JP6405274B2 - Guide wire - Google Patents

Description

  The present invention relates to a guide wire.

  The guide wire can be used for the treatment of a site where surgical operation is difficult, such as PTCA (Percutaneous Transluminal Coronary Angioplasty), or for the purpose of minimally invasive to the human body or cardiovascular Used to guide catheters used for imaging and other examinations. The guide wire used in PTCA is inserted into the vicinity of the target vessel stenosis with the balloon catheter with the tip of the guide wire protruding from the tip of the balloon catheter. Guide to. Then, the guide wire that has reached the vascular stenosis part spreads the vascular stenosis part by passing through the vascular stenosis part, thereby guiding the tip of the balloon catheter to the vascular stenosis part (see, for example, Patent Document 1). .

  In such a procedure, a plurality of types of guidewires having different distal end rigidity (tip load) and the like may be sequentially replaced and used depending on the stage of the procedure and the case. In this case, there is a problem that the procedure becomes complicated because the guide wires have to be used properly each time, and it takes time to exchange the guide wires.

International Publication No. 2010/113915 Pamphlet

  An object of the present invention is to provide a guide wire excellent in operability that can be used quickly.

Such an object is achieved by the present invention described below.
(1) A long core and flexible core wire;
Provided at least at the distal end of the core wire, and includes a changing portion whose rigidity or outer diameter changes,
A first coil formed by winding a first wire rod along the circumferential direction of the outer periphery of the core wire, the tip of the changing portion being fixed to the tip of the core wire;
A second coil connected to the proximal end side of the first coil and wound around a second wire along the circumferential direction of the outer periphery of the core wire;
Adjustment of the space | interval of the winding which adjoins the central-axis direction of the said core wire of the wire which comprises one coil of the said 1st coil and the said 2nd coil, and the inner peripheral part of the other coil The guide wire is configured such that the changing portion is changed by collectively adjusting the distance between the core wire and the outer peripheral portion of the core wire.

(2) The smaller the spacing, the greater the stiffness,
The guide wire according to (1), wherein the rigidity increases and the outer diameter decreases as the separation distance decreases.

(3) The changing portion includes a connecting member that connects the first coil and the second coil and forms a ring shape along a circumferential direction of the outer peripheral portion of the core wire,
One of the inner peripheral portion of the connecting member and the outer peripheral portion of the core wire is formed with a cam groove along the central axis direction of the core wire, and the other is inserted into the cam groove, and the cam The guide wire according to (1) or (2), wherein a follower portion that slides along a groove forming direction is formed to protrude.

(4) The changing portion is coupled to the proximal end side of the first coil together with the second coil, and is arranged on the outer peripheral portion of the core wire in the direction opposite to the second wire along the circumferential direction. The third wire has a third coil intersecting with the second wire,
4. The method according to any one of (1) to (3), wherein the operation is performed by compressing the second coil and the third coil together toward the center line side of the core wire. Guide wire.

  (5) When changing the change part, adjustment of the space | interval of the said 1st wire adjacent to the central axis direction of the said core wire, the inner peripheral part of the said 2nd coil, and the outer periphery of the said core wire The guide wire according to any one of (1) to (4), wherein the adjustment of the separation distance from the portion is collectively operated.

  (6) When changing the changing portion, adjustment of the interval between the second wire rods adjacent to each other in the central axis direction of the core wire, the inner peripheral portion of the first coil, and the outer periphery of the core wire The guide wire according to any one of (1) to (4), wherein the adjustment of the separation distance from the portion is collectively operated.

  (7) The guide wire according to any one of (1) to (6), further including an operation unit connected to a proximal end side of the second coil and performing the operation.

  In the guide wire of the present invention, it is preferable that the operation portion is supported so as to be rotatable around the central axis of the core wire and the movement of the core wire in the central axis direction is restricted.

  In the guide wire of the present invention, it is preferable that the length of the changing portion along the central axis direction of the core wire is constant.

  In the guide wire of the present invention, the adjustment of the separation distance between the inner peripheral portion of the second coil and the outer peripheral portion of the core wire is performed by adjusting the distance between the second wires adjacent to each other in the central axis direction of the core wire. It is preferable to carry out the adjustment.

  In the guide wire of the present invention, the adjustment of the separation distance between the inner peripheral portion of the first coil and the outer peripheral portion of the core wire is performed by adjusting the distance between the first wire rods adjacent to each other in the central axis direction of the core wire. It is preferable to carry out the adjustment.

  In the guide wire of the present invention, it is preferable that the winding direction of the first wire rod and the winding direction of the second wire rod are the same.

In the guide wire of the present invention, the changing portion is disposed inside the other coil, and has an inner coil formed by winding an inner coil wire around the outer circumferential portion of the core wire along the circumferential direction thereof.
When the change portion changes, it is preferable that the wire constituting the other coil enters between the inner coil wires adjacent to each other in the central axis direction of the core wire.

  In the guide wire of the present invention, it is preferable to include a lock portion that maintains the changed state of the changing portion.

  In the guide wire of the present invention, it is preferable that the degree of change of the changing portion can be grasped.

  According to the present invention, it is possible to appropriately change, that is, switch the changing portion according to the stage of the procedure and the case. As a result, it is possible to save time and effort in conventional procedures such as sequentially exchanging a plurality of types of guidewires having different tip end stiffness (tip load), etc. Excellent in properties.

FIG. 1 is a longitudinal sectional side view showing an operation state of a guide wire (first embodiment) of the present invention. 2 is a cross-sectional view taken along line AA in FIG. FIG. 3 is a longitudinal sectional side view for explaining an example of use of the guide wire shown in FIG. FIG. 4 is a side view showing the operating state of the guide wire (second embodiment) of the present invention. FIG. 5 is a longitudinal sectional view showing an operation state of the guide wire (third embodiment) of the present invention. FIG. 6 is a side view showing the operating state of the guide wire (fourth embodiment) of the present invention. FIG. 7 is a cross-sectional view of the core wire and the operation member provided in the guide wire (fifth embodiment) of the present invention.

  Hereinafter, the guide wire of the present invention will be described in detail based on a preferred embodiment shown in the accompanying drawings.

<First Embodiment>
FIG. 1 is a longitudinal sectional side view showing an operation state of a guide wire (first embodiment) of the present invention. 2 is a cross-sectional view taken along line AA in FIG. FIG. 3 is a longitudinal sectional side view for explaining an example of use of the guide wire shown in FIG. In the following, for convenience of explanation, the right side in FIGS. 1 and 3 (the same applies to FIGS. 4 to 6) is referred to as “base end”, and the left side is referred to as “tip”. Further, in FIG. 1 (the same applies to FIGS. 4 to 6), for the sake of easy understanding, the length direction of the guide wire is shortened and the radial direction of the guide wire is exaggerated and schematically illustrated. The ratio between the length direction and the radial direction is greatly different from the actual ratio.

  A guide wire 1 shown in FIG. 1 is provided at a long core wire 2, a tip portion of the core wire 2, a change portion 3 in which rigidity or an outer diameter changes, and an operation so that the change portion 3 changes. An operation member (operation unit) 4 is provided. Hereinafter, the configuration of each unit will be described. The total length of the guide wire 1 is not particularly limited. For example, when the guide wire 1 is inserted from the lower limb and used in the peripheral region, it is preferably 1500 to 3500 mm, and is 1800 to 3000 mm. Is more preferable.

  The core wire 2 is made of a flexible material. Such a constituent material is not particularly limited, and for example, various metal materials can be used, and among them, a superelastic alloy is particularly preferable. Superelastic alloys include any shape of the stress-strain curve caused by tension, including those that can significantly measure transformation points such as As, Af, Ms, and Mf, and those that cannot be deformed. However, everything that returns to its original shape by removing stress is included. The preferred composition of the superelastic alloy is Ni-Ti alloy such as Ni-Ti alloy of 49-52 atomic% Ni, Cu-Zn alloy of 38.5-41.5 wt% Zn, 1-10 wt% X Cu-Zn-X alloy (X is at least one of Be, Si, Sn, Al, and Ga), 36-38 atomic% Al-Ni-Al alloy, and the like. Of these, a Ni-Ti alloy is particularly preferable.

  Such a superelastic alloy is relatively flexible, has a resilience, and is difficult to bend, so that the guide wire 1 has sufficient flexibility and resilience to bending as a whole, and is curved in a complicated manner. -The followability to the bending blood vessel is improved, and more excellent operability is obtained. Further, even when the guide wire 1 is repeatedly bent and bent, the guide wire 1 is not bent due to the restoring property of the guide wire 1, so that the operability is prevented from being deteriorated due to the guide wire 1 being bent during use. be able to.

  As shown in FIG. 1, the core wire 2 includes a small diameter portion 21, a tapered portion 22, and a large diameter portion 23 that are arranged in order from the distal end toward the proximal end.

  The small diameter portion 21 is a constant outer diameter constant portion (first constant outer diameter portion) whose outer diameter is constant along the wire longitudinal direction, and is the smallest portion in the core wire 2.

  The tapered portion 22 is a portion where the outer diameter gradually decreases toward the front, and is continuously provided at the proximal end of the small diameter portion 21. The taper angle of the taper portion 22 (which can also be referred to as “the decrease rate of the outer diameter”) is constant along the wire longitudinal direction in the illustrated configuration, but is not limited thereto, and is not limited thereto. There may be a site that changes along the line. In this case, for example, a portion where the taper angle is relatively large and the portion where the taper angle is relatively small may be alternately formed a plurality of times.

  In addition, the taper portion 22 can gradually reduce the rigidity (bending rigidity, torsional rigidity) of the core wire 2 toward the distal end direction. As a result, the guide wire 1 has good flexibility at the distal end portion. Thus, followability to the blood vessel and safety can be improved, and bending and the like can be prevented.

  The large diameter portion 23 is provided continuously at the proximal end of the tapered portion 22. The large diameter portion 23 is a constant outer diameter portion (second constant outer diameter portion) whose outer diameter is constant along the wire longitudinal direction, and is the largest portion of the core wire 2 in size.

  The changing portion 3 is a portion where both rigidity and outer diameter change. The state shown in FIG. 1A is an initial state (first state). The state shown in FIG. 1 (b) has higher rigidity than the state shown in FIG. 1 (a), and the average outer diameter of the change part 3 is the average outer diameter of the change part 3 in the state shown in FIG. 1 (a). This is a smaller state (second state). The state shown in FIG. 1C is more flexible than the state shown in FIG. 1A, that is, the rigidity is low, and the average outer diameter of the change part 3 is the state shown in FIG. This is a state (third state) larger than the average outer diameter of the change part 3. The state shown in FIG. 1A can also be referred to as an “intermediate state” between the state shown in FIG. 1B and the state shown in FIG.

  The changing unit 3 is disposed between the first coil 5, the second coil 6 disposed on the proximal end side of the first coil 5, and the first coil 5 and the second coil 6. And a connecting member 7.

  The changing portion 3 includes a first coil 5, a second coil 6, and a connecting member 7 provided on the small diameter portion 21 of the core wire 2. The changing portion 3 collectively covers these members, for example, Teflon (“ “Teflon” may have a cover member made of registered trademark).

  The first coil 5 is a member formed by winding the first wire 51 in a coil shape around the outer peripheral portion 211 of the small diameter portion 21 of the core wire 2 along the circumferential direction. In the first coil 5, the distal end portion 511 of the first wire 51 is fixed to the distal end of the core wire 2 via the fixing material 11, and the proximal end portion 512 is fixed to the connecting member 7.

  As shown in FIG. 1A, in the initial state, the first coil 5 is formed by winding the first wire 51 adjacent in the direction of the central axis 20 of the core wire 2 (left and right direction in the drawing). Are spaced apart from each other, so-called “sparse winding”. Thereby, the first coil 5 can be expanded and contracted by an operation by the operation member 4. Further, the inner peripheral portion 52 of the first coil 5 is separated from the outer peripheral portion 211 of the small diameter portion 21.

  Note that the fixing material 11 is, for example, solder, and the tip 111 is preferably rounded.

  The second coil 6 is formed by winding the second wire 61 in a coil shape along the circumferential direction around the outer peripheral portion 211 of the small diameter portion 21 of the core wire 2 on the proximal end side of the first coil 5. It is a member. The winding direction of the second wire 61 is the same as the winding direction of the first wire 51. Thereby, for example, the blood vessel followability at the changing portion 3 is improved.

  In the second coil 6, the distal end portion 611 of the second wire 61 is fixed to the connecting member 7, and the proximal end portion 612 is fixed to the operation member 4.

  As shown in FIG. 1A, in the initial state, the second coil 6 has the second wire 61 adjacent to each other in the direction of the central axis 20 of the core wire 2 spaced apart from each other, Similar to the coil 5, it is a so-called “sparse winding”. Thereby, the second coil 6 can also be expanded and contracted by the operation by the operation member 4. Further, the inner peripheral portion 62 of the second coil 6 is separated from the outer peripheral portion 211 of the small diameter portion 21.

  In addition, although the internal diameter of the 1st coil 5 in the initial state and the internal diameter of the 2nd coil 6 are the same in the structure shown to Fig.1 (a), it is not limited to this, You may differ. In this case, the inner diameter of the first coil 5 is preferably larger than the inner diameter of the second coil 6.

The outer diameter .phi.d ₅ of the first coil 5 in the initial state and the outer diameter .phi.d ₆ of the second coil 6 is the same in the configuration shown in FIG. 1 (a), not limited to this, May be different. In this case, preferably smaller than the outer diameter .phi.d ₅ of the first coil 5 outer diameter .phi.d ₆ of the second coil 6.

  Further, the length (full length) of the first coil 5 in the direction of the central axis 20 and the length (full length) of the second coil 6 in the direction of the central axis 20 in the initial state are shown in FIG. Although it is the same in configuration, it is not limited to this and may be different. In this case, it is preferable that the total length of the first coil 5 is smaller than the total length of the second coil 6.

Further, in the initial state, the separation distance g ₅ between the inner peripheral portion 52 of the first coil 5 and the outer peripheral portion 211 of the small diameter portion 21, and the inner peripheral portion 62 of the second coil 6 and the outer peripheral portion 211 of the small diameter portion 21. the distance g ₆ and is the same in the configuration shown in FIG. 1 (a), without being limited thereto, may be different. In this case, preferably larger than the distance g ₆ the distance g _5.

  Moreover, the wire diameter of the 1st wire 51 which comprises the 1st coil 5, and the wire diameter of the 2nd wire 61 which comprises the 2nd coil 6 are the same in the structure shown to Fig.1 (a). However, it is not limited to this and may be different. In this case, it is preferable that the wire diameter of the first wire 51 is smaller than the wire diameter of the second wire 61.

  The constituent material of the first wire 51 and the constituent material of the second wire 61 are each preferably made of a metal material. Examples of the metal material include stainless steel, superelastic alloy, Examples thereof include cobalt-based alloys, noble metals such as gold, platinum, and tungsten, and alloys containing these. In particular, when the guide wire 1 is made of an X-ray opaque material such as a noble metal, X-ray contrast can be obtained in the guide wire 1, and the guide wire 1 can be inserted into the living body while confirming the position of the tip under X-ray fluoroscopy. It is preferable in that it can be performed. Moreover, the constituent material of the 1st wire 51 and the constituent material of the 2nd wire 61 may be the same, and may differ.

  The first coil 5 and the second coil 6 configured as described above are connected via a connecting member 7. The connecting member 7 is a member that forms a ring shape along the circumferential direction of the small diameter portion 21 of the core wire 2.

  As shown in FIG. 2, a pair of follower portions 72 project from the inner peripheral portion 71 of the connecting member 7 toward the central axis 20 side. These follower portions 72 are disposed on opposite sides of the central axis 20.

  On the other hand, a pair of cam grooves 212 are formed on the outer peripheral portion 211 of the small-diameter portion 21 of the core wire 2 along the direction of the central axis 20 (the depth direction in FIG. 2). A follower portion 72 is inserted into each cam groove 212. Accordingly, the follower portion 72 is guided along the direction in which the cam groove 212 is formed, and thus the connecting member 7 can reciprocate along the direction of the central axis 20. Further, the cam groove 212 regulates the movement limit of the connecting member 7 toward the distal end and the movement limit toward the proximal end.

  As shown in FIG. 1, the operation member 4 is connected and fixed to the proximal end side of the second coil 6. The operation member 4 is a member for performing an operation so that the changing unit 3 changes.

  The operation member 4 is configured by a tubular member. A pair of convex portions 42 project from the inner peripheral portion 41 of the operation member 4 toward the central axis 20 side. These convex portions 42 are disposed on the opposite sides with respect to the central axis 20.

  Further, a concave portion (groove) 232 having a ring shape along the circumferential direction is formed on the outer peripheral portion 231 of the large-diameter portion 23 of the core wire 2. And each convex part 42 of the operation member 4 can be inserted in the recessed part 232, and can be engaged. As a result, the operation member 4 is supported so as to be rotatable about the central axis 20. Further, the movement of the operation member 4 is restricted in the direction of the central axis 20.

  A marker 44 is attached to the outer peripheral portion 43 of the operation member 4. The large-diameter portion 23 of the core wire 2 protrudes from the proximal end opening 45 of the operation member 4, and a marker 24 is attached to the protruding portion of the outer peripheral portion 231.

  In the initial state shown in FIG. 1A, the marker 44 and the marker 24 overlap each other. When the operation member 4 is rotated from this state as shown in FIG. 1B, the marker 44 is displaced from the marker 24 by that amount. Further, as shown in FIG. 1C, when the operation member 4 is rotated in the opposite direction, the marker 44 is displaced from the marker 24 by that amount. Then, an operator who is an operator of the guide wire 1 can visually recognize the amount of the deviation during the procedure. Thereby, the degree of change of the change unit 3 can be easily and reliably grasped, and thus the change unit 3 can be used properly.

  In addition, it does not specifically limit as a constituent material of the operation member 4 or the connection member 7, For example, the material quoted as a constituent material of the core wire 2 can be used.

  Next, the mechanism by which the change part 3 changes by operation of the operation member 4 is demonstrated, referring FIG.

When the operation member 4 is rotated around the central axis 20 at a desired rotation angle from the initial state shown in FIG. 1A as shown in FIG. Is transmitted to the coil 6 from the base end side. At this time, the second coil 6 tries to rotate around the central axis 20, but since the rotation is restricted by the connecting member 7 on the distal end portion 611 side, the second coil 6 is twisted around the central axis 20. Thereby, the outer diameter φd _{6 of} the second coil 6 is reduced as a whole, and the inner peripheral portion 62 and the outer peripheral portion 211 of the core wire 2 gradually approach each other, that is, the separation distance g _6. Will decrease. The change unit 3, the smaller this distance g _6, tends to rigidity increases. Incidentally, the distance g ₆ when zero in a state in which the outer peripheral portion 211 of the inner peripheral portion 62 and the core line 2 of the second coil 6 are in close contact.

Further, an amount corresponding to the outer diameter .phi.d ₆ is reduced in diameter, spreading the second wire 61 spacing S ₆ of which are adjacent to each other in the central axis 20 direction, the second coil 6, the overall length is gradually stretched, i.e., stretched To go. Thereby, the first coil 5 receives a compressive force via the connecting member 7, and the interval S ₅ between the first wire rods 51 adjacent in the direction of the central axis 20 is narrowed, that is, contracted. The change unit 3, the smaller this distance S _5, there is a tendency that the rigidity is increased. Note that the outer diameter φd _{5 of} the first coil 5 is slightly increased by the amount of contraction.

  In the state shown in FIG. 1B as described above, the changing portion 3 is increased in rigidity by the first coil 5 and is also increased in the second coil 6. As a result, the change part 3 will be in the state where rigidity increased as a whole. Moreover, the average outer diameter of the change part 3 in the state shown in FIG.1 (b) is smaller than the average outer diameter of the change part 3 in the state shown in FIG.1 (b). In such a high-rigidity / small-diameter state, the pushability of the guide wire 1 is improved and the passage through the narrowed portion 201 generated in the blood vessel 200 is also improved (see FIG. 3A). Further, in the high rigidity and small diameter state, the opposite characteristics of high rigidity and small diameter can be realized at the same time.

On the other hand, from the initial state shown in FIG. 1 (a), as shown in FIG. 1 (c), when the operation member 4 is rotated around the central axis 20 at a desired rotation angle in the opposite direction, the rotational force is increased. , Transmitted from the proximal end side to the second coil 6 of the changing portion 3. At this time, the second coil 6 tries to rotate around the central axis 20, but since the rotation is restricted by the connecting member 7 on the tip portion 611 side, the second coil 6 is twisted around the central axis 20 in the opposite direction. I will be struck. As a result, the outer diameter φd _{6 of} the second coil 6 increases as a whole, and the inner peripheral portion 62 and the outer peripheral portion 211 of the core wire 2 are further separated, that is, the separation distance g ₆ is increased. To increase. The change unit 3, the larger this distance g _6, tends to rigidity decreases.

Further, an amount corresponding to the outer diameter .phi.d ₆ is enlarged, narrowing the second wire 61 spacing S ₆ of which are adjacent to each other in the central axis 20 direction, the second coil 6 is gradually contracted. Thus, the first coil 5 receives a tensile force via the connecting member 7, spreads the first wire 51 spacing S ₅ of which are adjacent to the central axis 20 direction, i.e., gradually extended. The change unit 3, the larger this distance S _5, there is a tendency that the rigidity is reduced. The first coil 5 is slightly reduced in outer diameter φd ₅ by the amount of extension. In the state shown in FIG. 1C, the inner peripheral portion 52 of the first coil 5 remains separated from the outer peripheral portion 211 of the core wire 2.

  In the state shown in FIG. 1C as described above, the rigidity of the changing unit 3 is reduced by the first coil 5 and the rigidity is also reduced by the second coil 6. As a result, as a whole, the change part 3 will be in the state where rigidity fell, ie, the state which was rich in the softness | flexibility. Moreover, the average outer diameter of the change part 3 in the state shown in FIG.1 (c) is larger than the average outer diameter of the change part 3 in the state shown in FIG.1 (b). In such a high flexibility and large diameter state, blood vessel followability is improved, and safety that can reliably prevent damage to the blood vessel 200 during the procedure can be ensured.

Thus, the guide in wire 1, when changing the change unit 3, the adjustment of the spacing S ₅ of the first coil 5, the adjustment of the distance g ₅ of the second coil 6 and the core wire 2 It is possible by operating all of them together. Thereby, according to the stage of a procedure and a case, the grade of the change of the change part 3 can be switched suitably, Therefore The guide wire 1 can be used quickly and it is excellent in operativity.

  Further, the length of the changing portion 3 along the direction of the central axis 20 is constant regardless of the change, and the length depends on the procedure in which the guide wire 1 is used and various conditions such as the blood vessel 200. For example, when the guide wire 1 is inserted from the lower limb and used in the peripheral region, it is preferably 30 mm or more and 3000 mm or less, and more preferably 100 mm or more and 2000 mm or less.

Next, an example of how to use the guide wire 1 will be described with reference to FIG.
[1] As shown in FIG. 3 (a), a stenosis 201 occurs in the blood vessel 200, which inhibits blood flow.

  [2] Next, after the guide wire 1 is inserted into the blood vessel 200 and the change part 3 reaches just before the stenosis part 201, as shown in FIG. -As a small diameter state, the passing operation of the constriction part 201 is performed. Note that, until the guide wire 1 reaches the constricted portion 201, the changing portion 3 may be in a high rigidity / small diameter state, or may be in a high flexibility / large diameter state.

  [3] Next, as shown in FIG. 3C, the changing portion 3 is switched to a highly flexible and large diameter state. Thereby, the passage route (puncture route) 202 with respect to the constriction part 201 of the change part 3 can be expanded.

  [4] Next, as shown in FIG. 3D, the changing portion 3 is again returned to the high rigidity and small diameter state. Thereby, a gap is formed between the passage portion 202 and the changing portion 3.

  [5] Next, as shown in FIG. 3 (e), for example, a catheter 30 which is a balloon catheter is moved along the guide wire 1.

  [6] As described above, since a gap is formed between the passage portion 202 and the changing portion 3, the catheter 30 can easily pass through the passage route 202 as shown in FIG. Can do. Thereafter, 201 can be eliminated by expanding a balloon (not shown) of the catheter 30.

Second Embodiment
FIG. 4 is a side view showing the operating state of the guide wire (second embodiment) of the present invention.

Hereinafter, the second embodiment of the guide wire according to the present invention will be described with reference to this figure, but the description will focus on the differences from the above-described embodiment, and the description of the same matters will be omitted.
The present embodiment is the same as the first embodiment except that the configuration of the changing unit is different.

  In the present embodiment, the operation member 4 is omitted, and as shown in FIG. 4, the changing portion 3 is provided from the distal end portion to the proximal end portion of the core wire 2, and further includes a third coil 8. Yes.

  The third coil 8 is connected to the proximal end side of the first coil 5 through the connecting member 7 together with the second coil 6. The third wire 81 constituting the third coil 8 is wound around the outer peripheral portion 211 of the core wire 2 in a coil shape in the opposite direction to the second wire 61 along the circumferential direction. The third wire 81 intersects the second wire 61 at a plurality of locations. As a result, the second coil 6 and the third coil 8 form a “knitted pattern”.

  By grasping the third coil 8 and the second coil 6 arranged as described above together and compressing them toward the central axis 20 side, the third coil 8 can be Similar to the coil 6, the diameter of the coil 6 is reduced as a whole, and the outer peripheral portion 211 of the core wire 2 is approached to reduce the separation distance. Thereby, the change part 3 will be in a highly rigid and small diameter state.

  Moreover, in the guide wire 1 of this embodiment, the part grasped collectively functions as an operation part for performing change operation in a change part, and it can be set as the thing which abbreviate | omitted the operation member 4. FIG.

<Third Embodiment>
FIG. 5 is a longitudinal sectional view showing an operation state of the guide wire (third embodiment) of the present invention.

Hereinafter, the third embodiment of the guide wire of the present invention will be described with reference to this figure, but the description will focus on the differences from the above-described embodiment, and the description of the same matters will be omitted.
This embodiment is the same as the first embodiment except that the shape of the changing portion is different.

As shown in FIG. 5 (a), in the present embodiment, the first coil 5 changes 3 in the initial state, the distance S _5, the first interval of the coil 5 in the initial state of the first embodiment It is larger than S ₅ , that is, it is “sparsely wound” than the first coil 5 in the initial state of the first embodiment. The second coil 6 in the initial state, the distance S ₆ is smaller than the distance S ₆ of the second coil 6 in the initial state of the first embodiment, i.e., the first embodiment It is “tightly wound” rather than the second coil 6 in the initial state.

Next, the mechanism by which the changing unit 3 in the present embodiment changes will be described.
When the operation member 4 is rotated around the central axis 20 at a desired rotation angle from the initial state shown in FIG. 5A as shown in FIG. Is transmitted to the coil 6 from the base end side. At this time, the second coil 6 tries to rotate around the central axis 20, but since the rotation is restricted by the connecting member 7 on the distal end portion 611 side, the second coil 6 is twisted around the central axis 20. Thereby, the diameter of the second coil 6 is reduced overall. The second coil 6 is set so that the inner peripheral portion 62 is kept away from the outer peripheral portion 211 of the core wire 2 regardless of the degree of expansion and contraction. Then, in the second coil 6, the distance S ₆ between the second wire members 61 adjacent to each other in the direction of the central axis 20 is widened by the reduced diameter. Thereby, the change part 3 reduces the rigidity in the 2nd coil 6 side.

In addition, the first coil 5 receives a compressive force via the connecting member 7, and the interval S ₅ between the first wire rods 51 is narrowed, but the diameter is increased by that amount, and the inner peripheral portion 52 becomes the core wire 2. Further away from the outer peripheral portion 211. Thereby, the rigidity of the change part 3 also decreases on the first coil 5 side.

  Therefore, in the state shown in FIG. 5 (b), the change part 3 is in a state rich in flexibility due to a decrease in rigidity.

On the other hand, from the initial state shown in FIG. 5A, when the operation member 4 is rotated around the central axis 20 at a desired rotation angle in the opposite direction as shown in FIG. , Transmitted from the proximal end side to the second coil 6 of the changing portion 3. At this time, the second coil 6 tries to rotate around the central axis 20, but since the rotation is restricted by the connecting member 7 on the tip portion 611 side, the second coil 6 is twisted around the central axis 20 in the opposite direction. I will be struck. Accordingly, the second coil 6 are enlarged, correspondingly, will be spacing S ₆ between the second wire 61 is narrowed, the second wire 61 come in close contact with each other. Thereby, the change part 3 increases the rigidity on the second coil 6 side.

Further, the first coil 5, the connecting member 7 receives a tensile force via a spread distance S ₅ between the first wire 51, correspondingly, reduced in diameter. Thus, the distance g ₅ becomes zero, i.e., the inner peripheral portion 52 of the first coil 5 is in close contact with the outer periphery 211 of the core wire 2, therefore, the rigidity of the first coil 5 side of the changing portion 3 Will increase.
Therefore, in the state shown in FIG. 5C, the changing portion 3 is in a state where the rigidity is increased.

Thus, the guide wire 1, when changing the change unit 3, the adjustment of the second wire 61 spacing S ₆ between, the adjustment of the distance g ₅ of the first coil 5 and the core wire 2 It is possible by operating all of them together. Thereby, also in this embodiment, the change of the change part 3 can be switched suitably according to the stage and case of a procedure, Therefore The guide wire 1 can be used quickly and it is excellent in operativity.

In the initial state, the separation distance g ₅ between the inner peripheral portion 52 of the first coil 5 and the outer peripheral portion 211 of the small diameter portion 21, and the inner peripheral portion 62 of the second coil 6 and the outer peripheral portion 211 of the small diameter portion 21. the distance g ₆ and is the same in the configuration shown in FIG. 5 (a), without being limited thereto, may be different. In this case, preferably smaller than the distance g ₆ the distance g _5.

<Fourth embodiment>
FIG. 6 is a side view showing the operating state of the guide wire (fourth embodiment) of the present invention.

Hereinafter, the fourth embodiment of the guide wire according to the present invention will be described with reference to these drawings. However, the difference from the above-described embodiment will be mainly described, and the description of the same matters will be omitted.
The present embodiment is the same as the first embodiment except that the configuration of the changing unit is different.

  As shown to Fig.6 (a), in this embodiment, the change part 3 has the inner side coil 9 arrange | positioned inside the 1st coil 5 by the initial state.

  The inner coil wire 91 constituting the inner coil 9 is wound around the outer peripheral portion 211 of the core wire 2 in a coil shape in the same direction as the first coil 5 along the circumferential direction. The inner coil wires 91 adjacent to each other in the direction of the central axis 20 of the core wire 2 are separated from each other, and the inner coil wires 91 are so-called “sparsely wound”. In addition, the space | interval of the separated inner coil wire 91 is larger than the wire diameter of the 1st wire 51. FIG. Further, the inner coil wire 91 is in close contact with the outer peripheral portion 211 of the core wire 2 and is fixed by, for example, solder.

  Then, by operating the operating member 4 from the state shown in FIG. 6A, when the first coil 5 expands while reducing its diameter as shown in FIG. The first wire 51 enters between the coil wire members 91. As a result, on the first coil 5 side of the changing portion 3, the first coil 5 and the inner coil 9 are combined to form a so-called “tightly wound” state as a whole, and rigidity is increased.

  The wire diameter of the inner coil wire 91 is the same as the wire diameter of the first wire 51 in the configuration shown in FIG. 6, but is not limited to this, for example, the wire diameter of the first wire 51 It may be thin or thick.

  Further, in the configuration shown in FIG. 6, the inner coil 9 is arranged only inside the first coil 5, but the inner coil 9 is not limited to this. For example, the inner coil 9 may be arranged only inside the second coil 6. Alternatively, they may be arranged inside the first coil 5 and the second coil 6, respectively.

<Fifth Embodiment>
FIG. 7 is a cross-sectional view of the core wire and the operation member provided in the guide wire (fifth embodiment) of the present invention.

  Hereinafter, the fifth embodiment of the guide wire of the present invention will be described with reference to this drawing. However, the description will focus on the differences from the above-described embodiment, and the description of the same matters will be omitted.

  This embodiment is the same as the first embodiment except that the configurations of the core wire and the operation member are different.

  As shown in FIG. 7, in the present embodiment, a ratchet mechanism 12 is provided as a lock portion that maintains the changed portion 3 in a changed state.

  The ratchet mechanism 12 includes a plurality of ratchet teeth 25 arranged along the circumferential direction of the outer peripheral portion 231 of the large-diameter portion 23 of the core wire 2 and the inner peripheral portion 41 of the operation member 4 via the central shaft 20. And a pair of claws 46 arranged on the opposite side. In the ratchet mechanism 12 having such a configuration, when the operation member 4 is rotated, each claw 46 sequentially climbs over the ratchet teeth 25 and engages with the ratchet teeth 25 that have been overcome. Then, when the rotation operation of the operation member 4 is stopped, the operation member 4 is in a state in which the rotation in the opposite direction is restricted. Thereby, even if the surgeon releases the hand from the guide wire 1, the changed portion 3 can be maintained in a changed state.

  The ratchet mechanism 12 may be configured to be able to release the engagement between the claw 46 and the ratchet teeth 25 in a state where the rotation of the operation member 4 is stopped.

  As mentioned above, although the guide wire of this invention was demonstrated about embodiment of illustration, this invention is not limited to this, Each part which comprises a guide wire is a thing of arbitrary structures which can exhibit the same function. Can be substituted. Moreover, arbitrary components may be added.

  In addition, the guide wire of the present invention may be a combination of any two or more configurations (features) of the above embodiments.

  Further, the wire body may be made of stainless steel having higher rigidity than the superelastic alloy, or a first wire arranged on the proximal end side and made of stainless steel, and a distal end It may be arranged on the side and joined with a second wire made of a superelastic alloy.

  In addition, the changing portion is configured such that both the rigidity and the outer diameter change in each of the above embodiments, but is not limited thereto, and is configured so that only one of the rigidity and the outer diameter changes. Also good.

  Moreover, in each said embodiment, the cam groove is formed in the core wire, and the follower part is formed in the connection member. In this invention, it is not limited to this, A cam groove may be formed in a connection member, and a follower part may be formed in the core wire.

DESCRIPTION OF SYMBOLS 1 Guide wire 2 Core wire 20 Center axis 21 Small diameter part 211 Outer part 212 Cam groove 22 Taper part 23 Large diameter part 231 Outer part 232 Recessed part (groove)
24 marker 25 ratchet tooth 3 changing part 4 operation member (operation part)
41 Inner peripheral portion 42 Convex portion 43 Outer peripheral portion 44 Marker 45 Base end opening portion 46 Claw 5 First coil 51 First wire rod 511 Tip portion 512 Base end portion 52 Inner peripheral portion 6 Second coil 61 Second wire rod 611 distal end portion 612 proximal end portion 62 inner circumferential portion 7 connecting member 71 inner circumferential portion 72 follower portion 8 third coil 81 third wire 81 inner coil 91 inner coil wire 11 fixing material 111 distal end 12 ratchet mechanism 30 catheter 200 Blood vessel 201 Stenosis 202 Passing path (piercing path)
φd ₅ , φd ₆ outer diameter g ₅ , g ₆ spacing S ₅ , S ₆ spacing

Claims (7)

A core wire having a long shape and having flexibility;
Provided at least at the distal end of the core wire, and includes a changing portion whose rigidity or outer diameter changes,
A first coil formed by winding a first wire rod along the circumferential direction of the outer periphery of the core wire, the tip of the changing portion being fixed to the tip of the core wire;
A second coil connected to the proximal end side of the first coil and wound around a second wire along the circumferential direction of the outer periphery of the core wire;
Adjustment of the space | interval of the winding which adjoins the central-axis direction of the said core wire of the wire which comprises one coil of the said 1st coil and the said 2nd coil, and the inner peripheral part of the other coil The guide wire is configured such that the changing portion is changed by collectively adjusting the distance between the core wire and the outer peripheral portion of the core wire. The smaller the spacing, the greater the stiffness,
The guide wire according to claim 1, wherein the rigidity increases and the outer diameter decreases as the separation distance decreases. The changing portion includes a connecting member that connects the first coil and the second coil and forms a ring shape along a circumferential direction of an outer peripheral portion of the core wire,
One of the inner peripheral portion of the connecting member and the outer peripheral portion of the core wire is formed with a cam groove along the central axis direction of the core wire, and the other is inserted into the cam groove, and the cam The guide wire according to claim 1, wherein a follower portion that slides along a groove forming direction is formed to protrude. The changing portion is connected to the proximal end side of the first coil together with the second coil, and a third wire in the direction opposite to the second wire along the circumferential direction of the outer periphery of the core wire. And the third wire has a third coil intersecting with the second wire,
The guide according to any one of claims 1 to 3, wherein the operation is performed by collectively compressing the second coil and the third coil toward the center line side of the core wire. Wire.   When changing the changing portion, the adjustment of the interval between the first wire rods adjacent to each other in the central axis direction of the core wire, and the inner peripheral portion of the second coil and the outer peripheral portion of the core wire. The guide wire according to any one of claims 1 to 4, wherein the adjustment of the separation distance is collectively performed.   When changing the changing portion, the adjustment of the interval between the second wire rods adjacent to each other in the central axis direction of the core wire, the inner peripheral portion of the first coil and the outer peripheral portion of the core wire The guide wire according to any one of claims 1 to 4, wherein the adjustment of the separation distance is collectively performed.   The guide wire according to any one of claims 1 to 6, further comprising an operation unit connected to a proximal end side of the second coil and performing the operation.

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