JP2024082845A - catheter - Google Patents

Abstract

To provide a catheter that is suitable for manipulation of inserting a catheter into a specific blood vessel through a subclavian artery.SOLUTION: A catheter 1 includes: a flexible shaft 2, at least tip side of which is inserted into a body, where the shaft 2 includes a lumen through which a guide member is inserted and a curved part 14 having a curved shape in a state where the guide member is not inserted into the lumen; an expandable balloon 4 installed on the tip side relative to the curved part 14 in the shaft 2; and a radiation contrast part 8 which is installed to the shaft 2 and of which position corresponds to the curved part 14.SELECTED DRAWING: Figure 1

Description

This disclosure relates to a catheter.

A catheter is a component that is inserted into the body for diagnosis or treatment. For example, Patent Document 1 discloses a guiding catheter that is inserted into a blood vessel to guide a stent to a target site in the blood vessel.

JP 2004-357805 A

A procedure is known in which a catheter for guiding a medical device such as a stent is inserted from the right or left subclavian artery into the right or left common carotid artery. As a result of extensive research, the present inventor has found a catheter suitable for the procedure of passing the catheter through the subclavian artery and inserting it into a specific blood vessel, including the common carotid artery.

This disclosure has been made in light of these circumstances, and its purpose is to provide a catheter that is suitable for the procedure of passing the catheter through the subclavian artery and inserting it into a specific blood vessel.

One aspect of the present disclosure is a catheter that passes through the right or left subclavian artery and is inserted into a specific blood vessel to guide a medical device. This catheter is a flexible shaft that is inserted into the body at least at its distal end, and includes a shaft having a lumen through which a guide member is inserted and a curved portion that is curved when the guide member is not inserted into the lumen, an expandable balloon provided on the shaft distal to the curved portion, and a radiographic imaging section provided on the shaft and positioned in correspondence with the curved portion.

Another aspect of the present disclosure is a catheter that passes through the right or left subclavian artery and is inserted into a specific blood vessel to guide a medical device. This catheter is a flexible shaft that is inserted into the body at least at its distal end, and includes a lumen through which the medical device is inserted, a curved portion that is curved by operating a handle provided on the proximal end of the shaft, an expandable balloon provided on the shaft distal to the curved portion, and a radiographic imaging section provided on the shaft and positioned in correspondence with the curved portion.

Any combination of the above components, and conversions of the expressions of this disclosure between methods, devices, systems, etc., are also valid aspects of this disclosure.

The present disclosure provides a catheter suitable for a procedure in which a catheter is passed through the subclavian artery and inserted into a specific blood vessel.

FIG. 1 is a side view of a catheter according to an embodiment. Fig. 2(A) is a cross-sectional view of the shaft, and Fig. 2(B) is an enlarged view of the bent portion. FIG. 4A to 4I are diagrams illustrating the first procedure. 5(A) to 5(H) are views for explaining the second procedure. 6(A) to 6(H) are views for explaining the second procedure. 7(A) to 7(H) are views for explaining the third technique. 8(A) to 8(E) are diagrams illustrating the third technique. 9(A) to 9(H) are views for explaining the fourth technique.

The present disclosure will be described below with reference to the drawings based on preferred embodiments. The embodiments are illustrative and do not limit the present disclosure, and all features and combinations thereof described in the embodiments are not necessarily essential to the present disclosure. The same or equivalent components, members, and processes shown in each drawing are given the same reference numerals, and duplicated descriptions are omitted as appropriate. The scale and shape of each part shown in each drawing are set for convenience to facilitate explanation, and are not to be interpreted as being limiting unless otherwise specified. In addition, when terms such as "first" and "second" are used in this specification or claims, unless otherwise specified, these terms do not indicate any order or importance, but are intended to distinguish one configuration from another. In addition, some of the members that are not important in explaining the embodiment are omitted in each drawing.

Figure 1 is a side view of a catheter 1 according to an embodiment. Figure 2 (A) is a cross-sectional view of the shaft 2. Figure 2 (B) is an enlarged view of the curved portion 14. Figure 1 shows the balloon 4 in an expanded state. Also, Figure 1 omits the illustration of the cover 10. Figure 2 (A) shows a cross section perpendicular to the axis of the shaft 2. Figure 2 (B) shows the cover 10 as seen through.

The catheter 1 according to this embodiment is a catheter that passes through the right subclavian artery 28 or the left subclavian artery 30 and is inserted into a predetermined blood vessel to guide a medical device (not shown). Examples of the predetermined blood vessel include the common carotid artery, the external carotid artery, the internal carotid artery, the subclavian artery, the brachiocephalic artery, and the vertebral artery. In this embodiment, the right common carotid artery 32 or the left common carotid artery 34 is given as an example of a predetermined blood vessel, and a procedure for inserting the catheter into the blood vessel is described. The catheter 1 includes a long shaft 2, a balloon 4, a handle 6, a radiographic section 8, and a cover 10. In this embodiment, "long" refers to a ratio (first length/second length) of a first length in the longitudinal direction to a second length in a direction perpendicular to the longitudinal direction of the catheter 1 being, for example, 5 or more. The first length is the length in the direction in which the axis of the shaft 2 extends when the entire shaft 2 is extended linearly.

The shaft 2 is made of a flexible tubular body, and at least the tip side is inserted into the body. The shaft 2 is made of a known flexible material, including resins such as polyolefin, polytetrafluoroethylene, polyether block amide, polyamide, polyurethane, and silicone. The first length of the shaft 2 is, for example, 600 mm to 1800 mm. The shaft 2 has a lumen 12 and a curved portion 14. The lumen 12 extends from one end to the other end of the shaft 2, and a guide member 18 (see FIG. 3) and a medical device, which will be described later, are inserted into the curved portion 14 when the guide member 18 is not inserted into the lumen 12 (when no external force is applied to the shaft 2).

For example, the curved portion 14 is V-shaped (bent shape) or U-shaped (curved shape). The region of the shaft 2 from the balloon 4 to just before the curved portion 14 and the region from the handle 6 to just before the curved portion 14 are both straight when the guide member 18 is not inserted into the lumen 12, and extend in directions that intersect with each other. For example, the angle between the two regions is an acute angle.

The balloon 4 is provided around the axis of the shaft 2 on the tip side (distal end side) of the curved portion 14 in the shaft 2. The balloon 4 is approximately spherical. Hereinafter, the side of the catheter 1 or shaft 2 on which the balloon 4 is provided will be referred to simply as the "tip side" as appropriate. The balloon 4 can be expanded by a fluid supplied from the base end side (proximal end side) of the shaft 2. The fluid is, for example, physiological saline. The balloon 4 is made of a known flexible material, including resins such as polyolefin, polytetrafluoroethylene, polyether block amide, polyamide, polyurethane, and silicone.

The handle 6 is provided on the base end side of the shaft 2. Hereinafter, the side of the catheter 1 or shaft 2 on which the handle 6 is provided will be referred to simply as the "base end side" where appropriate. The handle 6 is placed outside the body when the catheter 1 is in use, and is grasped or operated by the operator. The handle 6 has a first port 6a and a second port 6b.

The first port 6a is connected to the base end of a fluid lumen (not shown) provided in the shaft 2. The tip of the fluid lumen is connected to the balloon 4. By flowing fluid into the first port 6a, the fluid is supplied to the balloon 4, causing it to expand. By discharging the fluid from the first port 6a, the fluid is discharged from the balloon 4, causing it to contract. The second port 6b is connected to the base end of the lumen 12. The guide member 18 and the medical device are inserted into and removed from the lumen 12 via the second port 6b.

The radiographic contrast section 8 is provided on the shaft 2, and its position corresponds to that of the curved portion 14 according to a predetermined rule. In other words, the distance of the radiographic contrast section 8 from the curved portion 14 is determined. Therefore, the operator of the catheter 1 can know the position of the curved portion 14 from the position of the radiographic contrast section 8 by knowing in advance the rule regarding the positional relationship between the curved portion 14 and the radiographic contrast section 8. The radiographic contrast section 8 is a so-called contrast marker, and is made of a radiopaque material such as Au or Pt. The radiation is, for example, X-rays. The operator of the catheter 1 can confirm the position of the radiographic contrast section 8, and therefore the position of the curved portion 14, based on the radiation image.

Preferably, the position of the radiographic contrast section 8 corresponds to the position of the apex of the curved section 14. The catheter 1 of this embodiment has one radiographic contrast section 8, and the radiographic contrast section 8 is disposed at the apex of the curved section 14. That is, the distance from the apex of the radiographic contrast section 8 is substantially 0. In this case, the distance between the radiographic contrast section 8 and the apex being 0 corresponds to the above-mentioned rule. The apex of the curved section 14 is the bottommost part (the most protruding part) of the V-shape or U-shape. The catheter 1 may have multiple radiographic contrast sections 8. For example, as shown by the two-dot chain line in FIG. 2(B), the catheter 1 has two radiographic contrast sections 8. One radiographic contrast section 8 is provided at a position shifted from the apex by a predetermined distance L toward the tip end. The other radiographic contrast section 8 is provided at a position shifted from the apex by the same distance L toward the base end. In other words, the two radiographic contrast sections 8 are arranged relative to the apex so that an isosceles triangle is formed with the apex of the curved portion 14 as the apex angle and the two radiographic contrast sections 8 as the two base angles. In this case, the above rule is met when the two radiographic contrast sections 8 are shifted from the apex by a predetermined distance L in opposite directions.

The cover 10 covers at least the boundaries 16a and 16b of the radiographic imaging portion 8 and the shaft 2. The cover 10 is made of a known flexible material, including resins such as polyolefin, polytetrafluoroethylene, polyether block amide, polyamide, polyurethane, and silicone. The cover 10 of this embodiment covers the boundary 16a on the base end side of the cover 10 and the shaft 2, the boundary 16b on the tip end side of the cover 10 and the shaft 2, and the entire radiographic imaging portion 8. When the curved portion 14 is elastically deformed, the edge portion of the radiographic imaging portion 8 may protrude from the surface of the shaft 2. By covering the boundaries 16a and 16b with the cover 10, it is possible to prevent the edge portion of the radiographic imaging portion 8 from directly contacting the inner wall of a blood vessel or the like. In addition, when the catheter 1 has multiple radiographic imaging portions 8, it is preferable that a cover 10 is provided for each radiographic imaging portion 8.

Figure 3 is a side view of the guide member 18. The guide member 18 includes a guidewire 20 and a secondary catheter 22. The guidewire 20 is a long body made of stainless steel or the like, and has flexibility and bending rigidity. The secondary catheter 22 has a long shaft 24 and a handle 26. The shaft 24 is made of a flexible tubular body. The shaft 24 is made of a known flexible material, including resins such as polyolefin, polytetrafluoroethylene, polyether block amide, polyamide, polyurethane, and silicone. The shaft 24 has a lumen (not shown) and a curved portion 25, similar to the shaft 2. The guidewire 20 is inserted into the lumen.

The handle 26 is provided on the base end side of the shaft 24. The handle 26 is placed outside the body when the catheter 1 is in use, and is grasped or operated by the operator. The handle 26 has a third port 26a. The third port 26a is connected to the base end of the lumen. The guidewire 20 is inserted into and removed from the lumen via the third port 26a.

Next, the manner of use of the catheter 1 will be described. The catheter 1 is inserted from the right subclavian artery 28 or the left subclavian artery 30 into the right common carotid artery 32 or the left common carotid artery 34. Various medical devices are then inserted into the lumen 12 and, while being guided by the catheter 1, are sent into the carotid artery and further into the blood vessel beyond the carotid artery. Examples of medical devices include stents, balloons, coils, thrombus removal catheters, contrast catheters, microcatheters, guiding catheters, etc.

Below, the first to fourth procedures for inserting the catheter 1 through the right subclavian artery 28 into the right common carotid artery 32 or the left common carotid artery 34 will be described. The first procedure is a procedure (Push-in method) for inserting the catheter 1 through the right subclavian artery 28 into the right common carotid artery 32. The second procedure is a procedure (DAT/Pull-back method) for inserting the catheter 1 through the right subclavian artery 28 into the right common carotid artery 32, which is a procedure with a different procedure from the first procedure. The third procedure is a procedure (DAT/Pull-back method) for inserting the catheter 1 through the right subclavian artery 28 into the left common carotid artery 34. The fourth procedure is a procedure (Push-in method) for inserting the catheter 1 through the right subclavian artery 28 into the left common carotid artery 34, which is a procedure with a different procedure from the third procedure.

In each procedure, the TRA (Trans-Radial-Approach) method is used as an example, and the guide member 18 and catheter 1 are inserted into the body from the right radial artery. Note that the guide member 18 and catheter 1 may also be inserted from the ulnar artery or brachial artery.

In either procedure, the catheter 1 advances through the body while elastically deforming the curved portion 14 along the guide member 18 inserted into the body through the insertion operation by the operator. During this process, the curved portion 14 may become straight. When the guide member 18 is removed from the lumen 12 at a predetermined position, the shape of the curved portion 14 is restored. The curved portion 14 that has restored its shape extends along the two blood vessels at the junction of the two blood vessels. For example, at the junction of the right subclavian artery 28 and the right common carotid artery 32, in other words, at the branching point of the brachiocephalic artery 33 to the right subclavian artery 28 and the right common carotid artery 32, the curved portion 14 is positioned so as to follow the right subclavian artery 28 and the right common carotid artery 32. This makes it possible to suppress displacement of the catheter 1.

(First procedure)
4(A) to 4(I) are diagrams for explaining the first procedure. In addition, in FIG. 4(A) to FIG. 4(I), the radiographic imaging unit 8 and the cover 10 are omitted. As shown in FIG. 4(A), the guidewire 20 and the secondary catheter 22 are advanced from the right radial artery through the right subclavian artery 28 into the ascending aorta 36 prior to the catheter 1. At least temporarily, the secondary catheter 22 precedes the guidewire 20. Since the secondary catheter 22 has a curved portion 25, the direction of the tip of the secondary catheter 22 can be changed by rotating the handle 26 or the like. This makes it possible to control the direction in which the guidewire 20 advances. With the guidewire 20 and the secondary catheter 22 advanced into the ascending aorta 36, the catheter 1 is advanced along the secondary catheter 22 into the right subclavian artery 28.

Next, as shown in FIG. 4(B), the secondary catheter 22 and guidewire 20 are advanced into the aortic arch 38. Next, as shown in FIG. 4(C), the tips of the secondary catheter 22 and guidewire 20 are moved to the entrance of the right common carotid artery 32. Next, as shown in FIG. 4(D), the secondary catheter 22 and guidewire 20 are advanced into the right common carotid artery 32. Next, as shown in FIG. 4(E), the guidewire 20 is advanced into the right external carotid artery 40. Next, as shown in FIG. 4(F), the secondary catheter 22 is advanced into the right external carotid artery 40.

Next, as shown in FIG. 4(G), the guide wire 20 is withdrawn, and a guide wire 20a that is harder than the guide wire 20 is inserted. Next, as shown in FIG. 4(H), the catheter 1 is advanced into the right common carotid artery 32. Next, as shown in FIG. 4(I), the secondary catheter 22 and the guide wire 20a are retracted. Through the above procedure, the catheter 1 can be inserted from the right subclavian artery 28 into the right common carotid artery 32. With the catheter 1 inserted from the right subclavian artery 28 into the right common carotid artery 32 and the guide wire 20 and secondary catheter 22 withdrawn, the curved portion 14 is positioned along both blood vessels at the junction between the right subclavian artery 28 and the right common carotid artery 32.

Then, the balloon 4 is expanded. This allows the position of the catheter 1 to be fixed. It also allows blood flow beyond the balloon 4 to be stopped. Then, instead of the guide member 18, a medical device is inserted into the lumen 12. The medical device is guided to the brain side of the balloon 4 and is used for various treatments. For example, if the medical device is a stent, the stent is deployed in the blood vessel beyond the balloon 4 and is used to expand a narrowed blood vessel, etc.

When the catheter 1 advances from the right subclavian artery 28 to the right common carotid artery 32 along the secondary catheter 22, the curved portion 14 deforms along the secondary catheter 22. Therefore, it is difficult to confirm the position of the curved portion 14 based on its shape. If the curved portion 14 is displaced from the position where it should be placed, when the secondary catheter 22 is pulled out and the shape of the curved portion 14 is restored, the curved portion 14 may get caught on the inner wall of the blood vessel, causing damage to the blood vessel. In addition, the curved portion 14 may be pushed by the inner wall of the blood vessel, causing the catheter 1 to shift position or to fall off the right common carotid artery 32. In addition, the portion of the shaft 2 other than the curved portion 14, i.e., the straight portion, may be forcibly bent at the connection portion between the right subclavian artery 28 and the right common carotid artery 32, causing the portion to kink. In addition, if a medical device with high rigidity is inserted into the straight portion while the straight portion is forcibly bent, the portion may also kink.

In contrast, the catheter 1 has a radiographic imaging section 8 whose position corresponds to that of the curved section 14. Therefore, the position of the curved section 14 can be ascertained by checking the position of the radiographic imaging section 8 from outside the body. This allows the curved section 14 to be positioned more accurately at the desired position. As a result, damage to the blood vessels and the catheter 1 can be suppressed. In addition, it is possible to avoid having to redo the procedure due to the catheter 1 being displaced or falling off. Therefore, the catheter 1 can be suitably used for the first procedure.

(Second procedure)
5(A) to 5(H) and 6(A) to 6(H) are diagrams for explaining the second procedure. In addition, in Fig. 5(A) to 5(H) and Fig. 6(A) to 6(H), the radiographic section 8 and the cover 10 are omitted. As shown in Fig. 5(A), prior to the catheter 1, the guidewire 20 and the secondary catheter 22 are advanced from the right radial artery through the right subclavian artery 28 into the ascending aorta 36. With the guidewire 20 and the secondary catheter 22 advanced into the ascending aorta 36, the catheter 1 is advanced along the secondary catheter 22 into the right subclavian artery 28.

Next, as shown in FIG. 5(B), the secondary catheter 22 and the guidewire 20 are advanced into the aortic arch 38. Next, as shown in FIG. 5(C), the guidewire 20 is advanced into the descending aorta 42. Next, as shown in FIG. 5(D) and FIG. 5(E), the secondary catheter 22 is advanced into the descending aorta 42. Next, as shown in FIG. 5(F), the guidewire 20 is withdrawn, and a guidewire 20a harder than the guidewire 20 is inserted. Next, as shown in FIG. 5(G), the catheter 1 is advanced into the aortic arch 38. At this time, the catheter 1 is advanced until the curved portion 14 reaches the downstream of the ascending aorta 36 or the upstream of the aortic arch 38. Next, as shown in FIG. 5(H), the secondary catheter 22 and the guidewire 20a are retracted to the base end side of the curved portion 14. This causes the shape of the curved portion 14 to be restored, and the apex of the curved portion 14 advances upstream of the ascending aorta 36. In other words, the curved portion 14 is dropped into the ascending aorta 36.

Next, as shown in Fig. 6(A), Fig. 6(B), Fig. 6(C) and Fig. 6(D), the tip of the catheter 1 is moved from the aortic arch 38 to the entrance of the right common carotid artery 32 by rotating the handle 6 or the like. Next, as shown in Fig. 6(E), the secondary catheter 22 and the guidewire 20 are advanced into the right common carotid artery 32. Next, as shown in Fig. 6(F) and Fig. 6(G), the catheter 1 is advanced into the right common carotid artery 32. Next, as shown in Fig. 6(H), the guidewire 20 and the secondary catheter 22 are retracted. Through the above procedure, the catheter 1 can be inserted from the right subclavian artery 28 into the right common carotid artery 32. With the catheter 1 inserted from the right subclavian artery 28 into the right common carotid artery 32 and the guidewire 20 and the secondary catheter 22 withdrawn, the curved portion 14 is positioned along both blood vessels at the junction between the right subclavian artery 28 and the right common carotid artery 32. The subsequent operations are the same as those in the first procedure.

In the second procedure, by checking the position of the radiographic contrast section 8, the curved portion 14 can be more accurately aligned with the junction between the right subclavian artery 28 and the right common carotid artery 32. In addition, the curved portion 14 can be more reliably dropped into the ascending aorta 36. As a result, damage to the blood vessels and the catheter 1 can be suppressed. In addition, it is possible to avoid having to redo the procedure due to the catheter 1 being displaced or falling off. Therefore, the catheter 1 can be suitably used in the second procedure.

(Third procedure)
7(A) to 7(H) and 8(A) to 8(E) are diagrams for explaining the third procedure. In addition, in Fig. 7(A) to 7(H) and Fig. 8(A) to 8(E), the radiographic section 8 and the cover 10 are omitted. As shown in Fig. 7(A), prior to the catheter 1, the guidewire 20 and the secondary catheter 22 are advanced from the right radial artery through the right subclavian artery 28 into the ascending aorta 36. With the guidewire 20 and the secondary catheter 22 advanced into the ascending aorta 36, the catheter 1 is advanced along the secondary catheter 22 into the right subclavian artery 28.

Next, as shown in FIG. 7(B), the secondary catheter 22 and the guidewire 20 are advanced into the aortic arch 38. Next, as shown in FIG. 7(C), the guidewire 20 is advanced into the descending aorta 42. Next, as shown in FIG. 7(D) and FIG. 7(E), the secondary catheter 22 is advanced into the descending aorta 42. Next, as shown in FIG. 7(F), the guidewire 20 is withdrawn, and a guidewire 20a harder than the guidewire 20 is inserted. Next, as shown in FIG. 7(G), the catheter 1 is advanced into the aortic arch 38. At this time, the catheter 1 is advanced until the curved portion 14 reaches the downstream of the ascending aorta 36 or the upstream of the aortic arch 38. Next, as shown in FIG. 7(H), the secondary catheter 22 and the guidewire 20a are retracted to the base end side of the curved portion 14. This causes the shape of the curved portion 14 to be restored, and the apex of the curved portion 14 advances upstream of the ascending aorta 36. In other words, the curved portion 14 is dropped into the ascending aorta 36.

Next, as shown in Fig. 8(A) and Fig. 8(B), the tip of the catheter 1 is moved from the aortic arch 38 to the entrance of the left common carotid artery 34 by rotating the handle 6 or the like. Next, as shown in Fig. 8(C), the secondary catheter 22 and the guidewire 20 are advanced into the left common carotid artery 34. Next, as shown in Fig. 8(D), the catheter 1 is advanced into the left common carotid artery 34. Next, as shown in Fig. 8(E), the guidewire 20 and the secondary catheter 22 are retracted. Through the above procedure, the catheter 1 can be inserted from the right subclavian artery 28 into the left common carotid artery 34. With the catheter 1 inserted from the right subclavian artery 28 into the left common carotid artery 34 and the guidewire 20 and secondary catheter 22 withdrawn, the curved portion 14 is positioned along the brachiocephalic artery 33 and the left common carotid artery 34. The subsequent operations are the same as those in the first procedure.

In the third procedure, by checking the position of the radiographic section 8, the curved portion 14 can be more accurately aligned with the brachiocephalic artery 33 and the left common carotid artery 34. In addition, the curved portion 14 can be more reliably dropped into the ascending aorta 36. As a result, damage to the blood vessels and the catheter 1 can be suppressed. In addition, the need to redo the procedure due to the catheter 1 being displaced or falling off can be avoided. Therefore, the catheter 1 can be suitably used in the third procedure.

(Fourth procedure)
9(A) to 9(H) are diagrams for explaining the fourth procedure. In addition, in FIG. 9(A) to FIG. 9(H), the radiographic imaging unit 8 and the cover 10 are omitted. As shown in FIG. 9(A), the guidewire 20 and the secondary catheter 22 are advanced from the right radial artery through the right subclavian artery 28 into the ascending aorta 36 prior to the catheter 1. With the guidewire 20 and the secondary catheter 22 advanced into the ascending aorta 36, the catheter 1 is advanced along the secondary catheter 22 into the right subclavian artery 28. Next, as shown in FIG. 9(B), the tip of the secondary catheter 22 is moved to the entrance of the left common carotid artery 34. Next, as shown in FIG. 9(C), the secondary catheter 22 is advanced into the left common carotid artery 34.

Next, as shown in FIG. 9(D), the guidewire 20 is advanced into the left external carotid artery 44. Next, as shown in FIG. 9(E), the secondary catheter 22 is advanced into the left external carotid artery 44. Next, as shown in FIG. 9(F), the guidewire 20 is withdrawn, and a guidewire 20a harder than the guidewire 20 is inserted. Next, as shown in FIG. 9(G), the catheter 1 is advanced into the left common carotid artery 34. Next, as shown in FIG. 9(H), the secondary catheter 22 and the guidewire 20a are retracted. Through the above procedure, the catheter 1 can be inserted from the right subclavian artery 28 into the left common carotid artery 34. With the catheter 1 inserted from the right subclavian artery 28 into the left common carotid artery 34 and the guidewire 20 and secondary catheter 22 withdrawn, the curved portion 14 is positioned along the brachiocephalic artery 33 and the left common carotid artery 34. The subsequent operations are the same as those in the first procedure.

In the fourth procedure, by checking the position of the radiographic contrast portion 8, the curved portion 14 can be more accurately aligned with the brachiocephalic artery 33 and the left common carotid artery 34. As a result, damage to the blood vessels and the catheter 1 can be suppressed. In addition, redoing the procedure due to the catheter 1 being displaced or falling off can be avoided. Therefore, the catheter 1 can be suitably used in the fourth procedure.

When inserting the catheter 1 from the left subclavian artery 30 into the right common carotid artery 32 or the left common carotid artery 34, the same procedures as the first to fourth procedures can be used. Therefore, the same problems as in the first to fourth procedures may arise. In contrast, the catheter 1 of this embodiment can achieve the same effects as in the first to fourth procedures.

In addition, when inserting the catheter 1 into blood vessels other than the right common carotid artery 32 and the left common carotid artery 34, such as the external carotid artery, internal carotid artery, subclavian artery, brachiocephalic artery, or vertebral artery, procedures similar to the first to fourth procedures can be used. Therefore, problems similar to those in the first to fourth procedures may arise. In contrast, the catheter 1 of this embodiment can achieve the same effects as those in the first to fourth procedures.

Above, the embodiments of the present disclosure have been described in detail. The above-mentioned embodiments merely show specific examples of implementing the present disclosure. The contents of the embodiments do not limit the technical scope of the present disclosure, and many design changes such as changes, additions, and deletions of components are possible within the scope of the idea of the present disclosure defined in the claims. A new embodiment with design changes has the effects of each of the combined embodiments and modifications. In the above-mentioned embodiments, the contents for which such design changes are possible are emphasized by adding notations such as "in this embodiment" and "in this embodiment", but design changes are permitted even in contents without such notations. Any combination of components included in each embodiment is also valid as an aspect of the present disclosure. Hatching on the cross sections of the drawings does not limit the material of the objects to which the hatching is applied.

The curved portion 14 described in the embodiment has a curved shape when the guide member 18 is not inserted into the lumen 12, that is, when no external force is applied to the shaft 2. In other words, the curved portion 14 is provided at the stage of molding the shaft 2. However, the curved portion 14 is not limited to this configuration. For example, the shaft 2 may be straight when no external force is applied, and the curved portion 14 may appear when the shaft 2 is bent by operating the handle 6. The deformation of the shaft 2 by operating the handle 6 can be realized by a conventionally known structure, for example, a structure in which the handle 6 pulls a pull wire inserted into the shaft 2. In addition, in a catheter 1 in which the curved portion 14 appears by operating the handle 6, the guide member 18 may not be used. In this case, only a medical device may be inserted into the lumen 12.

The embodiment may be specified by the items described below.
[Item 1]
A catheter (1) that passes through a right subclavian artery (28) or a left subclavian artery (30) and is inserted into a predetermined blood vessel (32, 34) to guide a medical device,
A flexible shaft (2) at least the tip side of which is inserted into a body, the shaft (2) having a lumen (12) through which a guide member (18) is inserted, and a curved portion (14) that is curved when the guide member (18) is not inserted into the lumen (12);
an expandable balloon (4) provided on the shaft (2) on the distal side of the curved portion (14);
A radiographic imaging portion (8) is provided on the shaft (2) and is positioned in correspondence with the curved portion (14).
Catheter (1).
[Second Item]
The radiographic portion (8) is disposed at the apex of the bent portion (14).
A catheter (1) as described in item 1.
[Item 3]
The catheter (1) comprises at least two radiographic sections (8),
One of the radiographic contrast sections (8) is disposed at a position shifted toward the tip end of the shaft (2) by a predetermined distance from the apex of the curved section (14);
The other radiographic imaging portion (8) is disposed at a position shifted from the apex by a predetermined distance toward the base end side of the shaft (2).
A catheter (1) according to either the first or second item.
[Fourth Item]
A cover (10) is provided which covers at least the borders of the radiographic contrast portion (8) and the shaft (2).
A catheter (1) according to any one of claims 1 to 3.
[Item 5]
A catheter (1) that passes through a right subclavian artery (28) or a left subclavian artery (30) and is inserted into a predetermined blood vessel (32, 34) to guide a medical device,
A flexible shaft (2) at least the tip side of which is inserted into a body, the shaft (2) having a lumen (12) through which a medical device is inserted, and a curved portion (14) that is curved by operating a handle (6) provided on the base end side of the shaft (2);
an expandable balloon (4) provided on the shaft (2) on the distal side of the curved portion (14);
A radiographic imaging portion (8) is provided on the shaft (2) and is positioned in correspondence with the curved portion (14).
Catheter (1).

1 Catheter, 2 Shaft, 4 Balloon, 8 Radiographic section, 10 Cover, 12 Lumen, 14 Curved section, 16 Boundary, 18 Guide member, 28 Right subclavian artery, 30 Left subclavian artery, 32 Right common carotid artery, 34 Left common carotid artery.

Claims (5)

A catheter that is inserted into a predetermined blood vessel through a right or left subclavian artery to guide a medical device,
a flexible shaft, at least a tip side of which is inserted into a body, the shaft having a lumen through which a guide member is inserted, and a curved portion that is curved when the guide member is not inserted into the lumen;
an expandable balloon provided on the shaft distal to the curved portion;
A radiographic imaging portion provided on the shaft and positioned in correspondence with the curved portion.
catheter. The radiographic portion is disposed at the apex of the bend.
The catheter of claim 1. The catheter comprises at least two of the radiographic imaging portions,
one of the radiographic sections is disposed at a position shifted toward the distal end of the shaft by a predetermined distance from the apex of the bent section;
the other radiographic imaging portion is disposed at a position shifted from the apex by the predetermined distance toward the base end side of the shaft;
The catheter according to claim 1 or 2. A cover is provided to cover at least the boundary of the radiographic portion and the shaft.
The catheter according to claim 1 or 2. A catheter that is inserted into a predetermined blood vessel through a right or left subclavian artery to guide a medical device,
A flexible shaft, at least the tip side of which is inserted into a body, has a lumen through which the medical device is inserted, and a curved portion that is curved by operating a handle provided on the base end side of the shaft;
an expandable balloon provided on the shaft distal to the curved portion;
A radiographic imaging portion provided on the shaft and positioned in correspondence with the curved portion.
catheter.

Images