WO2020202742A1

WO2020202742A1 - Catheter assembly, light-emitting method, and training method for catheter manipulation

Info

Publication number: WO2020202742A1
Application number: PCT/JP2020/002795
Authority: WO
Inventors: 田中葉子; 高橋治彦; 齊藤佳之; 楠耕太郎; 福岡徹也
Original assignee: テルモ株式会社
Priority date: 2019-03-29
Filing date: 2020-01-27
Publication date: 2020-10-08
Also published as: JPWO2020202742A1

Abstract

Provided are a catheter assembly, a light-emitting method, and a training method for catheter manipulation with which it is possible to train catheter manipulation with the same line of sight or attitude as in an actual maneuver.　A catheter carrying a phosphor (1) therewith is manipulated under a dark field DF and observation is made by an FPD (5) using a camera (4).

Description

Catheter assembly, luminescence method and catheter operation training method

The present invention relates to a luminescent catheter assembly using a catheter inserted into a living lumen, a luminescent method thereof, and a training method for catheter operation.

With the increase in catheter treatment in recent years, the surgeon may perform training using a silicon blood vessel model disclosed in Patent Document 1 in advance.

In training, you can insert a guide wire or guiding catheter into the model and learn the hardness and torque transmission of the catheter by hand. Further, in the training, it is possible to perform training to intentionally perforate a model blood vessel with a guide wire or to cause a trouble such as kinking the catheter when passing through a meandering blood vessel, and to recognize the hand sensation at that time.

This makes it possible to avoid troubles in advance based on the feeling of the hand in actual surgery.

Japanese Unexamined Patent Publication No. 2006-267565

Normally, when the vessel model is operated in warm water, the catheter by the model vessel is seen when the ceiling illumination is reflected on the water surface or the model surface and the catheter in the vessel model cannot be seen, or when the branched model vessels are viewed from the overlapping direction. May not be visible.

Also, in actual surgery, the surgeon visually recognizes the image through an X-ray contrast device instead of the human body, except at the time of puncture. Therefore, the operator's line of sight, posture, or standing position is not a blood vessel model, but a line of sight to a flat panel display (FPD) displaying an X-ray contrast image, and a posture or standing position in which this line of sight is directed is preferable.

Furthermore, the X-ray contrast image is limited to the X-ray irradiation range, and it is difficult to visually recognize the blood vessel, the catheter body portion other than the contrast marker portion, and the like with the contrast agent.

For these reasons, if training is performed by visually recognizing (hereinafter referred to as visual recognition) a blood vessel or the catheter body that is originally difficult to see as a mark, there may be a difference from the visual recognition in the actual procedure.

In addition, the contrast between the blood vessel model and the catheter is small in a bright state with ceiling lighting, and it is difficult to see the movement of the catheter, especially the movement in the small peripheral blood vessels.

It is the following invention that achieves the above object.

(1) The catheter assembly according to the present invention is characterized by having a main body portion, a hand portion and a light emitting body, and having the light emitting body in the lumen and / or the outer surface of the main body portion. is there.

(2) The light emitter was selected from a phosphor coated on the outer surface of the main body, a side light emitting optical fiber arranged in the main body cavity, and a chip type LED arranged in the main body cavity. The catheter assembly according to (1) above, which is at least one or more.

(3) The light emitting method according to the present invention includes a step of preparing a catheter, a step of imparting a light emitting body to the catheter, a step of causing the light emitting body to emit light, and a step of causing the catheter to emit light by the light emitting body. It may be a light emitting method having.

(4) The light emitting method according to (3) above, wherein the light emitting body is a phosphor that emits visible light by irradiation with ultraviolet rays.

(5) The side light emitting optical fiber in which the light emitting body is arranged in the lumen of the catheter and a light source is arranged on at least one of the distal end opening side and the proximal end opening side of the catheter, according to the above (3). It may be a light emitting method.

(6) The light emitting method according to (3) above, wherein the light emitting body is a chip type light emitting diode arranged in the lumen of the catheter.

(7) The light emitting method according to (3) above, wherein the fluorescent substance is a fluid containing a fluorescent substance that can flow in the lumen of the catheter.

(8) The light emitting method according to (3) above, wherein the phosphor is a phosphor fixed to the outer surface of the catheter.

(9) The light emitting method according to (3) above, wherein the light emitting body is a phosphor that can be peeled off from the outer surface of the catheter.

(10) The catheter operation training method according to the present invention includes a step of preparing a catheter, a step of preparing a blood vessel model, a step of preparing a luminescent material, a cavity of the catheter, an outer surface of the catheter, and the above. It includes a step of arranging the illuminant at at least one position away from the catheter in the blood vessel model, a step of causing the illuminant to emit light, and a step of operating the catheter while visually recognizing the illuminant. The training method may be characterized in that.

(11) A step of preparing an ultraviolet light source, at least one film containing an ultraviolet absorber, an imaging unit, an image display unit, a transparent medium that partially transmits light and partially reflects light, and a dark field of view. In the dark field, the ultraviolet light source irradiates the light, the catheter, the vascular model, and the illuminant are irradiated with the light, and the amount of luminescence generated from the illuminant is reflected. The training method according to (10) above, which comprises a step of observing at least one of the catheter, the vascular model, and the luminescent material in a state larger than the amount of light emitted by the light source.

(12) The training method according to (10) above, wherein the light emitting body is a phosphor that emits fluorescence by the ultraviolet rays.

(13) The training method according to (10) above, wherein the light source emits light including the ultraviolet rays.

(14) The training method may be the training method according to (10) above, wherein an image taken by the imaging unit is displayed on the image display unit and the training method is performed while visually recognizing the image.

According to the catheter assembly, the light emitting method and the training method according to the present invention, the catheter assembly is made to emit light by using a simple device, and the product display or the training of the catheter operation whose hand sensation and visual recognition are close to those of the actual operation is performed. Can be done.

FIG. 1 is a perspective view of a conventional method for training catheter operation in a bright field BF. FIG. 2 is a perspective view of a method for training catheter operation in a dark field DF using the catheter assembly according to the first embodiment of the present invention. FIG. 3 is a side perspective view showing a light emitting state in a dark field DF and a method for training catheter operation using the catheter assembly according to the first embodiment of the present invention. FIG. 4 is a plan view of a blood vessel model in a conventional bright field BF. FIG. 5 is a cross-sectional view of the catheter assembly according to the first embodiment of the present invention. FIG. 6 is a plan view of a light emitting state in a dark field DF using the catheter assembly of the first embodiment of the present invention. FIG. 7 is a cross-sectional view of the catheter assembly according to the second embodiment of the present invention. FIG. 8 is a vertical sectional view of a modified example of the catheter assembly according to the second embodiment of the present invention. FIG. 9 is a plan view showing a light emitting state in a bright field BF of the catheter assembly according to the second embodiment of the present invention. FIG. 10 is a plan view showing a light emitting state in the dark field DF of the catheter assembly according to the second embodiment of the present invention. FIG. 11 is a side enlarged view of a catheter assembly in a non-luminous state according to a second embodiment of the present invention and a lower limb blood vessel model in a bright field BF. FIG. 12 is a side enlarged view of the luminescent catheter assembly according to the second embodiment of the present invention and the lower limb blood vessel model in the dark field DF. FIG. 13 is a cross-sectional view of the catheter assembly according to the third embodiment of the present invention. FIG. 14 is a vertical cross-sectional view of the catheter assembly according to the third embodiment of the present invention. FIG. 15 is a plan view showing a light emitting state in the dark field DF of the catheter assembly according to the third embodiment of the present invention. FIG. 16 is an enlarged side view showing a light emitting state of the catheter assembly according to the third embodiment of the present invention. FIG. 17 is a schematic cross-sectional view showing a state of the catheter assembly according to the fourth embodiment of the present invention before expansion of the balloon portion in the bright field BF. FIG. 18 is a schematic cross-sectional view showing a state of the catheter assembly according to the fourth embodiment of the present invention before expansion of the balloon portion in the dark field DF. FIG. 19 is a schematic cross-sectional view showing a state of the catheter assembly according to the fourth embodiment of the present invention when the balloon portion is expanded in the bright field BF. FIG. 20 is a schematic cross-sectional view showing a state of the catheter assembly according to the fourth embodiment of the present invention when the balloon portion is expanded in the dark field DF. FIG. 21 is a schematic cross-sectional view showing a state in which powder crystals are recovered after the balloon portion contracts in the bright field BF of the catheter assembly according to the fourth embodiment of the present invention. FIG. 22 is a schematic cross-sectional view showing a state in which powder crystals are recovered after the balloon portion contracts in the dark field DF of the catheter assembly according to the fourth embodiment of the present invention. FIG. 23 is an overall view of the catheter assembly according to the fifth embodiment of the present invention in a bright field BF. FIG. 24 is an overall view of the catheter assembly according to the fifth embodiment of the present invention in the dark field DF. FIG. 25 is a schematic enlarged cross-sectional view of the catheter assembly according to the fifth embodiment of the present invention in the dark field DF.

Hereinafter, preferred embodiments of the present invention will be mentioned and described in detail with reference to the accompanying drawings. The dimensional ratios in the drawings may be exaggerated and differ from the actual ratios for convenience of explanation. Further, in the following description, the hand side of the catheter is referred to as a "base end", and the side inserted into the living body is referred to as a "tip".

Conventionally, training using a blood vessel model as shown in FIG. 1 is performed under a light 20 provided in a bright field (hereinafter referred to as BF), that is, a ceiling or the like. For this reason, catheters outside the range of the X-ray contrast image using an X-ray contrast device and blood vessels that cannot be seen unless a contrast medium is injected are visually recognized, which causes a difference between actual surgery and visual recognition. .. On the other hand, when the ceiling light 20 is turned off, the hand part outside the body cannot be seen.

<First Embodiment>
As shown in FIG. 2, the blood vessel model 2 is covered with the box body 3, and the guiding catheter assembly 10 provided with the blood vessel model 2 and the illuminant 1 is observed as a dark field (Dark Field or less DF). Of the sheath 11, the balloon catheter 12, and the guide wire 13, those exposed to the outside of the body at the proximal end are directly visually recognized by the bright field BF.

As shown in FIG. 3, the operator who cannot directly see the blood vessel model 2 and the catheter assembly 10 in the blood vessel model 2 is an image display unit that displays an image from the camera 4 as an imaging unit attached to the box body 3. The training is performed while observing the light emitting body 1 of the catheter assembly 10 projected on the flat panel display (FPD) 5.

Here, the catheter assembly means a catheter assembly having a main body portion, a hand portion, and a light emitting body, and having a light emitting body in at least a part of the lumen and / or outside of the main body portion. The main body is a long part having a lumen. The hand portion is a portion that is fixed to the base end side of the main body portion and can be operated by hand.

The light emitting body means at least one selected from a phosphor coated on the outer surface of the main body, a side light emitting optical fiber arranged in the main body cavity, and a chip type LED arranged in the main body cavity. ..

The line of sight and posture of the catheter operation are different between the conventional bright field BF shown in FIG. 1 and the dark field DF of FIG. 2, and the hand sensation during the catheter operation is also different due to the difference in the positions of the neck and shoulders during the catheter operation. May occur.

By emitting light from the illuminant 1 of the catheter assembly 10 provided with the illuminant 1 inside or outside the guiding catheter 10', only the illuminant 1 can be visually recognized in the dark field DF, which is close to an X-ray contrast image. An image with clear contrast can be obtained. This makes it possible to train catheter operation in which visual recognition and hand sensation are closer to those of actual surgery.

FIG. 4 shows a state in which the silicon blood vessel model 2 in the conventional bright field BF is placed in the water tank 21 containing the hot water 22 and the catheter assembly 10 is placed in the blood vessel model 2 under the illumination 20. It is a thing. The blood vessel model 2 is immersed in a water tank 21 filled with warm water 22 having a water temperature of 37 ° C., which is the same as the body temperature, so that the physical properties of the catheter and the viscosity of the contrast medium are the same as in the actual surgery. Since water is a transparent medium that transmits a part of light and reflects a part of it, the ceiling light 23 is reflected on the water surface, and the light 23 is reflected on the surface of the blood vessel model 2. Further, a wave 24 is generated on the water surface due to a water flow by a temperature controller with a pump (not shown) for maintaining the water temperature or vibration caused by the movement of a person, and a part of the guiding catheter 10'is difficult to see. With the dark field DF, the guiding catheter 10'can be visually recognized with less reflection from the water surface or the blood vessel model.

As an effect of observing with the dark field DF, it is generally mentioned that the dark field DF has better sensitivity for the retina of the eye, and can recognize differences in shape and small objects.

This is because the retina has about 5 to 6 million pyramidal cells and 120 to 140 million rod cells, and there are more rod cells that are sensitive to light and dark than pyramidal cells, and one photon. This is because it can be felt even in (photon). The blood vessel model 2 is intended for training in which the catheter assembly 10 is inserted from the blood vessel of the arm to treat the lesion X of the left superficial femoral artery of the lower limb artery.

The light emitting method for emitting light from the catheter includes a step of preparing the catheter, a step of imparting a light emitting body to the catheter, and a step of causing the catheter to emit light by the light emitting body.

Catheter operation training methods include a step of preparing a catheter, a step of preparing a blood vessel model, a step of preparing a luminescent material, and a step of preparing a catheter, an outer surface of the catheter, and / or from the catheter within the blood vessel model. A training method comprising: arranging the illuminant at at least one or more distant positions, illuminating the illuminant, and operating the catheter while visually recognizing the illuminant. is there.

As shown in FIG. 5, the catheter assembly 10 used in the first embodiment is coated with the light emitting body 1 in order to impart the light emitting body 1 to at least a part of the outer surface. As the light emitting body 1, preferably, a phosphor 100 that emits fluorescence that is visible light by ultraviolet rays is preferable. As the phosphor, a compound having an aromatic ring or a metal compound is particularly preferable.

The phosphor 100 may be a water-soluble or water-dispersible pigment, a water-insoluble powder, or one fixed to the outer surface of the catheter by drying or cross-linking depending on the purpose or site. Those that do not detach from the outer surface of the catheter in warm water by fixation are particularly preferred because they can be used in training hard lesion models in warm water.

Alternatively, if the phosphor 1 is a powdery phosphor coated on the outer surface of the catheter, or is the phosphor 100 that can be peeled off from the outer surface of the catheter assembly by dissolving in water, the drug-coated balloon It is possible to perform training to visually check how the catheter and other drugs provided flow out at the lesion.

Further, by injecting the water-soluble phosphor 160 as a contrast medium as a fluid that can flow, the entire catheter assembly may be made to emit light so that the entire catheter assembly can be visually recognized under the dark field DF, and the water-soluble phosphor 160 may be injected into the balloon catheter 12. The balloon portion 12a may be made to emit light by injecting into the dilated lumen of the above.

The phosphor 100 in the first embodiment is thinly applied to the outer surface of the tip soft tip of the guiding catheter 10', and the physical properties do not change, so that the same hand sensation as in an actual operation can be obtained. The catheter may be a balloon catheter, a stent delivery catheter, or an atherectomy catheter, in addition to a guiding catheter. The phosphor 100 may be applied to the guide wire 13.

The site to which the phosphor 100 is applied may be any site of the catheter, but the outer surface of the catheter is preferable, and the base shaft or the tip is particularly preferable.

When an ultraviolet light source 6 is arranged on the inner surface of the box 3 and irradiated with ultraviolet rays, the phosphor 100 emits visible light and the tip portion 10a of the catheter assembly emits light. Here, the ultraviolet ray is light having a wavelength that is invisible to humans, and here, it means light having a wavelength of 10 nm to 400 nm, preferably including light having a wavelength of 300 nm to 380 nm.

Visible light means that the short wavelength limit of the wavelength range defined in JISZ8120 is 360 nm to 400 nm and the long wavelength limit is 760 nm to 830 nm.

If the ultraviolet light source 6 does not contain visible light, only the emission of the phosphor 100 can be observed, but the ultraviolet light source 6 may include visible light due to the amount of light and the cost of the ultraviolet light source 6. In this case, if the amount of fluorescence emitted from the phosphor 100 is larger than the amount of visible light generated by the reflection from the medium on the blood vessel model or the water surface, training for visually recognizing the movement of the catheter assembly can be performed. Alternatively, visible light may be reduced from the light source by an ultraviolet transmitted visible light absorbing filter.

Alternatively, at least one or more films 26 containing an ultraviolet absorber may be placed in the observation window 25 in order to directly visually recognize the movement of the catheter assembly 10 in the blood vessel model 2. In addition to protecting the eyes and skin, it is also preferable because it can protect the image sensor of the camera 4.

The FPD5 is arranged at the same position as the FPD5 of the X-ray contrast apparatus normally used by the operator, and the operator's line of sight and posture can be arranged at the same position as the familiar position. As a result, the catheter assembly 10 can be operated while viewing the image of the dark field DF whose visual recognition is similar to that of the X-ray contrast image. Alternatively, guidance or training may be provided to correct a posture in which fatigue is likely to accumulate or an unnecessarily time-consuming movement.

Further, if the box body 3 overlaps with the flow line of the operator's hand or body, a lid is provided on the upper part of the water tank 21, and the camera 4 is placed on the side surface side of the water tank or under the water tank so that a gap is formed under the water tank. A pedestal may be provided on the bottom surface of the aquarium or placed in water.

This allows training with hand sensation and visual recognition close to the actual surgery. Furthermore, since there is no exposure to X-rays in training using a conventional X-ray contrast apparatus, long-term training is possible. Alternatively, it may be used in an exhibition hall where a large X-ray contrast apparatus cannot be brought in.

<Second embodiment>
FIG. 7 is a cross-sectional view showing a state in which the catheter assembly 110 is made to emit light by causing the side light emitting optical fiber 120 to emit light.

A normal optical fiber has a structure in which light introduced from the irradiation end (entrance) of light propagates in the long axis direction and does not emit light from the side.

On the other hand, the side light emitting optical fiber 120 has a structure in which the entire side light emitting optical fiber 120 shines by emitting the introduced light to the side surface by the additive of the core 120b. Therefore, the side light emitting optical fiber 120 emits a larger amount of light from the portion closer to the light source.

If the maximum outer diameter of the guiding catheter 10'introduced from the arm is 2.3 mm or more and 2.6 mm or less, the maximum inner diameter is 2.1 mm or more, and the total length is about 1500 mm to 1600 mm, a side light emitting optical fiber 120 having an outer diameter of 2 mm is used. Inserted and connected to both ends of the side light emitting optical fiber 120, an LED light source 150 having a power LED having a light emitting amount of at least 30 lumens or more.

When power is supplied to the LED light source 150 to cause the LED light source 150 to emit light, the side light emitting optical fiber 120 emits light, and the catheter assembly 110 emits light using the light of the side light emitting optical fiber 120.

The side light emitting optical fiber 120 is arranged in the lumen of the catheter, and the light source is arranged on at least one of the tip opening side and the proximal opening side of the catheter.

As a result, the light emitted from the side light emitting optical fiber 120 passes from the inner layer 14 of the guiding catheter 10'to the outer layer 15 through the gap at the intersection of the blades 16 and reaches the outside. The reinforcing body may be a coil type, and the outer layer may contain a pigment, but it is preferable that the reinforcing body does not contain a pigment because the amount of light emitted from the catheter is large.

The LED light source 150 is fixed to the end of the side light emitting optical fiber 120 and is fixed in an aluminum housing with a socket so that light does not leak to the surroundings unnecessarily and heat is dissipated. May be good.

Alternatively, as in the modified example shown in FIG. 8, the light emitting surface of the tip-type LED 130 is arranged perpendicular to the long axis of the catheter in the lumen of the guiding catheter 10', and the tip-type LED 130 is made to emit light in the catheter lumen. You may. As a result, the side light emitting optical fiber 120 arranged in the catheter lumen at a position away from the distal end opening and the proximal end opening may emit light.

The light emitting surface of the chip type LED 130 is arranged adjacently to 130A facing the tip side of the guiding catheter 10'and 130B facing the base end side, and a tube type spacer 180 having heat resistance and insulation is provided between them. , It is possible to avoid contact between LEDs and promote heat dissipation by light emission.

Alternatively, the concave portion 120d may be provided on the end surface of the side light emitting optical fiber 120, and the spherical lens of the chip type LED 130 may be brought close to the concave portion 120d to increase the amount of light emitted from the side emitting optical fiber 120.

The chip type means a surface mount type (SMD) or a chip-on-board type (COB). As the chip-type LED 130, a commercially available chip-type LED may be used. For example, in the case of an LED with a dome-shaped lens having a length of 1.6 mm, a width of 1.6 mm, and a height of 1.6 mm, the corner portion 130a on the outer surface is polished. By chamfering, the light emitting surface can be inserted into the lumen of the guiding catheter 10'with an inner diameter of 2.2 mm even if the light emitting surface is directed in the direction perpendicular to the long axis of the catheter.

Alternatively, if the light emitting surface is a flat flat plate type LED chip (not shown), it may be arranged so as to be in contact with the irradiation end 120c of the side light emitting optical fiber 120.

A copper wire having an outer diameter less than 1/2 of the difference between the inner diameter of the guiding catheter 10'and the outer diameter of the side light emitting optical fiber 120 between the chip type LED 130 and the power supply P for supplying power is used. A plurality of sets of copper wires connected to the anode and cathode of the chip type LED 130 by solder 195 can be arranged. The plurality of sets of leads are arranged between the inner surface of the guiding catheter 10'and the outer surface of the side emitting optical fiber 120.

Assuming that the total length of the guiding catheter 10'is 1500 mm and the length of the side emitting optical fiber 120 is 300 mm, four sets of chip-type LEDs arranged in opposite directions and five side emitting optical fibers 120 are arranged in the lumen of the guiding catheter 10'. This is placed. When the light emitting surface of the chip-type LED 130 is on the distal end side, the set of copper wires connected to the chip-type LED 130 is connected to the power supply P through the proximal opening of the guiding catheter 10'.

Similarly, when the light emitting surface of the chip-type LED 130 is on the proximal end side, the set of copper wires connected to the chip-type LED 130 is connected to the power supply P through the tip opening of the guiding catheter 10'.

When the outer diameter of the side light emitting optical fiber 120 is 2 mm and the length is 1500 mm, the amount of light emitted from the catheter assembly 110 can be increased as compared with arranging the LED light sources 150 only at both ends.

When the amount of light emitted is increased, the catheter assembly 110 appears to emit light even in the bright field BF as shown in FIG. 9 for exhibition. Therefore, the ceiling light 20 may be turned off to make the catheter assembly 110 emit light more clearly in the dark field DF.

Further, even if the blood vessels overlap, the contrast-enhanced catheter may be visible in the X-ray contrast image. As shown in FIG. 11, when the catheter assembly 110 according to the second embodiment is viewed from the side, the blood vessels of the blood vessel model 2 overlap and are difficult to see, but as shown in FIG. 12, the catheter assembly 110 emits light. Then, the arrangement and shape of the stationary catheter assembly 110 may be visually recognized in three dimensions.

<Third embodiment>
In the catheter assembly 210 according to the third embodiment shown in FIG. 13, a chip-type light emitting diode (LED) 130'that causes the catheter assembly 210 to emit light is wired in the lumen of the guiding catheter and connected to a power source. Ru.

For example, in a catheter assembly 210 having an inner diameter of 2.2 mm, a copper wire 190 is soldered to a chip-type LED 130'having a width of 1.6 mm or less, specifically, a chip-type LED 130'having a length of 4.0 mm and a width of 1.5 mm shown in FIG. At least one of those fixed at 195 can be inserted and arranged. Further, as shown in FIG. 14, due to overcurrent or overvoltage, such as a chip type resistor 196 having a length of 3.2 mm, a width of 1.6 mm, and a thickness of 0.6 mm or less, and a constant current diode 197 having an outer diameter of 1.8 mm or less. A protection circuit to prevent damage to the LED may be placed in the lumen of the guiding catheter 10'.

Further, if the chip type LED 130'has a high light emission amount of 30 lm / mm ² or more, as shown in FIG. 13 (B), the light is emitted outside the outer diameter of the catheter even under a bright field BF of about 300 lux. It can be visually recognized that the light is emitted larger than the outer diameter so as to spread.

For example, in the case of an LED with a dome-shaped lens having a length of 1.6 mm, a width of 1.6 mm, and a height of 1.6 mm, the light emitting surface is parallel to the long axis of the catheter as it is in the lumen of the guiding catheter having an inner diameter of 2.2 mm. It can also be inserted in the direction.

As shown in FIG. 15, the catheter assembly 210 emits light in the dark field DF. Alternatively, the catheter assembly 210 may be used for product display or the like in a bright field BF.

For the calcified lesion model in which the superficial femoral artery is occluded over the entire length, it is necessary to use a transparent gel in order to grasp the position of the catheter.

As shown in FIG. 16, even if a material that does not allow light to pass through is used to faithfully reproduce the hardness and the like, the amount of light emitted by the chip-type LED 130'inside the catheter is large, and the light spreads outside the outer diameter of the catheter. appear. Therefore, training can be performed while visually recognizing the position of the catheter assembly 210 in the calcified lesion model.

Alternatively, if the length is 1.6 mm or more and the length is 1.6 mm or more, the length is about the same as that of the tip contrast marker or the pipe marker of the catheter. Therefore, when the chip-type LED 130 emits light, a range larger than the maximum outer diameter of the guiding catheter 10'appears to emit light, so that it can be visually recognized as a marker.

On the contrary, the current or voltage may be controlled to reduce the amount of light emitted from the chip-type LED 130, and training for finding a marker may be performed.
<Training method>
The catheter that emits light by the light emitting method of the first to third embodiments can be used for training of catheter operation as described above.

As the training method of the fourth embodiment, it can be used for training of drug application to the inner wall of the blood vessel by the drug coated balloon catheter 12 as shown in FIGS. 17 to 22.

As shown in FIGS. 17 and 18, a phosphor 100 at the tip 10a of the guiding catheter 10'and a phosphor 101 are provided in the inner tube of the balloon catheter, and a powdery phosphor 140 is supported on the balloon 12a of the balloon catheter 12. Then, by arranging it in the model lesion X and irradiating ultraviolet rays from the ultraviolet light source 6 under the dark field DF, the position of the powdery phosphor 140 carried on the emitting balloon portion 12a is visually recognized, and the catheters are relative to each other. Training to visually recognize the position may be performed.

Alternatively, a powder phosphor 141 simulating cholesterol crystals in the plaque may be placed in the model lesion X, and training may be performed to visually recognize the relative positions of the catheter and the lesion X. As shown in FIGS. 19 and 20, the powdery phosphor 140 applied to the model lesion X by expanding the balloon 12a may be irradiated with ultraviolet rays from the ultraviolet light source 6. As a result, it is possible to visually recognize whether or not the powdered phosphor 140 has been applied to the model lesion X and whether the application position is the target position, and it is possible to train the application of the drug to the lesion.

Alternatively, as shown in FIGS. 21 and 22, the powdery phosphor 140 and the powdery phosphor 141 flowing out from the model lesion X or the balloon 12a can be trained to be sucked and collected.

The fifth embodiment as a training method is a tumor model Ca of the liver model Lv, so-called transcatheter arterial embolization (TAE) for treating liver cancer with a catheter, or transcatheter arterial hepatic artery chemoembolization (TAE). Training in catheter operation such as chemoembolization (TACE) can be performed.

As shown in FIG. 23, an angiographic catheter 10'''is placed in the celiac artery model, a microcatheter 10'' is inserted into the lumen thereof, and the tip is placed at the occlusion target X2 of the tumor blood vessel model 2'. ..

Prepare a mixture 163 of the water-soluble phosphor 160 and the embolic beads 161 and the water-dispersible phosphor 162 which is a highly viscous liquid imitating a contrast agent and an anticancer agent.

Under the bright field BF, it is visually recognized that the mixture 163 blocked the obstruction target X2 connected to the tumor model Ca as intended by the diffused reflection of the water surface, or that a part of the embolic beads 161 flowed out from X2 to the peripheral side. Is difficult.

The mixture 163 is injected into the microcatheter 10 "with a syringe (not shown), and is injected from the tip of the microcatheter 10" into the occlusion target X2 of the tumor blood vessel model 2'.

As shown in FIG. 24, when observed by irradiating ultraviolet rays with a dark field DF, the mixture 163 emits light in the microcatheter 10 ”, and it is possible to visually recognize whether the flow in the tumor model 2 ′ or the obstruction target position X2 is obstructed. can do.

Alternatively, training for directly confirming the success or failure of occlusion and the outflow of excess beads after the water-soluble phosphor 150 has flowed out from the blockage target X2 as shown in FIG. 25 using the embolic beads 161'carrying a phosphor. It can be performed.

This makes it possible to perform training that allows the microcatheter 10 "to be placed in the optimum position in order to effectively occlude the obstruction target X2.

If the occlusion range is wide, an angiographic catheter 10'''with a large inner diameter may be used, or a catheter capable of changing the flow path by attaching a balloon to the tip may be used, or a catheter having these functions can be used. Different catheters may be used together.

Although the present invention has been described above with reference to preferred embodiments, it goes without saying that the present invention is not limited to the above-described embodiments and various modifications can be made without departing from the spirit of the present invention. Alternatively, the catheter assembly may be used for display.

It should be noted that this application is based on Japanese Patent Application No. 2019-65272 filed on March 29, 2019, and the disclosure contents thereof are referred to and incorporated as a whole.

1 illuminant 2 blood vessel model,
2'Tumor vessel model,
3 box body,
4 cameras,
5 FPD,
6 UV light source,
10 Catheter Assembly 10'Guiding Catheter,
10'' Microcatheter,
10''' Angiography catheter,
11 sheath,
12 Balloon catheter 12a Balloon,
13 guide wire,
14 inner layer,
15 outer layer,
16 Reinforcing body,
21 aquarium,
22 water,
23 Reflected ceiling lighting,
24 waves,
25 Observation window,
26 UV absorbing film,
100 fluorophore,
101 Balloon catheter marker,
102 Microcatheter marker,
110 Catheter assembly of the second embodiment,
120 side emitting optical fiber,
130 chip type light emitting diode,
140 powdery phosphor,
141 powdered phosphor,
LED light source with 150 socket,
160 water-soluble phosphor,
161 Embolic beads,
162 water-dispersible phosphor,
163 mixture,
180 spacer,
190 copper wire,
195 solder,
196 chip resistors,
197 constant current diode,
X lesion,
X2 obstruction target,
BF bright field,
DF dark field,
Lv liver model,
Ca tumor model.

Claims

It has a main body, a hand, and a luminous body.
A catheter assembly comprising the luminous body in the lumen and / or outer surface of the main body.
The light emitter is at least one selected from a phosphor coated on the outer surface of the main body, a side light emitting optical fiber arranged in the main body cavity, and a chip type LED arranged in the main body cavity. The catheter assembly according to claim 1.
It is a light emitting method
Steps to prepare the catheter and
The step of applying a luminescent material to the catheter and
The step of making the illuminant emit light,
The step of causing the catheter to emit light by the illuminant,
A light emitting method having.
The light emitting method according to claim 3, wherein the light emitting body is a phosphor that emits visible light by irradiation with ultraviolet rays.
The light emitting method according to claim 3, wherein the light emitting body is a side light emitting optical fiber in which the light emitting body is arranged in the lumen of the catheter and a light source is arranged on at least one of the tip opening side and the proximal opening side of the catheter.
The light emitting method according to claim 3, wherein the light emitting body is a light emitting diode arranged in the lumen of the catheter.
The light emitting method according to claim 3, wherein the fluorescent substance is a fluid containing a fluorescent substance that can flow in the lumen of the catheter.
The light emitting method according to claim 3, wherein the phosphor is a phosphor fixed to the outer surface of the catheter.
The light emitting method according to claim 3, wherein the light emitting body is a peelable phosphor coated on the outer surface of the catheter.
It is a training method for catheter operation.
Steps to prepare the catheter and
Steps to prepare a blood vessel model and
Steps to prepare the illuminant and
A step of placing the luminescent material in at least one position away from the catheter in the lumen of the catheter, the outer surface of the catheter and in the blood vessel model.
The step of emitting light from the illuminant and
The step of operating the catheter while visually recognizing the illuminant,
A training method characterized by having.
A step of preparing an ultraviolet light source, at least one or more films containing an ultraviolet absorber, an imaging unit, an image display unit, and a transparent medium that partially transmits and partially reflects light.
Have a step to prepare a dark field,
A state in which ultraviolet rays are irradiated from the ultraviolet light source in the dark field, the catheter, the blood vessel model, and the illuminant are irradiated with the ultraviolet rays, and the emission intensity generated from the illuminant is larger than the intensity of light generated by reflection. 10. The training method according to claim 10, further comprising observing at least one or more of the catheter, the blood vessel model and the illuminant.
The training method according to claim 10 or 11, wherein the light emitter is a phosphor that fluoresces due to the ultraviolet rays.
The training method according to any one of claims 10 to 12, wherein the light source emits light including the ultraviolet rays.
The training method according to any one of claims 10 to 13, wherein the training method displays an image taken by the imaging unit on the image display unit and visually recognizes the image.