JPWO2008012914A1 - catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To further improve the backup in the case of introducing a distal end through a main biological duct including the ascending aorta to a secondary biological duct including the coronary artery, Provided is a catheter that can further reduce the possibility of causing a burden. The shape of the second curve 11 of the distal end portion 5 in the indwelling state is a curved shape along the wall from the mouth of the left coronary artery L to the wall portion of the ascending aorta U on the opposite side, or the curve In order to take the shape, the shape of the second curve 11 of the tip 5 in the natural state is three-dimensionally curved. [Selection] Figure 2

Description

  The present invention relates to a catheter as a medical instrument.

  As coronary catheters, those described in Patent Documents 1 and 2 below are known. The former introduces the tip of the arm from the artery of the arm to the left coronary artery that branches from the ascending aorta, and as shown in FIG. When the distal end is introduced (dwelling), as shown in FIG. 5 of Patent Document 1, the distal end is curved so that it is supported by the left coronary artery opening and the ascending aortic wall opposite to it. Is.

  On the other hand, the latter introduces the distal end from the descending aorta to the right coronary artery that branches from the ascending aorta, and as shown in FIGS. 2B to 12B of Patent Document 2, the descending aorta is connected to the ascending aorta. From the viewpoint of facilitating introduction into the right coronary artery with a curve corresponding to the aortic arch, as shown in FIGS. 5B and 6B of Patent Document 2, it is ahead or near the tip of the curve corresponding to the aortic arch. Are disclosed in which a slight angle is given from the base end portion.

Japanese Patent No. 3659502 Japanese Patent No. 3469578

  In the catheter of Patent Document 1, since it is supported by the ascending aortic wall and the left coronary artery opening away from it during indwelling, there is a possibility that the portion ahead of the ascending aortic wall may be up and down during the operation. When a reaction force due to insertion of an instrument such as a guide wire into the catheter acts on the distal end portion of the catheter, an unintended displacement may occur at the distal end. Therefore, in the catheter of Patent Document 1, there is a possibility of unexpected movement and unintentional detachment from the left coronary artery opening.

  The catheter of Patent Document 2 also floats from the aortic arch wall at the time of placement and is not always supported by the aortic arch. In the vicinity of the right coronary artery of the ascending aorta, as in Patent Document 1, Supporting two points may cause troubles in operation.

  Therefore, the invention according to claim 1 provides support by the inner wall of the main biological conduit when the distal end is introduced into the secondary biological conduit including the coronary artery via the main biological conduit including the ascending aorta. Furthermore, it is an object of the present invention to provide a catheter that can further reduce the possibility of troubles in operation.

  In order to achieve the above object, the invention according to claim 1 is a catheter for introducing and placing a distal end into a sub-biological channel branched from the main bio-channel, and comprising a hollow catheter body And the inner wall of the main biological conduit from the branch portion of the main biological conduit and the secondary biological conduit to the inner wall portion of the main biological conduit opposite to the main biological conduit in the indwelling state. It is formed so as to include a shape corresponding to a curve along the line.

  The invention according to claim 2 is the invention according to claim 1, wherein the proximal end portion of the catheter body is formed linearly in a natural state and the distal end portion of the catheter body is in a natural state. The base end portion or an extension line thereof is formed so as to be wound.

  Furthermore, the invention described in claim 3 is characterized in that, in the invention described in claim 1, the distal end portion of the catheter body is formed to be bent in a natural state.

  Still further, the invention according to claim 4 is the invention according to claim 1, wherein the proximal end portion of the catheter body is formed in a straight line in the natural state, and the distal end portion of the catheter body is in the natural state. In this case, the base end portion is formed so as to be bent as viewed from the axial direction.

  In addition, the invention according to claim 5 is a catheter for introducing and indwelling the distal end of the secondary biological conduit that branches from the primary biological conduit, comprising a hollow catheter body, In the natural state, the distal end portion of the catheter body corresponds to a curve along the inner wall of the main biological conduit from the branch portion of the main biological conduit and the secondary biological conduit to the inner wall portion of the opposite main biological conduit It is formed so that the shape to be included may be included.

  According to the present invention, it is possible to prevent a situation in which the proximal end side of the catheter main body from the introduction portion of the secondary biological conduit in the main body conduit moves in the primary biological pipeline, and to perform operations such as detachment from the distal end of the secondary biological conduit. Can be prevented.

  A catheter according to an embodiment of the present invention will be described based on the drawings as appropriate. 1 is a partially omitted explanatory view of the catheter 1, FIG. 2 is an explanatory view of the vicinity of the distal end of the catheter 1, FIG. 3 is an explanatory view of the catheter 1 in an indwelling body, and FIG. 4 is a cross-sectional view taken along line AA in FIG. FIG. The catheter 1 is a guiding catheter for coronary arteries. The catheter 1 has a hollow flexible resin-made catheter body (hereinafter referred to as “main body”) 2 formed in an open-ended tubular shape, and a hub 3 for connecting a contrast medium injector or the like. The hub 3 is joined to the base end of the main body 2.

  The main body 2 has an outer diameter of 1.7 mm (millimeters), an inner diameter of 1.15 mm, and an effective length of 990 mm. Examples of the material of the main body 2 include polyamide, polyester-based polyamide, polyether-based polyamide, polyurethane, and fluorine-based resin.

  The base end portion 4 of the main body 2 is linearly formed in a natural state. On the other hand, as shown also in FIG. 2, the front-end | tip part 5 of the main body 2 is formed so that it may curve in a natural state. In addition, as FIG. 3 shows, the front-end | tip part 5 is curved also in the indwelling state.

  In the distal end portion 5, a first curve 10 is provided near the distal end (10 mm from the distal end). In addition, a third curve 12 is given to a portion of the inner wall of the ascending aorta U away from the first curve 10 by a length (55 mm) corresponding to a distance corresponding to a half circumference in the vicinity of the left coronary artery L or the right coronary artery R. ing. A space between the first curve 10 and the third curve 12 is a second curve 11 that bends more gently than the third curve 12. Note that the ascending aorta U corresponds to the main biological duct, and the left coronary artery L corresponds to the sub-biological duct as a distal introduction target that branches off from the main biological duct.

  The first curve 10 is bent in a direction different from that of the second curve 11. The second curve 11 has a shape corresponding to a curve along the inner wall of the ascending aorta U from the branching portion of the left coronary artery L to the ascending aorta U to the inner wall portion of the ascending aorta U on the opposite side. The third curve 12 is given so that the base end side is away from the virtual plane including the second curve 11. The proximal end side of the third curve 12 at the distal end portion 5 is gently curved so as to gradually approach the linear proximal end portion 4.

  As described above, the distal end portion 5 is formed so as to bend continuously from the first curve 10 in a natural state, and is formed so as to wind an extension line of the proximal end portion 4 except for the first curve 10. . Further, the main body 2 is formed in a three-dimensional manner so that an extension line on the base end side 4 intersects with a virtual plane including the second curve 11 in a natural state.

  The catheter 1 can be introduced and placed by an operator as shown below. That is, first, the operator passes a guide wire (not shown) through the main body 2, makes the distal end portion 5 linear from the base end portion 4, and makes the main body 2 a flexible linear shape. Next, an operator introduce | transduces the front-end | tip part 5 from the artery of a right arm using the catheter introducer which is not shown in figure. Subsequently, the operator advances the distal end portion 5 from the brachial artery (not shown) to the axillary artery, to the ascending aorta U via the right subclavian artery S shown in FIG. In addition, since the right and left in the blood vessel name is based on the introduction target person, the left and right in FIG. 3 represented from the abdomen side of the introduction target person are reversed.

  The operator pulls the guide wire when the distal end side of at least the portion corresponding to the third curve 12 in the distal end portion 5 enters the ascending aorta U, and pulls the first curve 10 or the third curve 12 in the ascending aorta U. Make it appear. Thereafter, the operator introduces the left coronary artery L from the first curve 10 to the distal end side, that is, the distal end of the main body 2.

  Further, the operator moves the second curve 11 so as to be positioned above the aortic valve V and below the left coronary artery L and the right coronary artery R (the branch from the ascending aorta U). The catheter is placed in the indwelling state. At this time, the virtual plane including the second curve 11 is substantially orthogonal to the cylindrical wall surface of the ascending aorta U.

  The second curve 11 has a shape corresponding to a curve along the inner wall of the ascending aorta U from the mouth of the left coronary artery L to the inner wall portion of the ascending aorta U on the opposite side, or an extension line of the proximal end portion 5 Since the main body 2 is three-dimensional and has a length corresponding to the half circumference of the inner wall of the ascending aorta U, the operator appropriately advances the distal end portion 5 slightly. The second curve 11 corresponds to a curve along the wall of the ascending aorta U from the mouth of the left coronary artery L to the lower part of the mouth of the right coronary artery R on the opposite side of the ascending aorta wall U in the indwelling state. The shape to be taken can be taken. In this case, as shown in FIG. 4, the second curve 11 is in continuous contact with the inner wall of the ascending aorta U.

  In the catheter 1 described above, the shape of the distal end portion 5 in the indwelling state includes a curved shape along the wall from the mouth of the left coronary artery L to the wall portion of the ascending aorta U on the opposite side, or takes the curved shape. Thus, since the shape of the distal end portion 5 in the natural state is three-dimensional and curved, the distal end portion 5 is continuous with the inner wall of the ascending aorta U from the left coronary artery L to the opposite side. Can be contacted. Therefore, the catheter 1 is supported by the inner wall of the ascending aorta U immediately after the distal end of the main body 2 introduced into the left coronary artery L during indwelling, and the proximal end side moves from the distal end of the main body 2 relative to the distal end. Thus, it is possible to prevent troubles such as detachment from the left coronary artery L at the tip.

  In addition, the catheter 1 can cope with a deformation in which the diameter of the second curve 11 is increased when an instrument such as a guide wire or a balloon catheter is inserted into the distal end portion 5. That is, in the catheter 1, the force F in the diameter-enlarging direction of the second curve 11 generated by this deformation can be received by the inner wall of the ascending aorta U with which the second curve 11 continuously contacts. These forces F act on the inner wall of the ascending aorta U almost perpendicularly. Thereby, the distal end portion of the catheter 1 is supported more firmly on the inner wall of the ascending aorta U. This also prevents a situation in which the proximal end side moves from the distal end of the main body 2 and prevents troubles in operations such as detachment from the left coronary artery L at the distal end. .

  Furthermore, since the catheter 1 is supported by continuously contacting the distal end portion 5 to the inner wall of the ascending aorta U during placement, the load applied to the mouth of the left coronary artery L can be reduced. Therefore, with the catheter 1, the burden on the mouth of the left coronary artery L can be reduced.

  In addition, other embodiment of this invention which mainly changes the said embodiment and illustrates is illustrated. A hole is provided on the side face of the main body. The first curve is not provided and the second curve continues to the tip. The direction of bending of the first to third curves is reversed. For the material of the main body, a laminate of a synthetic resin and a metal mesh or a metal is used.

  Also, the flexibility at the tip is higher than the other parts, the flexibility of the second curve is higher than the other parts, the flexibility of the tip and the second curve is higher than the other parts, Increase flexibility and further increase flexibility at the tip. In this way, since the distal end portion is easily deformed by forming the portion to which at least the second curve is provided in the distal end portion more flexibly than the proximal end portion, during the introduction operation to introduce into the biological duct Interference with the biological duct can be suitably prevented, and a catheter introduction operation that can be firmly supported on the inner wall of the biological duct can be performed more easily.

  Alternatively, a hydrophilic coating is applied to a portion excluding the portion to which the second curve is given in the tip portion, and the friction coefficient between the portion to which the second curve is given and the inner wall of the biological duct is determined, and the other tip portion and the biological tube Higher than the coefficient of friction with the road inner wall. As a result, the introduction operation can be performed more easily while maintaining the level of support to the inner wall of the biological duct.

  In addition, the second curve is a semi-spiral curve along the ascending aorta wall from the left coronary artery mouth to the portion of the ascending aorta opposite to the right coronary artery mouth in the indwelling state or the natural state. Or a curve along any other ascending aorta from the left coronary ostium to the other wall portion of the ascending aorta on the opposite side.

  Alternatively, the second curve corresponds to a curve along the ascending aorta wall from the right coronary artery opening to the wall portion of the ascending aorta on the opposite side in the indwelling state or the natural state. In this case, the secondary biological duct that is the target for introduction at the distal end is the right coronary artery. The main biological duct is an aorta and the secondary biological duct is a renal artery that branches from the aorta. Alternatively, the main biological duct is an abdominal aorta and the secondary biological duct is a hepatic artery that branches from the abdominal aorta. The main biological duct is assumed to be another vessel, and the sub-biological duct is assumed to be a branching vessel.

  In addition, the catheter is a catheter for contrast or chemical solution discharge. Even in the case of a catheter for contrast or drug solution discharge, at the time of indwelling, it is supported by the inner wall of the main biological conduit immediately after the distal end of the main body introduced into the secondary biological conduit, and the base is closer than the distal end of the main body. It is possible to prevent a situation in which the end side is moved, and to prevent troubles in operations such as detachment from the secondary body duct at the tip end.

It is a partially omitted right side view of the catheter for coronary artery according to the embodiment of the present invention. FIG. 2A is a plan view, FIG. 2B is a right side view, and FIG. It is explanatory drawing at the time of indwelling the catheter of FIG. FIG. 4 is a sectional view taken along line AA in FIG. 3.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Coronary artery catheter 2 Catheter main body 4 Base end part 5 Tip part 10 1st curve 11 2nd curve 12 3rd curve

Claims (5)

A catheter for introducing and indwelling the distal end of a sub-biological channel that branches from the main bio-channel,
A hollow catheter body,
In the indwelling state, the distal end portion of the catheter body corresponds to a curve along the inner wall of the main biological conduit from the branch portion of the main biological conduit and the secondary biological conduit to the inner wall portion of the opposite main biological conduit The catheter is formed so as to include a shape to be formed. The proximal end of the catheter body is formed in a straight line in the natural state,
The catheter according to claim 1, wherein the distal end portion of the catheter body is formed so as to wind the proximal end portion or an extension line thereof in a natural state. The catheter according to claim 1, wherein a distal end portion of the catheter body is formed to be bent in a natural state. The proximal end of the catheter body is formed in a straight line in the natural state,
The catheter according to claim 1, wherein the distal end portion of the catheter body is formed so as to be bent in the natural state when viewed from the axial direction of the proximal end portion. A catheter for introducing and indwelling the distal end of a sub-biological channel that branches from the main bio-channel,
A hollow catheter body,
In the natural state, the distal end portion of the catheter body corresponds to a curve along the inner wall of the main biological conduit from the branch portion of the main biological conduit and the secondary biological conduit to the inner wall portion of the main biological conduit on the opposite side. The catheter is formed so as to include a shape to be formed.

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