JP4324535B2

JP4324535B2 - Medical treatment tool

Info

Publication number: JP4324535B2
Application number: JP2004280779A
Authority: JP
Inventors: 富久加藤
Original assignee: Asahi Intecc Co Ltd
Current assignee: Asahi Intecc Co Ltd
Priority date: 2004-09-28
Filing date: 2004-09-28
Publication date: 2009-09-02
Anticipated expiration: 2024-09-28
Also published as: JP2006094876A

Description

本発明は、血管内の血栓や胆管内の胆石等の体腔内異物の除去治療・肺塞栓症治療・血液透析治療等に用いる医療用処置具に関するものである。 The present invention relates to a medical treatment instrument used for removal of foreign matter in a body cavity such as a blood clot or a gallstone in a bile duct, a pulmonary embolism treatment, a hemodialysis treatment, or the like.

血管等の体腔内異物の除去治療に用いる医療用処置具として、体腔内に挿入する細長可撓性の線条体の先端部分に異物除去手段を備え、体外に出した手元操作部を押し・引き・回転操作して該異物の除去治療をする医療用処置具は特許文献１〜３に例示する背景技術がある。 As a medical treatment tool used for removal treatment of foreign matter in a body cavity such as a blood vessel, the distal end portion of an elongated flexible striate body inserted into the body cavity is provided with a foreign matter removal means, and a hand operating part that has been brought out of the body is pushed. There are background arts exemplified in Patent Documents 1 to 3 for medical treatment tools that perform pulling and rotating operations to remove the foreign substances.

即ち、その特許文献１のものは、線条体の先端部分に「弾性質円板形状または放射線状突設形状の弾性質の除去ブラシ」から成る異物除去手段を備え、その除去ブラシによって血管内血栓等の体腔内異物を容易にかき取り除去する構造に設定されている。 That is, the one disclosed in Patent Document 1 includes a foreign substance removing means composed of an “elastic disc-shaped or radial projecting elastic removing brush” at the distal end portion of the striate body. It is set to have a structure that easily scrapes and removes foreign matter in a body cavity such as a thrombus.

そして、特許文献２のものは血管内の血塊治療具にして、線条体の先端部位に「リボン・ワイヤの素線をクロス編成した拡縮自在の２個のボール部」をピッチ配設した構造を有し、そのボール部によって血栓を除去捕集したり血栓溶解剤注入して血流再開治療を施すように成っている。 Patent Document 2 uses a blood clot treatment device in a blood vessel, and has a structure in which “two ball parts that can be expanded and contracted by cross-knitting strands of a ribbon and a wire” are arranged at the distal end portion of a striatum. The ball portion removes and collects the thrombus or injects a thrombolytic agent to perform blood flow resumption treatment.

そして、特許文献３のものは、可撓性線条体のシース体の先端部位に、該シースから突出状態で拡大羽根を呈し、かつ、該シースへの引き込み収納可能な「らせん集合体のバスケット部」によって尿管・胆管内の結石等の体腔内異物を捕捉除去治療する構造を特徴としている。 And the thing of patent document 3 presents the expansion blade | wing in the front-end | tip part of the sheath body of a flexible linear body in the state which protrudes from this sheath, and can draw in and accommodate in this sheath It is characterized by a structure that captures and removes foreign matter in a body cavity such as a calculus in the ureter and bile duct.

特開２００３−３８５００公報JP 2003-38500 A 特表２００３−５２１２５９公報Special table 2003-521259 特表２００２−５１６１３９公報Special Table 2002-516139

以上の背景技術の特許文献１、２のものは、体腔内に挿入する線条体の先端部分に設けた除去ブラシ・ボール状部の体腔内治療部によって血栓等を除去治療する構造にして、病変部個個の形態に適するサイズに調整セット不能であり、かつ、単に摺擦削りするに過ぎず、また特許文献３のもののバスケット部もシースへの出入によって若干のサイズ変形は可能であるものの、病変部の個個の形態にマッチングさせる的確なサイズ変更は不能にして、いずれも体腔内異物を迅速的確にして容易に除去する治療性に欠ける。 More patent document 1 of the background art, two ones, have a structure for removing treating thrombosis or the like by the body cavity treatment of removing brush ball-shaped portion provided at the tip portion of the striatum to be inserted into a body cavity, it is not adjustable set a size suitable for the form of the lesion individual, and simply over Gizu to scraping rubbing and although the basket portion of the in Patent Document 3 is also possible slight size variations by and out of the sheath Therefore, it is impossible to accurately change the size to match the individual form of the lesion, and any of them lacks the therapeutic ability to quickly and easily remove foreign bodies in the body cavity.

そして、以上の背景技術のいずれも体腔内治療部を構成する要部が、構造複雑にして成形加工性に劣ると共に、病変部の個個に適する多様サイズのものを準備する必要があるので、成形加工性に劣ると共に、コスト高にして、かつ日常管理・治療前準備（病変部の個個に適合するサイズのものを択一する作業）が煩雑に成る。以上の諸難点がある。 And in any of the above background technologies, the main part constituting the treatment part in the body cavity has a complicated structure and is inferior in molding processability, and it is necessary to prepare various sizes suitable for individual lesions. In addition to being inferior in molding processability, the cost is high, and daily management / preparation before treatment (operation to select a size suitable for individual lesions) becomes complicated. There are the above difficulties.

本発明は、以上の背景技術の難点を解消して当該治療性の特段の向上を図ると共に、加工生産性に優れる高品質・高性能の「体腔内治療部つき医療用処置具」を提供するものである。 The present invention provides a high-quality and high-performance “medical treatment tool with an intracorporeal treatment unit” that solves the above-described problems of the background art and improves the therapeutic properties, and is excellent in processing productivity. Is.

以上の技術的課題を解決する本発明（その基本的形態を示す図１参照）は、「細長可撓性の主線条部２の先端部位に体腔内治療部を設けた医療用処置具において、主線条部２は、操作用芯材３を内挿した外層被覆Ｃつき中空撚線コイル体４で、中空撚線コイル体４は、全長に亘って多数の金属線を同一円周上に撚合構成した可撓性線条体から成り、体腔内治療部は、外層被覆Ｃを若干長剥離して中空撚線コイル体４のコイル素線７を露出した膨縮径部５Ａ・５Ｂの複数スパンの連設形態にして、操作用芯材３をプル操作することにより前記膨縮径部５Ａ・５Ｂの前記コイル素線７を個個に外方へスパイラル状のバスケット状膨径変体６Ａ・６Ｂと、操作用芯材３のプル操作をフリーにすることによりコイル素線７の自力弾性による復元力、又は、前記操作用芯材３をプッシュ操作することにより、バスケット状膨径変体６Ａ・６Ｂが縮径してストレート状の膨縮径部５Ａ・５Ｂとに復元縮径変体する、膨縮変体を自在にした構造」を特徴とする第１発明の医療用処置具１Ａと、 This onset bright to solve the above technical problems (see FIG. 1 showing the basic form) is the medical treatment instrument having a body cavity treatment unit to the main linear portions 2 of the distal end portion of the "elongate flexible The main wire portion 2 is a hollow stranded wire coil body 4 with an outer layer coating C in which an operation core material 3 is inserted , and the hollow stranded wire coil body 4 has a large number of metal wires on the same circumference over the entire length. The body cavities treatment section is composed of a flexible linear body having a twisted configuration, and the inflated / reduced diameter portions 5A and 5B in which the outer layer coating C is slightly peeled and the coil wire 7 of the hollow stranded coil body 4 is exposed . in the continuously provided the form of a plurality spans, the coil wire 7 outwardly individual spiral basket-like bulge variant 6A of the inflation and deflation diameter portion 5A · 5B by pulling operation of the operating core 3 · 6B and a restoring force due to their own elasticity of the coil wire 7 by free pull operation of the operating core material 3, and In the expansion / contraction deformation body, the basket-shaped expansion / contraction variation bodies 6A and 6B are reduced in diameter and restored to the straight expansion / contraction diameter portions 5A and 5B by pushing the operation core 3. and medical Ryoyo treatment instrument 1A of the first invention, wherein the structure "which is freely,

（基本形態を示す図２参照）同じく主線条部に体腔内治療部を設けた医療用処置具において、「主線条部２は、操作用芯材３を内挿した外層被覆Ｃつき中空撚線コイル体４から成る外側主線条部２Ａと内側主線条部２Ｂの２層管構造で、中空撚線コイル体４は、全長に亘って多数の金属線を同一円周上に撚合構成した可撓性線条体で、かつ外側主線条部２Ａと内側主線条部２Ｂの中空撚線コイル体４のコイル撚り方向が相互に逆方向の組み合わせから成り、体腔内治療部は、外層被覆Ｃを若干長剥離して中空撚線コイル体４のコイル素線７を露出した内外２層の膨縮径部５Ｃ、５Ｄにして、操作用芯材３をプル操作することにより膨縮径部５Ｃ、５Ｄのコイル素線を個個に外方へスパイラル方向が異なる内包外包形態の２層のバスケット状膨径変体６Ｃ、６Ｄと、操作用芯材３のプル操作をフリーにすることにより、コイル素線７の自力弾性による復元力、又は、操作用芯材３をプッシュ操作することにより、前記２層のバスケット状膨径変体６Ｃ、６Ｄが縮径してストレート状の膨縮径部５Ｃ、５Ｄとに復元縮径変体する、膨縮変体を自在にした構造」を特徴とする第２発明の医療用処置具１Ｂから成っている。なお、膨径変体６Ｃ、６Ｄの相対形態は、図示実線の略相似形態、または内側の膨径変体６Ｄの頂点が外側の膨径変体６Ｃの内周に内接・近接する非略相似形態のいずれでも良い。 (Refer to FIG. 2 showing the basic form) Similarly, in the medical treatment instrument in which the treatment portion in the body cavity is provided in the main striated portion, “the main striated portion 2 is a hollow stranded wire with an outer layer covering C in which an operation core material 3 is inserted. In the two-layer tube structure of the outer main wire portion 2A and the inner main wire portion 2B made of the coil body 4, the hollow stranded coil body 4 can be configured by twisting a large number of metal wires on the same circumference over the entire length. in FLEXIBLE striatum and outer main linear portions 2 a and inner main linear portions hollow stranded-wire coil lay direction of the coil body 4 and 2B consists of reverse combination with one another, the body cavity treatment section, the outer layer sheath C the expansion and contraction diameter portion 5C of slightly long stripped out two layers to expose the coil wire 7 of the hollow stranded-wire coil body 4, in the 5D, deflating diameter portion 5C by pulling operation of the operating core 3 , two layers basket-shaped for enclosing outer hull form outward spiral directions different coil wire of 5D individually Diameter change body 6C, and 6D, by free pull operation of the operating core material 3, the restoring force due to their own elasticity of the coil wire 7 or by pushing operation of the operation core material 3, the two layers basket-like upset variant 6C, 6D is reduced in diameter the straight deflating diameter 5C, restores shrink deformation body and 5D, medical second invention, wherein the structure "you freely expand and contract variants of It consists use treatment instrument 1B. The relative shapes of the expanded diameter deformed bodies 6C and 6D are substantially similar to the solid line shown in the figure, or the non-substantially similar shapes in which the apex of the inner expanded diameter deformed body 6D is inscribed and close to the inner periphery of the outer expanded diameter deformed body 6C. Either is fine.

即ち、以上の構成の医療用処置具１Ａ・１Ｂは、主として血栓・血餅病変部の治療や肺塞栓症治療に用いるものにして、血管内へ挿入する細長可撓性の主線条部２を「外層被覆Ｃつき中空撚線コイル体４」で形成すると共に、その主線条部２の先端部位に「外層被覆Ｃを若干長剥離してコイル素線７を露出した膨縮径部５Ａ〜５Ｄ」を設け、治療時に体外に出す手元操作部１０で操作用芯材３をプル操作することによって、膨縮径部５Ａ〜５Ｄを強制短縮させて、その膨縮径部５Ａ〜５Ｄのコイル素線７が個個に外方へスパイラル状に膨大径した「スパイラル素線７群から成る任意径バスケット形態の膨径変体６Ａ〜６Ｄ」に成し、その膨径変体６Ａ〜６Ｄによって血管Ｔの血栓・血餅病変部Ｐ等の治療を行い、その治療後には前記プル操作をフリーにすることによるコイル素線７の自力弾性による復元力、または操作用芯材３のプッシュ操作によって、縮径してストレート状の膨縮径部５Ａ〜５Ｄに復元縮径変体する膨縮変体自在にした思想から成るものである。 That is, the medical treatment tools 1A and 1B having the above-described configuration are mainly used for the treatment of thrombus / clot lesions and the treatment of pulmonary embolism, and the elongated flexible main striated portion 2 to be inserted into the blood vessel is used. It is formed of “a hollow stranded wire coil body 4 with an outer layer coating C” and “inflated / reduced diameter portions 5A to 5D in which the outer layer coating C is slightly peeled and the coil wire 7 is exposed at the tip portion of the main wire portion 2”. ”And pulling the operating core 3 with the hand operating unit 10 that is brought out of the body during treatment, the inflated / reduced diameter portions 5A to 5D are forcibly shortened, and the inflated / reduced diameter portions 5A to 5D coil elements The wire 7 is formed into an “inflated diameter variant 6A to 6D in the form of an arbitrary-diameter basket composed of a group of 7 spiral strands” in which the diameter of the wire 7 is spirally outwardly divided into individual pieces, and the expanded diameter variants 6A to 6D Treatment of thrombus / clot lesion P etc., and after the treatment, pull operation The expansion / contraction deformation body which is reduced in diameter and restored to a straight expansion / contraction diameter portion 5A to 5D by a restoring force due to self-elasticity of the coil wire 7 by making it free or a push operation of the operation core 3 It consists of free thoughts.

そして、前記第１・第２発明とも、その膨縮径部５を複数セットにする共通の上位概念構成から成り、前記第１発明のものは「膨縮径部５のスパン配設」前記第２発明のものは「同一ポイントへの膨縮径部５の２重配設」の下位概念構成を特徴にしている。なお前記の中空撚線コイル体４とは、特開２００２−２７５７７４公報等に示される多数のコイル素線を同一円周上に撚合構成した可撓性線状体の中空撚線コイル体」を意味し、膨縮径部５Ａ〜５Ｄ以外の部分は外層被覆Ｃを存在させて操作用芯材３の操作力に関係なく正常な可撓性管体を維持させる形態に構成すると共に、操作用芯材３は主線条部２の先端に固定され、主線条部２・内側主線条部２Ｂと相対滑り自在に挿入設定される。そして、その主線条部２・２Ａ・２Ｂの内周と操作用芯材３の中空部のいずれかの単数または複数を薬液・血液の流体流路９として機能させる。 Both the first and second inventions have a common high-level concept configuration in which a plurality of expansion / contraction diameter portions 5 are set, and the first invention is the “span arrangement of expansion / contraction diameter portions 5”. The invention of 2 invention is characterized by the subordinate conceptual configuration of “double arrangement of expansion / contraction diameter part 5 at the same point”. The hollow stranded coil body 4 is a flexible stranded hollow stranded coil body in which a number of coil strands disclosed in JP-A-2002-275774 are twisted on the same circumference. The portions other than the expansion / contraction diameter portions 5A to 5D are configured to maintain the normal flexible tubular body regardless of the operation force of the operation core member 3 by having the outer layer coating C present, The core material 3 is fixed to the front end of the main line portion 2 and is set so as to be slidable relative to the main line portion 2 and the inner main line portion 2B. Then, one or more of the inner circumferences of the main line portions 2, 2 A, and 2 B and the hollow portion of the operation core material 3 are caused to function as the fluid flow path 9 for the drug solution / blood.

そして、前記基本構成の医療用処置具１Ａ・１Ｂは作用効果のさらなる向上を図る意図から下記の態様が必要に応じて採択される。即ち、前記第１発明のものは膨縮径部５Ａ・５Ｂの長さＬ１・Ｌ２を大小異サイズに設定し、異なる膨大径Ｄの膨径変体６に成す態様を採択し、前記第２発明のものは、膨縮径部５Ｃ・５Ｄを撚り方向を相反方向に成す中空撚線コイル体４の態様にする。 The medical treatment instruments 1A and 1B having the above-described basic configuration adopt the following modes as necessary for the purpose of further improving the operational effects. That is, the first invention adopts a mode in which the lengths L1 and L2 of the inflated / reduced diameter portions 5A and 5B are set to different sizes, and the enlarged diameter deformed body 6 having a different enormous diameter D is adopted. In this embodiment, the expanded / contracted diameter portions 5C and 5D are in the form of a hollow stranded coil body 4 in which the twisting directions are opposite to each other.

さらに、前記第１・第２発明のいずれも、「中空撚線コイル体４の内周または操作用芯材の中空部を液体流路に成す態様」「膨径変体６の膨径サイズのセットロック手段の付設」「膨縮径部５Ｃ、５Ｄに、膨径変体６の一部に微細孔シートの弾性質被覆の付設」「中空撚線コイル体４のコイル素線７が、単線または撚り線の撚合線形態・異種金属の組合せ・異形断面線」「中空撚線コイル体４の外周を強制縮径加工した形状」といった態様を採択する。 Further, in both the first and second inventions , “a mode in which the inner periphery of the hollow stranded wire coil body 4 or the hollow portion of the core material for operation is formed in the liquid flow path” “the set of the expanded diameter size of the expanded diameter deformable body 6 lock attached means "" deflating diameter 5C, the 5D, attached elastic membrane coated microporous sheet part of bulge variant 6 "" coil wire 7 of the hollow stranded-wire coil body 4, solid or stranded adopt aspects such combinations, modified cross-section wire twisted lines form, different metal "" shape forced diameter reduction of the outer periphery of the hollow stranded-wire coil body 4 "of the line.

前記構成の本発明の医療用処置具１Ａは（図１（Ｃ）（Ｄ）参照）膨縮径部５Ａ・５Ｂをストレート状縮径状にして血管Ｔに挿入して、病変部Ｐを突き通して後方の膨縮径部５Ｂを病変部Ｐにセットし、しかるのち膨縮径部５Ａ・５Ｂを必要径の膨径変体６Ａ・６Ｂに成すと共に、必要に応じて薬液注吸入部１２から血塊溶解剤（ウロキナーゼ・ＴＰＡ）の薬液Ｍを中空撚線コイル体４の内周の液体流路９から注入して「押し・引き・回転」操作して病変部Ｐを治療する。 The medical treatment tool 1A of the present invention having the above-described configuration (see FIGS. 1C and 1D) is inserted into the blood vessel T with the inflated / reduced diameter portions 5A and 5B having a straight reduced diameter, and the lesioned portion P is pushed. Then, the rear expanded / contracted diameter part 5B is set in the lesioned part P, and then the expanded / contracted diameter parts 5A, 5B are formed into the expanded diameter deformed bodies 6A, 6B of the required diameter, and from the chemical injection / inhalation part 12 as necessary. A drug solution M of a clot lysing agent (urokinase / TPA) is injected from the liquid channel 9 on the inner periphery of the hollow stranded coil body 4 and “push / pull / rotate” is operated to treat the lesioned part P.

以上の治療手法において、膨径変体６は病変部Ｐの個別状態に適する小なる径から図示点線の圧縮状態にすることによる図１（E）に示す花弁状拡大形態に至る多様な変体形状の設定が自在にして、スパイラル状のリブ線の集合から成るので外力に対する機械的形状安定性に優れ、かつ押し・引き・回転操作が可能であることから、スパイラル状のコイル素線７群から成るバスケット形態の膨径変体６Ｂの病変部Ｐへの喰い込みとコイル素線７個個の血塊引き掻き作用の複合によって極めて効率的にして美麗な血塊除去治療ができる。 In the above treatment method, the swelled deformed body 6 has various deformed shapes ranging from a small diameter suitable for the individual state of the lesioned part P to a petal-like enlarged form shown in FIG. Since it can be set freely and consists of a set of spiral rib wires, it has excellent mechanical shape stability against external force, and can be pushed, pulled and rotated, so it consists of 7 groups of spiral coil wires. A beautiful clot removal treatment can be performed very efficiently by the combination of the bite into the lesioned part P of the basket-shaped expanded diameter deformed body 6B and the clot scratching action of seven coil strands.

そして、膨径変体６の存在によって病変部Ｐの血流Ｆを確保すると共に、前方の膨径変体６Ａが後方の膨径変体６Ｂによって剥離した血栓等の体腔内異物の受け入れバスケット部として機能して、血流Ｆによる流動異物の捕捉作用を成し、流動異物による末梢血管の閉塞トラブルを防止作用する。 And the blood flow F of the lesioned part P is ensured by the presence of the swelled deformed body 6, and the front swelled deformed body 6A functions as a receiving basket part for a body cavity foreign body such as a thrombus separated by the rear swelled deformed body 6B. Thus, the foreign substance is captured by the blood flow F, and the peripheral blood vessels are prevented from being troubled by the foreign substance.

さらに、注入された薬液Ｍは、その出口側の膨径変体６Ｂの入口側のスパイラル状の素線７群によってスパイラル流を生じるので、病変部への薬液Ｍの接触が効果的にして有効な血塊溶解ができる。以上の主たる特有の作用効果がある。 Furthermore, since the injected medicinal solution M generates a spiral flow by the group of spiral strands 7 on the inlet side of the expanded diameter deformable body 6B on the outlet side, the contact of the medicinal solution M with the lesion is effective and effective. Clot lysis is possible. There are the above-mentioned main specific effects.

一方、前記構成の医療用処置具１Ｂは（図２（Ｄ）参照）前記の医療用処置具１Ａと同様に血管Ｔの狭窄病変部Ｐに膨縮径部５Ｃ・５Ｄをセットし、しかるのち所要径の膨径変体６Ｃ・６Ｄに変体させて必要に応じて薬液注入して治療するにおいて、下記の特有の作用効果が存在する。即ち、膨径変体６Ｃ・６Ｄは同じく押圧外力に耐する形状安定性が良く、狭窄病変部Ｐの血塊・血餅の抵抗によって外側の膨縮径部５Ｃの円滑な膨径変体６Ｃが困難なケースや、円滑に拡径変体した膨経変体６Ｃを治療の為に押し・引き・回転操作したとき形状崩れを容易に生ずるケースでも、内側の膨径変体６Ｄが膨径変体６Ｃを内側から支承して機械的強度を補充して大なる変形・崩れを防止作用し、血流Ｆを確保しながら血塊・血餅の迅速良好な溶解除去作用を可能にする。 On the other hand, the medical treatment instrument 1B having the above-described configuration (see FIG. 2D) sets the expansion / contraction diameter portions 5C and 5D in the narrowed lesion portion P of the blood vessel T in the same manner as the medical treatment instrument 1A. There are the following specific effects in the treatment by transforming into the swelled deformed body 6C and 6D having the required diameter and injecting a chemical as necessary. That is, the expanded diameter deformed bodies 6C and 6D are also good in shape stability to withstand pressing external force, and the smooth expanded diameter deformed body 6C of the outer expanded / contracted diameter section 5C is difficult due to the resistance of blood clots and blood clots of the stenotic lesion P. Even when a case or a case where a deformed bulge deformed body 6C that has been smoothly expanded and deformed is pushed, pulled or rotated for treatment, the inner expanded diameter deformed body 6D supports the expanded diameter deformed body 6C from the inside. Thus, mechanical strength is replenished to prevent large deformation and collapse, and blood clot and blood clot can be quickly and well dissolved and removed while ensuring blood flow F.

そして、その内外２重の膨径変体６Ｃ・６Ｄを形成する中空撚線コイル体４が２重管形態となるので、その２重管のそれぞれの内周から薬液Ｍの放出が可能になり、治療作用のさらなる向上ができる。なお、以上の本発明の医療用処置具１Ａ・１Ｂは血液透析治療用・肺塞栓症治療用としても有用に使用できる（この用法と、それによる作用効果は実施例において詳述する）。 And since the hollow twisted wire coil body 4 that forms the inner and outer double expanded diameter deformed bodies 6C and 6D is in the form of a double pipe, it becomes possible to release the drug solution M from the respective inner circumferences of the double pipe, The therapeutic effect can be further improved. In addition, the medical treatment tools 1A and 1B of the present invention described above can be usefully used for hemodialysis treatment and pulmonary embolism treatment (this usage and the effects thereof will be described in detail in Examples).

さらに、本発明の医療用処置具１Ａ・１Ｂは、体腔内治療部の要部が中空撚線コイル体４の任意ポイントの外層被覆Ｃを必要長剥離するのみで成形加工ができるので、背景技術のものより成形加工性が特段に向上すると共に、単一の医療用処置具１Ａ・１Ｂによって多様な形態の病変部治療が可能にして、特段の低コスト性と日常管理性が確保され、当該治療性能の向上と治療コストの低減ができる特有の主たる作用効果が存在する。 Furthermore, the medical treatment instrument 1A or 1B according to the present invention can be molded by simply peeling the outer layer coating C at an arbitrary point of the hollow stranded coil body 4 from the main part of the intracorporeal treatment part, so that the processing is possible. Molding processability is significantly improved compared to the above, and various forms of lesion treatment are possible with a single medical treatment instrument 1A, 1B, and particularly low cost and daily management are ensured. There are unique main effects that can improve treatment performance and reduce treatment costs.

以下、前記基本形態の好ましい実施例諸元と、前記基本形態に基づく好ましい実施例を説明する。 Hereinafter, preferred embodiment specifications of the basic form and preferred embodiments based on the basic form will be described.

まず、図１に示す基本形態の１実施例の諸元は下記のとおりである。即ち、前記基本形態の血栓・血餅病変部治療用の医療用処置具１Ａの好ましい実施例の諸元は「主線条部２が「１×７の撚合線のコイル素線７の８本」から成るコイル体にポリエチレン・ポリプロピレン・ポリアミド等の外層被覆Ｃを施した内直径＝０．２粍・外直径＝０．５５粍の中空撚線コイル体４」「操作用芯材３が１×７の中実撚合線にして外直径＝０．１２粍」「膨縮径部５Ａ・５Ｂが長さＬ=５．０粍、スパンＳ=６粍」である。以上の諸元の実施例のものは前記の主たる作用効果が円満に享受できる。 First, the specifications of one embodiment of the basic form shown in FIG. 1 are as follows. That is, the specifications of the preferred embodiment of the medical treatment instrument 1A for treating the thrombus / clot lesion of the basic form are as follows: “main wire 2 is“ 1 × 7 twisted coil coil 7 ” A hollow twisted wire coil body 4 having an inner diameter of 0.2 mm and an outer diameter of 0.55 mm obtained by applying an outer layer coating C of polyethylene, polypropylene, polyamide, etc. The outer diameter = 0.12 mm and the expansion / contraction diameter portions 5A and 5B are the length L = 5.0 mm and the span S = 6 mm. In the embodiment of the above specifications, the main effects can be fully enjoyed.

続いて、図３〜図５を参照して医療用処置具１Ａの他の実施例を説明する。即ち、図３に示すものは膨縮径部５Ａ・５Ｂをスパン配設したものにおいて、膨縮径部５Ａ・５Ｂの長さＬ１・Ｌ２がＬ１＜Ｌ２の大小不等に設定され、後方大径の膨径変体６Ｂと前方小径の膨径変体６Ａの組合せ構造に成っている。なお、この構成のものは、Ｌ１・Ｌ２のそれぞれのコイル素線７の３６０°撚回スパンが、Ｌ１・Ｌ２のそれぞれの長さと同一の中空撚線コイル体４を用いて膨径変体作用をより容易になす構成としても良い。 Next, another embodiment of the medical treatment instrument 1A will be described with reference to FIGS. That is, in the example shown in FIG. 3, the expansion / contraction diameter portions 5A and 5B are spanned, and the lengths L1 and L2 of the expansion / contraction diameter portions 5A and 5B are set to be unequal in size such that L1 <L2. It has a combined structure of an enlarged diameter variant 6B having a diameter and an enlarged diameter variant 6A having a small front diameter. Incidentally, those of this configuration, 360 ° twist Kai span of each coil wire 7 of L1 · L2 is the upset variant action with each same length of the hollow stranded-wire coil body 4 of L1 · L2 It is good also as a structure made easier.

この大小不等構成のものは、血管内治療において血管末梢側に位置する膨径変体６Ａが小径となるので血管内配設の形態が好ましくなると共に（図３（Ｃ）参照）後方の膨径変体６Ｂを細長形態にして長い病変部へフィットセットすることができる。 In this type of unequal configuration, the swelled diameter deformed body 6A located on the peripheral side of the blood vessel in endovascular treatment has a small diameter, so that the form of intravascular placement is preferable (see FIG. 3C) and the swelled diameter behind The deformed body 6B can be made into an elongated form and fit-set to a long lesion.

そして、図４のものは膨縮径部５が３個連設スパン配設形態に形成されている。この図４のものは膨径変体６の膨径を大にして偏平ブラシ形態にすることによって、血管内異物の除去ブラシとして機能させると共に、後述する「膨径変体６の外周に弾性質被膜を付設する」ことによって、ブラッシング除去した体腔内異物Ｄの挟み込み捕捉回収」が可能となる。なお、この態様のものは異物Ｄの挟み込み捕捉作用を良好にさせる為に（図４（Ｃ）参照）膨縮径部５の長さをコイル素線７の３６０°撚回スパンにして異物キャッチ力を強くする形態が好ましい。そして、この図４（Ｃ）の形態にすると膨径変体６Ａ〜６Ｃの機械的強度が特段に向上するので、血管壁にこびりついている血塊・血餅の掻き取り回収ができると共に、捕獲した異物Ｄの体外への取り出し中の落下防止ができる。 And the thing of the expansion / contraction diameter part 5 of the thing of FIG. 4 is formed in the continuous span arrangement | positioning form. In FIG. 4, the expanded diameter of the expanded diameter deformable body 6 is enlarged to form a flat brush shape, thereby functioning as a brush for removing foreign substances in the blood vessel. By “attaching”, it is possible to “pinch and capture the foreign substance D in the body cavity after brushing”. In this embodiment, in order to improve the trapping and trapping action of the foreign matter D (see FIG. 4C), the length of the expansion / contraction diameter portion 5 is set to the 360 ° twisted span of the coil wire 7 to catch the foreign matter. A form in which the force is increased is preferable. In addition, since the mechanical strength of the expanded diameter deformed bodies 6A to 6C is remarkably improved in the form shown in FIG. 4 (C), the clot and blood clot stuck to the blood vessel wall can be scraped and collected, and the captured foreign matter D can be prevented from dropping while being taken out of the body.

次に図５を参照して、透析治療用に応用した医療用処置具１Ａの１実施例を説明する。即ち、この透析治療用のものは「膨径変体６Ａ・６Ｂを血液の取入れ部」「操作用芯材３の中空部を血液の戻し部」として機能させるものにして、縮径状態の膨縮径部５Ａ・５Ｂを腕動脈の所要ポイントに挿入セットして必要サイズの膨径変体６Ａ・６Ｂに成し、しかるのち、主線条部２の内周の液体流路９を往路用吸引路として液体注吸入部１２から血液Ｆを吸引して血液透析部２３を通して透析処理し、その透析血液Ｆを体外に出している操作用芯材３の中空部の後端に注入して操作用芯材３の中空部を復路用の液体流路９として機能させ、その先端開口部から血管Ｔ内に復流させて透析治療する。 Next, referring to FIG. 5, an embodiment of a medical treatment instrument 1A applied for dialysis treatment will be described. That is, this dialysis treatment is made to function as “the expanded diameter deformed bodies 6A and 6B function as blood intake portions” and “the hollow portion of the operation core 3 as the blood return portion”. The diameter portions 5A and 5B are inserted and set at the required points of the brachial artery to form the swelled deformed body 6A and 6B of the required size, and then the liquid flow path 9 on the inner periphery of the main striated portion 2 is used as the forward suction path. Blood F is sucked from the liquid injection / inhalation section 12 and dialyzed through the hemodialysis section 23, and the dialyzed blood F is injected into the rear end of the hollow portion of the operation core 3 that is out of the body. The hollow portion 3 is made to function as the liquid passage 9 for the return path, and the dialysis treatment is performed by returning to the blood vessel T from the tip opening.

なお、この透析治療用の医療用処置具１Ａの好ましい実施例の諸元は、「主線条部２が、線材７本の撚合線のコイル素線７から成るコイル体に同じく外層被覆Ｃを施した内直径＝３．２粍・外直径＝４．０粍の中空撚線コイル体４」「操作用芯材３が、ステンレス材・Ｎｉ−Ｔｉ材等の中空線材、または極細線の撚合線から成る中空線条体にして、外直径２．０粍・内直径＝１．６粍」「膨縮径部５Ａ・５Ｂが、それぞれの長さＬ=１４粍、スパンＳ=８粍」である。 The specifications of the preferred embodiment of the medical treatment instrument 1A for dialysis treatment are as follows: "The main wire 2 is a coil body composed of seven strands of coil wire 7 and the outer layer coating C is also applied. “A hollow stranded wire coil body 4 having an inner diameter of 3.2 mm and an outer diameter of 4.0 mm” “The operation core material 3 is a hollow wire material such as stainless steel and Ni—Ti material, or a twist of extra fine wire. It is a hollow striated body composed of merged wires, the outer diameter is 2.0 mm, the inner diameter is 1.6 mm, and the expansion / contraction diameter portions 5A and 5B are each of length L = 14 mm and span S = 8 mm. It is.

以上の透析治療用のものは（図５（Ｂ）参照）膨径変体６を血管内の要所にセットして液体注吸入部１２から被透析血液を往路用の「主線条部２の内周の液体流路９」を通して吸い取って血液透析部（図示しない）を通過させて透析し、その透析血液を復路用の「操作用芯材３の中空部の液体流路９」を通して操作用芯材３の先端開口部から血管Ｔ内に還流させて血液透析治療する。 For the above dialysis treatment (see FIG. 5 (B)), the enlarged diameter change body 6 is set at a key point in the blood vessel, and the blood to be dialyzed is sent from the liquid injection / inhalation section 12 to the “inside of the main line section 2”. The dialysis blood is sucked through the peripheral liquid flow path 9 ", passed through a hemodialysis part (not shown) and dialyzed, and the dialyzed blood is passed through the" liquid flow path 9 in the hollow part of the control core 3 "for the return path. Hemodialysis treatment is performed by refluxing into the blood vessel T from the distal end opening of the material 3.

以上の用法において、膨径変体６は血管の任意ポイントに自在にセット可能にして、かつ機械的形状安定性に優れるので、血管壁によって容易に押圧変形することなく効率的な血液吸い取りができると共に、中空撚線コイル体４は全長に亘って金属線の撚合線で形成された高引張強度体であることから、治療中に例えば血管のスパズム現象（けいれん）の異常が発生して当該部位が血管内拘束されたとき、その高引張強度によってその拘束から即時引き抜き可能にして治療トラブルの発生を有効に防止することができる。 In the above usage, the swelled deformable body 6 can be freely set at an arbitrary point of the blood vessel and has excellent mechanical shape stability, so that the blood can be sucked efficiently without being easily deformed by the blood vessel wall. , hollow stranded-wire coil body 4 from being a high tensile strength body formed of twisted wires of the metal wire over the entire length, abnormalities spa's arm phenomena during treatment such as vascular (spasms) occurs When the part is restrained in the blood vessel, the high tensile strength can be immediately pulled out from the restraint, thereby effectively preventing the occurrence of treatment trouble.

さらに、血液取入れ部の膨径変体６Ａ・６Ｂが少なるスパンＳを介して並列存在するので、血液Ｆの取り入れ性が顕著になると共に、膨径変体６を通過する血流は、膨径状態のコイル素線７のスパイラル形状に沿って誘導流されるスパイラル流となるので、血液吸引部等で生ずる有害な血液乱流の発生を防止して、円滑効率的な血液抜きが可能にして極めて有効かつ高効率の血液透析治療を行うことができる。

Furthermore, since the expanded diameter deformed bodies 6A and 6B of the blood intake portion exist in parallel through a small span S , the blood F intake property becomes remarkable, and the blood flow passing through the expanded diameter deformed body 6 is in an expanded diameter state. since the induction flowed spiral flow along the spiral shape of the coil wire 7, to prevent the occurrence of harmful blood turbulence caused by blood sucking unit such extremely and enabling smooth efficient blood vent Effective and highly efficient hemodialysis treatment can be performed .

次に、前記基本形態の体腔内異物除去治療用の医療用処置具１Ｂの好ましい実施例の諸元を説明する。即ち、外側主線条部２Ａが「０．０４粍直径線材の１×７撚りの直径＝０．１２粍の撚合線」のコイル素線から成るコイル体に同じく外層被覆Ｃを施した「外直径＝１．８粍、内直径＝１．２粍」、内側主線条部２Ｂが「直径＝０．０４粍のコイル素線７本から成るコイル体に同じく外層被覆Ｃを施した外直径＝１．０粍、内直径＝０．５粍」操作用芯材３が「０．１２粍直径の線材の１×７の撚合線にして、外直径＝０．３６粍の中実線」「膨縮径部５Ｃ・５Ｄの長さが２６粍と１４粍」である。以上の医療用処置具１Ｂは前記の作用効果が円満に享受できる。 Next, specifications of a preferred embodiment of the medical treatment tool 1B for removing foreign matter in the body cavity of the basic form will be described. That is, the outer main wire portion 2A is formed by applying an outer layer coating C to a coil body made of a coil wire of “0.04 mm diameter wire rod 1 × 7 twist diameter = 0.12 mm twisted wire”. Diameter = 1.8 mm, inner diameter = 1.2 mm ”, inner main wire portion 2B is“ coil body composed of seven coil strands having a diameter = 0.04 mm ”, and outer diameter C is similarly applied with outer layer coating C = "1.0 mm, inner diameter = 0.5 mm" The operation core material 3 is "0.12 mm diameter wire rod 1x7 twisted wire, outer diameter = 0.36 mm solid line" The lengths of the expansion / contraction diameter portions 5C and 5D are 26 mm and 14 mm ”. The above-described medical treatment instrument 1B can enjoy the above-mentioned effects fully.

続いて図６を参照して医療用処置具１Ｂの他の実施例を説明する。即ち、この図６のものは外側主線条部２Ａと内側主線条部２Ｂのコイル素線７が相互に逆方向の撚り方向に設定されている。この図６のものは２層の膨径変体６Ｃ・６Ｄのコイル素線７の撚り方向が逆になるので、外・内主線条部２Ａ・２Ｂのそれぞれの内周の流体流路から放出した薬液Ｍの膨径変体６Ｃ・６Ｄのスパイラル素線によるスパイラル流が相互に逆方向となり、薬液Ｍの乱流・拡散作用を生じて血栓・血餅等を溶解させる薬液投与効果が一段と向上する。 Next, another embodiment of the medical treatment tool 1B will be described with reference to FIG. That is, in FIG. 6, the coil wires 7 of the outer main wire portion 2 </ b> A and the inner main wire portion 2 </ b> B are set in opposite twist directions. In FIG. 6, the twist direction of the coil wire 7 of the two-layer expanded diameter deformed bodies 6C and 6D is reversed, and thus the discharge is released from the inner peripheral fluid flow paths of the outer and inner main wire portions 2A and 2B. The spiral flow by the spiral strands of the expanded diameter deformed bodies 6C and 6D of the drug solution M becomes opposite to each other, and the drug solution administration effect of dissolving the thrombus, blood clot and the like by causing the turbulent flow and diffusion action of the drug solution M is further improved.

さらに、医療用処置具１Ｂは、前記の体腔内異物の除去治療用以外に下記治療用として有用に活用できる。即ち、前記の透析治療用の医療用処置具１Ａと類似諸元にすることによって透析治療用として活用可能にして、前記透析治療用処置具１Ａと同様な作用効果が享受できる。そして、医療用処置具１Ａ・１Ｂのいずれも下記説明の肺塞栓症治療用として有用に活用できる。 Furthermore, the medical treatment instrument 1B can be usefully used for the following treatment in addition to the treatment for removing foreign matter in the body cavity. That is, it can be utilized for dialysis treatment by using similar specifications to the medical treatment tool 1A for dialysis treatment, and the same effects as the dialysis treatment treatment tool 1A can be enjoyed. And any of medical treatment tool 1A * 1B can be utilized effectively for the pulmonary embolism treatment of the following description.

即ち、飛行機エコノミークラス症候群と呼ばれる旅行者血栓症や、手術中・手術後の長時間寝たきり等によって下肢または骨盤内の静脈で形成された血栓が、肺に運ばれて肺動脈に詰まって心肺停止をもたらす症状において、静脈へ本発明の治療用処置具１Ａ・１Ｂの膨縮径部を挿入して血栓を捕獲回収することによって、血栓の肺への移動を防止する治療が可能にして、特に医療用処置具１Ｂの膨径変体６Ｃ・６Ｄの二重構造のものは、その捕獲回収作用が特段に的確にできる。 In other words, traveler's thrombosis called airplane economy class syndrome and thrombus formed in the veins in the lower limbs or pelvis due to bedridden for a long time during or after surgery are carried to the lungs and clogged into the pulmonary artery to stop cardiopulmonary arrest In the symptom to be brought about, the treatment for preventing movement of the thrombus to the lung can be made possible by inserting the expansion / contraction diameter portion of the therapeutic treatment tool 1A or 1B of the present invention into the vein and capturing and collecting the thrombus. In the treatment tool 1B having a double structure of the expanded diameter deformed bodies 6C and 6D, the capture and recovery action can be made particularly accurate.

次に図７〜図１０を参照して医療用処置具１Ａ・１Ｂ共通の他の態様実施例を説明する。即ち、図７のものは、前記各実施例の膨径変体６の外周の全部または２／３等の１部に「ポリウレタン・ポリエステル・シリコンゴム等から成る５０〜６０ミクロン膜厚にして無孔シートまたは微細孔シートの弾性質被覆２０」が覆着付設されている。この実施例のものは、被覆２０によって病変部Ｐから剥離した微細異物の捕捉回収が高能率にできると共に血管壁を傷めるおそれはない。 Next, with reference to FIG. 7 to FIG. 10, another embodiment of the common medical treatment instrument 1A / 1B will be described. That is, FIG. 7 shows that all the outer periphery of the expanded diameter deformable body 6 of each of the above-described embodiments or a part of 2/3, etc. is made “non-porous with a film thickness of 50 to 60 μm made of polyurethane, polyester, silicon rubber, etc. A sheet or microporous sheet of elastic covering 20 "is provided. In this embodiment, the fine foreign matter separated from the lesioned part P by the coating 20 can be captured and collected with high efficiency and there is no possibility of damaging the blood vessel wall.

次に図８を参照して、前記基本形態の医療用処置具１Ａ・１Ｂに設ける膨径変体６の膨径度のセットロック手段の実施例を説明する。 Next, with reference to FIG. 8, an embodiment of the set lock means for the degree of expansion of the expanded diameter deformable body 6 provided in the medical treatment instrument 1A or 1B of the basic form will be described.

詳しくは、主線条部２の後端は治療時に体外に出す手元操作部１０に連結されており、この手元操作部１０は、後端外周を雄ねじ部１６に成して主線条部２の後端を連結した中空管体のボス部１５と、このボス部１５の雄ねじ部１６に螺合する雌ねじ部１７を前端内周に有して操作用芯材３を中空部に挿通する中空管体の進退操作部１４との２部材の組合せから成り、この進退操作部１４の回転操作によるボス部１５との相対進退によって操作用芯材３の進退操作（主線条部２に対する進退操作）ができる。 Specifically, the rear end of the main striated portion 2 is connected to a hand operating unit 10 that is brought out of the body at the time of treatment. A hollow boss portion 15 having a hollow tube body connected to the ends and a female screw portion 17 screwed into the male screw portion 16 of the boss portion 15 on the inner periphery of the front end, and the operating core material 3 inserted through the hollow portion. It consists of a combination of two members with the tube advance / retreat operation part 14, and the operation core material 3 advances / retreats (advance / retreat operation with respect to the main line part 2) by relative advance / retreat with the boss part 15 by rotation operation of this advance / retreat operation part 14. Can do.

即ち、主線条部２に内挿した操作用芯材３は後端が手元操作部１０の進退操作部１４に連結されており、この進退操作部１４の押し引き操作によって主線条部２に内挿した操作用芯材３を進退させ、膨縮径部５の長さ変化による膨径変体６と縮径変体ができる。そして、そのボス部１５の雄ねじ部１６にはロックナット１８が螺合されており、このロックナット１８を進退操作部１４の前端に接合させて締付けることによって、ボス部１５と進退操作部１４の相対位置をロックして膨径変体６の膨径度を最適に保持したり、解除できるセットロック手段が設定されている。 That is, the operation core material 3 inserted in the main wire portion 2 has a rear end connected to the advance / retreat operation portion 14 of the hand operation portion 10, and the push-pull operation of the advance / retreat operation portion 14 causes the inner portion of the operation core material 3 to be inserted into the main wire portion 2. The inserted core 3 for operation is advanced and retracted, and the expansion diameter change body 6 and the diameter reduction deformation body by the length change of the expansion / contraction diameter part 5 are made. A lock nut 18 is screwed into the male threaded portion 16 of the boss portion 15, and the lock nut 18 is joined to the front end of the advance / retreat operation portion 14 and tightened to thereby tighten the boss portion 15 and the advance / retreat operation portion 14. Set lock means is provided that locks the relative position and optimally holds or releases the expansion degree of the expansion diameter variation body 6.

以上のセットロック手段を有するのものは、操作用芯材３と主線条部２の相対位置のセットロックと解除が可能にして、膨径変体６のサイズを病変部の大小多様サイズの所要径にマッチングさせてセットロックして当該治療ができるので、治療性が向上すると共に長時間治療も可能になる特有の作用効果がある。なお、このセットロック手段は外側・内側主線条部２Ａ・２Ｂを、ボス部１５に連結することによって医療用処置具１Ｂにも適用する。 Those having the above set lock means enable the set lock and release of the relative positions of the operation core material 3 and the main striate portion 2, and the size of the expanded diameter deformed body 6 can be set to the required sizes of various sizes of the lesioned portion. Since the treatment can be performed by matching with the set lock, the therapeutic properties can be improved and the treatment can be performed for a long time. This set lock means is also applied to the medical treatment instrument 1B by connecting the outer / inner main line portions 2A and 2B to the boss portion 15.

次に図９に示すものは、前記基本形態のものにおいて膨縮径部５以外の主線条部２・２Ａの主要部が、弾性質薄肉の鞘管２１に遊挿されており、この鞘管２１が外周を構成して血管内挿入する形態に成っている。この鞘管２１つきのものは若干の径大をもたらすものの鞘管２１の内周も薬液Ｍの液体流路９として活用したり、鞘管２１の内側遊隙を剥離した小血塊片等の吸引回収路として活用できる。 Next, what is shown in FIG. 9 is that the main portion of the main filaments 2 and 2A other than the expansion / contraction diameter portion 5 is loosely inserted into an elastic thin-walled sheath 21 in the basic configuration. 21 forms the outer periphery and is inserted into the blood vessel. The one with the sheath tube 21 brings about a slightly larger diameter, but the inner periphery of the sheath tube 21 is also used as the liquid flow path 9 of the drug solution M, or the suction and collection of a small clot piece etc. from which the inner play of the sheath tube 21 is peeled off. It can be used as a road.

次に図１０に示す他の態様実施例を説明する。即ち、まず図１０（Ａ）に示すものは主線条部２の中空撚線コイル体４のコイル素線が、図示７Ａ・７Ｂのようにステンレス鋼線・Ｎｉ−Ｔｉ合金線・タングステン線等の異種金属の組合せに成っている。このＮｉ−Ｔｉ合金線使用のものは膨径変体６の形状記憶性・超弾性特性によって反復使用による曲りぐせ発生の防止と特段の形状安定性を図ることができる。 Next, another embodiment shown in FIG. 10 will be described. That is, first, as shown in FIG. 10A, the coil wire of the hollow stranded wire coil body 4 of the main wire portion 2 is made of stainless steel wire, Ni—Ti alloy wire, tungsten wire, etc. as shown in FIGS. 7A and 7B. It consists of a combination of different metals. This Ni-Ti alloy wire can prevent the occurrence of bending due to repeated use and special shape stability by the shape memory property and superelastic property of the expanded diameter deformable body 6.

次に図１０（Ｂ）のものは主線条部２の中空撚線コイル体４が円形加工後にスエージング加工または外周ダイス引き加工によって外周が強制縮径加工されている。この縮径加工形態のものは、縮径による細径化と加工による剛性向上効果があり、長手方向または径方向の縮径部位および縮径度を調整することによって長手方向の先柔後剛の好ましい形態設定が可能になる。 Next, in FIG. 10B, the outer periphery of the hollow stranded wire coil body 4 of the main wire portion 2 is subjected to forced diameter reduction by swaging or outer peripheral die drawing after circular processing. This reduced diameter processed form has the effect of increasing the rigidity by reducing the diameter and reducing the diameter, and adjusting the longitudinal or radial reduced diameter portion and the degree of diameter reduction of the longitudinal flexure after bending. Preferred configuration is possible.

そして、図１０（Ｃ）のものは主線条部２の中空撚線コイル体４のコイル素線７Ｃが断面矩形状の異形形状に設定されている。この平板素線を用いると主線条部２の外径細径化または「液体流路９として活用する内径の増径化による流路拡大」が可能になるメリット作用がある。 In the case of FIG. 10C, the coil strand 7C of the hollow stranded wire coil body 4 of the main wire portion 2 is set in a deformed shape having a rectangular cross section. When this flat wire is used, there is a merit effect that the outer diameter of the main wire portion 2 can be reduced or the passage can be expanded by increasing the inner diameter utilized as the liquid passage 9.

一方、図１０（Ｄ）のものは膨縮径部５の両端の主線条部２の外周に、膨縮径部５の反復変体の応力を受ける外周を押えロックする「コイル体・リング体」等からなる変形防止用の結束部２２が施してある。この図１０（Ｄ）のものは、その部位の外側チューブ体２の変体反復による「変形・ほぐれ」を防止するので膨縮径部５の変体形状が安定して変体反復性が向上する。そして、結束部２２を放射線不透過材にすると体腔内の膨径変体６の視認性が確保できる。 On the other hand, the one shown in FIG. 10D is a “coil body / ring body” that presses and locks the outer periphery of the main wire portion 2 at both ends of the expanded / contracted diameter portion 5 to press and lock the outer periphery that receives the stress of repeated deformation of the expanded / contracted diameter portion 5. A bundling portion 22 for preventing deformation is provided. 10D prevents "deformation and loosening" due to repeated deformation of the outer tube body 2 at the site, so that the deformed shape of the inflated and contracted diameter portion 5 is stabilized and the deformable repeatability is improved. If the bundling portion 22 is made of a radiopaque material, the visibility of the expanded diameter deformable body 6 in the body cavity can be ensured.

なお、主線条部２の中空撚線コイル体４のコイル素線７は、治療中の視認性を確保する金・白金・タングステン等の放射線不透過線にしたり、異種材質の組合せにしたり、単線にすることがあり、さらに手元操作部１０は（図１参照）、指先によってスライド移動させる指先操作片１１の形態等にすることがあり、前記セットロック手段は、別物品クランプによるクランプロック形態・クランプピンのセットロックでも良い。 The coil wire 7 of the hollow stranded coil body 4 of the main wire portion 2 may be a radiopaque wire such as gold, platinum, tungsten or the like that ensures visibility during treatment, a combination of different materials, or a single wire In addition, the hand operating unit 10 (see FIG. 1) may be in the form of a fingertip operating piece 11 that is slid by a fingertip, etc. A clamp pin set lock may be used.

さらに、中空撚線コイル体４の外層被覆Ｃは、膨径時の操作用芯材３の引張りによる圧縮反力を円滑に享受するため、比較的硬質材料が好ましく、熱可塑性樹脂のみならず「フェノール樹脂・エポキシ樹脂等の熱硬化性樹脂」でも良く、またステンレス鋼管・アルミニウム管等によって形成しても良い。そして操作用芯材３は可撓性中空線・可撓性中実線のいずれの形態であっても良い。そして（図５参照）前記の血液透析治療用等に用いるものにおいて、操作用芯材３内を流体流路として用いる場合は、図示点線のように操作用芯材３を伸長して、その端部に「進退操作部１４に固定した接続具２４」を設け、血液透析部２３から引き出したホース２５に接続する構造にすることがある。 Furthermore, the outer layer coating C of the hollow stranded coil body 4 is preferably a relatively hard material in order to smoothly enjoy the compression reaction force due to the tension of the operation core material 3 at the time of expansion, and is not limited to a thermoplastic resin. A thermosetting resin such as a phenol resin or an epoxy resin "may be used, or a stainless steel tube, an aluminum tube, or the like may be used. The operation core material 3 may be in the form of either a flexible hollow line or a flexible solid line. And (refer to FIG. 5) In the above-described use for hemodialysis treatment or the like, when the inside of the operation core 3 is used as a fluid flow path, the operation core 3 is elongated as shown by the dotted line in the drawing, The connection part 24 fixed to the advance / retreat operation part 14 may be provided in the part and connected to the hose 25 drawn from the hemodialysis part 23.

第１発明の医療用処置具の基本形態を示し、（Ａ）はその正面図、（Ｂ）はその膨径変体の説明図、（Ｃ）は膨縮径部の構造説明図、（Ｄ）（Ｅ）はその作用説明図The basic form of the medical treatment tool of 1st invention is shown, (A) is the front view, (B) is explanatory drawing of the expansion diameter change body, (C) is structure explanatory drawing of the expansion / contraction diameter part, (D) (E) is an explanatory diagram of its operation. 第２発明の医療用処置具の基本形態を示し、（Ａ）はその正面図、（Ｂ）はその膨径変体の説明図、（Ｃ）は膨縮径部の構造説明図、（Ｄ）はその作用説明図The basic form of the medical treatment tool of 2nd invention is shown, (A) is the front view, (B) is explanatory drawing of the expansion diameter change body, (C) is structure explanatory drawing of the expansion / contraction diameter part, (D) Is an illustration of its function 第１発明の医療用処置具の実施例を示し、（Ａ）はその要部正面図、（Ｂ）（Ｃ）はその作用説明図The Example of the medical treatment tool of 1st invention is shown, (A) is the principal part front view, (B) (C) is the action explanatory drawing. 第１発明の医療用処置具の他の実施例を示し、（Ａ）はその要部正面図、（Ｂ）（Ｃ）はその作用説明図The other example of the medical treatment tool of 1st invention is shown, (A) is the principal part front view, (B) (C) is the effect explanatory drawing. 第１発明の医療用処置具の他の実施例を示し、（Ａ）はその全体正面図、（Ｂ）はその作用説明図The other Example of the medical treatment tool of 1st invention is shown, (A) is the whole front view, (B) is the effect explanatory drawing. 第２発明の医療用処置具の他の実施例の要部説明図Explanatory drawing of the principal part of the other embodiment of the medical treatment instrument of the second invention 本発明の医療用処置具の他の実施例の要部説明図Explanatory drawing of the principal part of the other Example of the medical treatment tool of this invention 本発明の医療用処置具のセットロック手段の１実施例の説明図Explanatory drawing of one Example of the set lock means of the medical treatment tool of this invention 本発明の医療用処置具の他の実施例の要部説明図Explanatory drawing of the principal part of the other Example of the medical treatment tool of this invention 本発明の医療用処置具の他の実施例を示し、（Ａ）〜（Ｄ）ともその要部説明図The other example of the medical treatment tool of the present invention is shown, and (A)-(D) are the principal part explanatory views.

符号の説明Explanation of symbols

１Ａ第１発明の医療用処置具
１Ｂ第２発明の医療用処置具
２主線条部
２Ａ外側主線条部
２Ｂ内側主線条部
３操作用芯材
４中空撚線コイル体
５膨縮径部
６膨径変体
７コイル素線
９液体流路
１０手元操作部
１４進退操作部
１５ボス部
１８ロックナット
２０弾性質被覆
２１鞘管
２２結束部
Ｃ外層被覆
Ｄ体腔内異物
Ｆ血流
Ｍ薬液
Ｐ病変部
Ｔ血管
DESCRIPTION OF SYMBOLS 1A Medical treatment tool 1B of 1st invention Medical treatment tool 2 of 2nd invention 2 Main wire part 2A Outer main wire part 2B Inner main wire part 3 Operation core material 4 Hollow stranded wire coil body 5 Expansion / contraction diameter part 6 Expansion Diameter change body 7 Coil wire 9 Liquid flow path 10 Hand operation part 14 Advance / retreat operation part 15 Boss part 18 Lock nut 20 Elastic coating 21 Sheath tube 22 Bundling part C Outer layer covering D Body cavity foreign substance F Blood flow M Drug solution P Diseased part T Blood vessels

Claims

細長可撓性の主線条部の先端部位に体腔内治療部を設けた医療用処置具において、
前記主線条部は、操作用芯材を内挿した外層被覆つき中空撚線コイル体で、
前記中空撚線コイル体は、全長に亘って多数の金属線を同一円周上に撚合構成した可撓性線状体から成り、
前記体腔内治療部は、前記外層被覆を若干長剥離して前記中空撚線コイル体のコイル素線を露出した膨縮径部の複数スパンの連設形態にして、
前記操作用芯材をプル操作することにより前記膨縮径部の前記コイル素線を個個に外方へスパイラル状のバスケット状膨径変体と、
前記操作用芯材のプル操作をフリーにすることによりコイル素線の自力弾性による復元力、又は、前記操作用芯材をプッシュ操作することにより、前記バスケット状膨径変体が縮径してストレート状の膨縮径部に復元縮径変体する、膨縮変体を自在にした構造を特徴とする医療用処置具。 In a medical treatment instrument provided with a body cavity treatment section at the distal end portion of an elongated flexible main striate section,
The main wire portion is a hollow stranded coil body with an outer layer coating in which an operation core material is inserted ,
The hollow stranded coil body is composed of a flexible linear body in which a large number of metal wires are twisted on the same circumference over the entire length,
The body cavity treatment section is a continuous form of a plurality of spans of expansion and contraction diameter parts in which the outer layer coating is peeled slightly longer to expose the coil wire of the hollow stranded wire coil body,
And a basket-like upset variant spiral outward to the individual the coil wire of'm Ri said expansion and contraction diameter portion to the pull-operate the above-mentioned operation for the core material,
The pulling operation of the operation core material is made free so that the restoring force due to the self-elasticity of the coil strands or the operation core material is pushed, so that the basket-like swelled deformed body is reduced in diameter and straightened. A medical treatment instrument characterized by a structure in which an expanded / contracted deformable body is freely deformed and deformed into a deformed / expanded diameter portion .

細長可撓性の主線条部の先端部位に体腔内治療部を設けた医療用処置具において、
前記主線条部は、操作用芯材を内挿した外層被覆つき中空撚線コイル体から成る外側主線条部と内側主線条部の２層管構造で、
前記中空撚線コイル体は、全長に亘って多数の金属線を同一円周上に撚合構成した可撓性線条体で、かつ前記外側主線条部と前記内側主線条部の前記中空撚線コイル体のコイル撚り方向が相互に逆方向の組み合わせから成り、
前記体腔内治療部は、前記外層被覆を若干長剥離して前記中空撚線コイル体のコイル素線を露出した内外２層の膨縮径部にして、
前記操作用芯材をプル操作することにより前記膨縮径部の前記コイル素線を個個に外方へスパイラル方向が異なる内包外包形態の２層バスケット状膨径変体と、
前記操作用芯材のプル操作をフリーにすることにより、コイル素線の自力弾性による復元力、又は、前記操作用芯材をプッシュ操作することにより、前記２層のバスケット状膨径変体が縮径してストレート状の膨縮径部に復元縮径変体する、膨縮変体を自在にした構造を特徴とする医療用処置具。 In a medical treatment instrument provided with a body cavity treatment section at the distal end portion of an elongated flexible main striate section,
The main wire portion is a two-layer tube structure of an outer main wire portion and an inner main wire portion made of a hollow stranded wire coil body with an outer layer covering in which an operation core material is inserted,
The hollow twisted wire coil body is a flexible wire body in which a large number of metal wires are twisted on the same circumference over the entire length, and the hollow twisted wire of the outer main wire portion and the inner main wire portion. The coil twist direction of the wire coil body consists of a combination of opposite directions,
The body cavity treatment part is an expansion / contraction diameter part of the inner and outer two layers in which the outer layer coating is peeled slightly longer to expose the coil wire of the hollow stranded wire coil body,
A two-layer basket-like expanded diameter deformed body in the form of an envelop with different spiral directions outwardly by pulling the core material for operation to the individual coil element wires of the expanded / contracted diameter portion;
By making the pull operation of the operation core material free, the restoring force due to the self-elasticity of the coil wire, or by pushing the operation core material, the two-layer basket-like expanded diameter deformed body is reduced. A medical treatment instrument characterized by having a structure in which an expanded / contracted deformed body is freely deformed and deformed into a straight expanded / contracted diameter part .

前記膨縮径部の長手方向の長さが、前記中空撚線コイル体のコイル素線の３６０°撚回スパンの長手方向の長さと同一とし、膨径変体作用を容易と成す構成としたことを特徴とする請求項１〜請求項２のいずれか一つに記載の医療用処置具。 The length in the longitudinal direction of the expanded / contracted diameter portion is the same as the length in the longitudinal direction of the 360 ° twisted span of the coil wire of the hollow stranded wire coil body to facilitate the expansion diameter changing action. The medical treatment tool according to any one of claims 1 to 2, wherein

中空撚線コイル体の内周または操作用芯材の中空部を液体流路に成す請求項１〜請求項３のいずれか一つに記載の医療用処置具。 The medical treatment tool according to any one of claims 1 to 3 , wherein an inner periphery of the hollow stranded wire coil body or a hollow portion of the core material for operation is formed in a liquid channel .

操作用芯材のプル・プッシュ操作の手元操作部に、主線条部と操作用芯材の相対位置のセットロック手段を設けた請求項１〜請求項４のいずれか一つに記載の医療用処置具。 The medical use according to any one of claims 1 to 4, wherein a set lock means for the relative position of the main striated portion and the operation core material is provided in a hand operation portion of the pull / push operation of the operation core material . Treatment tool.

膨縮径部に、膨径変体の一部に微細孔シートの弾性質被覆を設けた請求項１〜請求項５のいずれか一つに記載の医療用処置具。 The medical treatment tool according to any one of claims 1 to 5, wherein an elastic coating of a microporous sheet is provided on a part of the expanded diameter portion in the expanded / contracted diameter part .

中空撚線コイル体のコイル素線が、単線または撚り線の撚合線から成る請求項１〜請求項６のいずれか一つに記載の医療用処置具。 The medical treatment tool according to any one of claims 1 to 6, wherein the coil wire of the hollow stranded coil body is a single wire or a stranded wire of a stranded wire .

主線条部の中空撚線コイル体のコイル素線がステンレス鋼線とＮｉ−Ｔｉ合金線の組合わせから成る請求項１〜請求項７のいずれか一つに記載の医療用処置具。 The medical treatment tool according to any one of claims 1 to 7, wherein the coil wire of the hollow stranded coil body of the main wire portion is a combination of a stainless steel wire and a Ni-Ti alloy wire .

中空撚線コイル体の外周が長手方向、又は径方向に縮径加工されて縮径部位、及び縮径度を調整することにより長手方向に先柔後剛形態としたことを特徴とする請求項１〜請求項８のいずれか一つに記載の医療用処置具。 Claims periphery of the hollow stranded-wire coil body you characterized in that the Sakiyawara KoTsuyoshi form in the longitudinal direction by adjusting the longitudinal or radial direction diameter reduction has been reduced diameter portion position, and downsizing The medical treatment tool according to any one of claims 1 to 8.