drawing which shows the other example of the folding method of the balloon which comprises the balloon catheter shown in FIG. In the balloon catheter shown in FIG. 1, it is explanatory drawing which shows typically the state in which the anti-slip | skid element which presses the inner surface of a balloon bites into the constriction part of the blood vessel. It is a perspective view which shows the front-end | tip part of the balloon catheter which concerns on other embodiment of this invention. It is a perspective view which shows the front-end | tip part of the balloon catheter which concerns on other embodiment of this invention.

The balloon catheter 100 of this embodiment shown in FIGS. 1 to 5 (FIGS. 5A and 5B) is used for percutaneous coronary angioplasty (PTCA) or the like.
The balloon catheter 100 is connected to the distal end side shaft 10 (outer shaft) made of a resin tube, the rear end side shaft 20 made of a metal tube connected to the rear end of the distal end side shaft 10, and the distal end of the distal end side shaft 10. A balloon 30, a lumen of the distal shaft 10, and a resin tube that is inserted into the balloon 30 to form a guide wire lumen, the rear end of which is opened as a guide wire port on the side surface of the distal shaft 10 The tip of the balloon 30 is fixed to the tip of the balloon 30, and the tip of the balloon 30 is bonded and fixed to the outer peripheral surface of the inner tube 40. Anti-slip required to press the inner surface of the balloon 30 during expansion 50, a hub 60 connected to the rear end of the rear end side shaft 20, a strain relief 70 provided at a connection portion between the rear end of the rear end side shaft 20 and the hub 60, and a lumen of the front end side shaft 10. And a core wire (not shown) inserted therethrough.

The distal shaft 10 constituting the balloon catheter 100 is an outer shaft made of a resin tube.
The distal shaft 10 (outer shaft) is formed with a lumen (expansion lumen) through which a fluid for expanding the balloon 30 flows.

The outer diameter of the resin tube constituting the distal shaft 10 is usually 0.7 to 1.0 mm, and the inner diameter of this resin tube is usually 0.65 to 0.95 mm.
The length of the distal end side shaft 10 is usually 150 to 450 mm.

Examples of the material of the resin tube constituting the distal end side shaft 10 include thermoplastic resins such as polyamide, polyether polyamide, polyurethane, polyether block amide (PEBAX) (registered trademark), and nylon. Among these, PEBAX Is preferred.
The hardness of the resin tube constituting the distal shaft 10 is preferably 63 to 80 as measured by a D-type hardness meter.

A rear end side shaft 20 is connected to the rear end of the front end side shaft 10.
The rear end side shaft 20 constituting the balloon catheter 100 is formed with a lumen (expansion lumen) communicating with the lumen of the front end side shaft 10.
The rear end side shaft 20 is made of a metal tube (hypotube) such as stainless steel, Ni—Ti alloy, Cu—Mn—Al alloy, and a spiral slit is formed at the tip of the metal tube. May be.

The metal tube constituting the rear end side shaft 20 is inserted at the front end portion thereof into the rear end portion of the resin tube constituting the front end side shaft 10, and the rear end portion thereof is inserted into the hub 60.
The outer diameter of the metal tube constituting the rear end side shaft 20 is usually 0.5 to 0.8 mm, and the inner diameter of this metal tube is usually 0.4 to 0.7 mm.
The length of the rear end side shaft 20 is usually set to 900 to 1500 mm.

A balloon 30 is attached to the distal end of the distal shaft 10.
The balloon 30 constituting the balloon catheter 100 is expanded by the liquid flowing through the lumens of the distal end side shaft 10 and the rear end side shaft 20. Here, examples of the liquid include physiological saline and a contrast medium.

As shown in FIG. 4, the balloon 30 includes a partial cylindrical portion 30A and a convex portion 30B, and the cross-sectional shape thereof is not a circle like a conventionally known balloon, but is a saddle shape narrowed in one direction. (The constricted part is the convex part 30B).
The diameter of the balloon 30 (partial cylindrical portion 30A) during expansion is usually 1.0 to 5.0 mm, and preferably 2.0 to 3.5 mm.
The length of the balloon 30 is usually 5 to 40 mm, preferably 15 to 30 mm.
As a constituent material of the balloon 30, the same balloon as that of a conventionally known balloon catheter can be used, and PEBAX can be cited as a suitable material.

The inner tube 40 constituting the balloon catheter 100 extends to the lumen of the distal shaft 10 and the interior (lumen) of the balloon 30, and forms a lumen (guide wire lumen) for inserting a guide wire. It is a tube.
The rear end of the inner tube 40 is opened on the side surface of the distal end side shaft 10, and the opening 41 is a guide wire port.
The distal end portion of the inner tube 40 is fixed to the distal end portion of the balloon 30, and an opening 42 is formed at the distal end of the inner tube 40.
As shown in FIGS. 2 to 4, the inner tube 40 extends eccentrically from the central axis of the balloon 30 in a direction in which the convex portion 30 </ b> B is located (a protruding direction of a slip prevention element 50 described later).

The outer diameter of the inner tube 40 is usually 0.48 to 0.60 mm, and the inner diameter is usually 0.35 to 0.45 mm.
The axial distance from the position where the opening 41 of the inner tube 40 serving as the guide wire port is formed to the rear end position of the balloon 30 is normally 150 to 300 mm.
The axial distance from the formation position of the opening 41 of the inner tube 40 to the tip of the rear end side shaft 20 is usually 50 mm or less, preferably 5 to 50 mm.
Examples of the constituent material of the inner tube 40 include synthetic resins such as PEBAX, nylon, and PEEK.
The bending elastic modulus (the bending elastic modulus measured according to JIS K 7171) of the resin constituting the inner tube 40 is usually 50 to 10,000 MPa, preferably 150 to 5,000 MPa, more preferably 3, 500 to 4,200 MPa.
The hardness of the resin constituting the inner tube 40 is preferably 55 or more as measured by a D-type hardness meter.

As shown in FIGS. 2 to 4, an anti-slip element 50 protruding outward in the radial direction of the inner tube 40 is fixed to the outer peripheral surface of the inner tube 40 by adhesion.
The anti-slip element 50 constituting the balloon catheter 100 is accommodated in a convex portion 30B of the balloon 30 formed along the shape thereof, and when the balloon 30 shown in FIGS. The tip of 50 presses the inner surface of the convex portion 30B.

  As shown in FIG. 4, the anti-slip element 50 has a substantially triangular cross section. Here, the apex angle (θ) of the triangle is preferably 30 to 100 °, and more preferably 40 to 60 °.

  If this angle (θ) is too narrow, the balloon wall interposed between the stenosis part may be damaged when the balloon is expanded (especially when the hardness of the anti-slip element is high), or the tip of the anti-slip element may be It may be deformed (especially when the hardness of the anti-slip element is low) and cannot be made to bite into the constriction. On the other hand, if the angle (θ) is too wide, the anti-slip element cannot be bitten into the constriction when the balloon is expanded.

As a constituent material of the slip prevention element 50, the same synthetic resin as the constituent material of the inner tube 40 can be mentioned.
The bending elastic modulus (the bending elastic modulus measured in accordance with JIS K 7171) of the resin constituting the slip prevention element 50 is usually 50 to 10,000 MPa, preferably 150 to 5,000 MPa, more preferably 3 , 500-4,200 MPa.
The hardness of the resin constituting the slip prevention element 50 is preferably 55 or more as measured by a D-type hardness meter.

  If the flexural modulus is too low, the tip of the anti-slip element cannot be deformed and bite into the constriction when the balloon is expanded. On the other hand, if the flexural modulus of the resin constituting the anti-slip element is too high, the balloon wall interposed between the stenosis and the stenosis may be damaged when the balloon is expanded. In addition, since the balloon portion where such an anti-slip element is located is difficult to bend and it is difficult to follow the bent blood vessel and curve the portion, the blood vessel penetrability as a balloon catheter is impaired. Sometimes.

As shown in FIGS. 5A and 5B, the deflated balloon 30 can be folded so as to wind around the inner tube 40 and the anti-slip element 50.
Here, in the conventional balloon catheter provided with the anti-slip element on the outside of the balloon, the anti-slip element interferes with the folding of the balloon and cannot be folded cleanly. According to this balloon catheter 100 provided with the balloon 30, the balloon 30 can be folded easily and cleanly.

Even after the balloon 30 is expanded and contracted, it can be easily and neatly folded into the same form as before use.
That is, the balloon catheter 100 of this embodiment in which the anti-slip element 50 is located inside the balloon 30 is also excellent in rewrapping property.

According to the balloon catheter 100 of the present embodiment, the stenosis can be effectively expanded and the balloon 30 during expansion can be effectively prevented from slipping.
That is, when the balloon 30 is expanded, as shown in FIG. 6, the anti-slip element 50 and the wall portion of the balloon 30 (convex portion 30B) are bitten into the lesion (stenosis portion 90) of the blood vessel and become the lesion tissue. A channel can be formed. Thereby, the stress of the blood vessel is relieved and the constricted portion 90 can be effectively expanded, and the frictional resistance with the diseased tissue can be increased to prevent the balloon 30 from moving (sliding) in the axial direction.

  Further, according to the balloon catheter 100 of the present embodiment, unlike the conventionally known balloon catheter in which the element for preventing the balloon slippage is located outside the balloon, the slip prevention element 50 is provided inside the balloon 30. Therefore, the anti-slip element 50 does not interfere with the bent part of the blood vessel outside the balloon 30 and other devices, and the anti-slip element 50 drops away from the balloon 30. There is nothing.

  Further, according to the balloon catheter 100 of the present embodiment, since the inner tube 40 is eccentric from the central axis of the balloon 30 in the protruding direction of the anti-slip element 50, the inner tube extends on the central axis of the balloon. As compared with, the anti-slip element 50 can be reduced, and the blood vessel penetrability can be further improved.

  Further, according to the balloon catheter 100 of the present embodiment, since the convex portion 30B is formed on the balloon 30 along the shape of the anti-slip element 50, the balloon 30 (the convex portion 30B when the balloon 30 is expanded) is formed. ) Can be prevented from being applied with excessive tension due to the pressing of the anti-slip element 50.

As mentioned above, although one Embodiment of this invention was described, the balloon catheter of this invention is not limited to these, A various change is possible.
For example, the shape and number of the anti-slip element are not particularly limited as long as the anti-slip element can bite into the narrowed portion via the balloon wall. For example, a plurality of anti-slip elements having a short length (for example, The anti-slip elements 51, 52, 53) shown in FIG. 7A may be arranged on a straight line. Further, as shown in FIG. 7B, the anti-slip elements 51 ′, 52 ′, and 53 ′ may be arranged at intervals.

  In addition, the balloon preferably has a convex portion formed along the shape of the anti-slip element, but may have a circular cross section (no convex portion is formed).

100 balloon catheter 10 distal shaft (outer shaft)
20 Rear end side shaft 30 Balloon 40 Inner tube 41 Opening (guide wire port)
42 Opening 50 Anti-slip element 60 Hub 70 Strain relief

Claims (3)

An outer shaft,
A balloon connected to the tip of the outer shaft;
An inner tube that is inserted through the lumen of the outer shaft and the balloon to form a guide wire lumen;
An anti-slip element that is fixed to the outer peripheral surface of the inner tube or integrally formed with the inner tube, protrudes radially outward of the inner tube, and presses the inner surface of the balloon when the balloon is expanded is provided. A balloon catheter characterized by that.   The balloon catheter according to claim 1, wherein the inner tube is eccentric from a central axis of the balloon in a protruding direction of the anti-slip element.   The balloon catheter according to claim 1, wherein a convex portion is formed on the balloon along the shape of the anti-slip element.

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