JP6045067B2 - Aspiration catheter assembly - Google Patents
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- JP6045067B2 JP6045067B2 JP2013089554A JP2013089554A JP6045067B2 JP 6045067 B2 JP6045067 B2 JP 6045067B2 JP 2013089554 A JP2013089554 A JP 2013089554A JP 2013089554 A JP2013089554 A JP 2013089554A JP 6045067 B2 JP6045067 B2 JP 6045067B2
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Description
本発明は、血管内の異物を吸引するための吸引カテーテル組立体に関するものである。 The present invention relates to a suction catheter assembly for sucking foreign substances in blood vessels.
従来から、血管内に堆積した血栓などの異物は、血管内に挿入された吸引カテーテル組立体により、吸引されて体外に排出される。吸引カテーテル組立体は、血管内の異物を吸引する吸引カテーテルがガイドカテーテルの内腔に挿入された構成になっている。吸引カテーテルは、ガイドカテーテルにより目的部位まで案内されると、吸引カテーテルに接続された吸引手段を作動させて、血管内の異物を吸引カテーテルの先端口から内腔を介して体外に排出させる。 Conventionally, a foreign substance such as a thrombus accumulated in a blood vessel is sucked and discharged out of the body by a suction catheter assembly inserted in the blood vessel. The suction catheter assembly is configured such that a suction catheter for sucking foreign matter in a blood vessel is inserted into the lumen of the guide catheter. When the suction catheter is guided to the target site by the guide catheter, the suction means connected to the suction catheter is operated to discharge foreign matter in the blood vessel from the distal end of the suction catheter through the lumen to the outside of the body.
しかし、血栓などの異物は粘度が高いため、吸引された異物が吸引カテーテルの内腔に残留する恐れがある。特に、異物が点在している場合、吸引手段の作動及び停止を繰り返している間に、異物が吸引カテーテルの内腔にこびり付いて、吸引カテーテルの吸引力が低下する恐れがあるため、吸引カテーテル自体を取り換える必要があった。 However, since foreign matter such as thrombus has a high viscosity, the sucked foreign matter may remain in the lumen of the suction catheter. In particular, in the case where foreign substances are scattered, the suction catheter may decrease the suction force of the suction catheter because the foreign substances may stick to the lumen of the suction catheter while the suction unit is repeatedly operated and stopped. It was necessary to replace itself.
この問題を解決するために、吸引カテーテルの内腔を広くした場合、目的部位まで案内するガイドカテーテルの内腔も広くなり、結果的に血管内に挿入する吸引カテーテル組立体の外径が太くなってしまう。その結果、吸引カテーテル組立体を目的部位まで到達させることが困難となり、末梢血管内にある異物を吸引できないという新たな問題が生じた。 In order to solve this problem, when the lumen of the suction catheter is widened, the lumen of the guide catheter that guides to the target site is also widened. As a result, the outer diameter of the suction catheter assembly that is inserted into the blood vessel is increased. End up. As a result, it has become difficult to reach the target site of the suction catheter assembly, and a new problem has arisen that foreign matter in the peripheral blood vessels cannot be sucked.
そこで、吸引カテーテルの内腔よりも大きな内腔を有するガイドカテーテルを用いた吸引カテーテル組立体が知られている（例えば、下記特許文献１参照）。特許文献１の吸引カテーテル組立体では、内径の大きなガイドカテーテルを用いることで、吸引カテーテル組立体の外径を太くせずに吸引カテーテルの吸引力を確保することができ、かつ、ガイドカテーテルの内径と吸引カテーテルの外径とのクリアランスを０．０５ｍｍ〜０．１５ｍｍに調整することで、吸引カテーテルがガイドカテーテルの内腔を移動しやすくなっている。 Therefore, a suction catheter assembly using a guide catheter having a lumen larger than the lumen of the suction catheter is known (for example, see Patent Document 1 below). In the suction catheter assembly of Patent Document 1, by using a guide catheter having a large inner diameter, the suction force of the suction catheter can be ensured without increasing the outer diameter of the suction catheter assembly, and the inner diameter of the guide catheter can be secured. By adjusting the clearance between the outer diameter of the suction catheter and 0.05 mm to 0.15 mm, the suction catheter can easily move through the lumen of the guide catheter.
しかしながら、上記の方法では、蛇行した血管内の異物を吸引するときに、以下の問題があった。蛇行した血管内にガイドカテーテルを挿入すると、ガイドカテーテルは血管に沿って湾曲した状態になる。この状態で吸引カテーテルを挿入すると、ガイドカテーテルの内径と吸引カテーテルの外径とのクリアランスが軸方向に一定であるため、吸引カテーテルのほぼ全長がガイドカテーテルの内腔と接触して、摩擦面積が大きくなり、吸引カテーテルの通過性が極端に悪くなる。特に、異物が末梢血管に存在する場合、ガイドカテーテル内に挿入された吸引カテーテルが末梢血管の目的部位まで到達できないという問題が顕著となった。 However, the above-described method has the following problems when sucking foreign substances in meandering blood vessels. When the guide catheter is inserted into the meandering blood vessel, the guide catheter is bent along the blood vessel. When the suction catheter is inserted in this state, since the clearance between the inner diameter of the guide catheter and the outer diameter of the suction catheter is constant in the axial direction, almost the entire length of the suction catheter comes into contact with the lumen of the guide catheter, and the friction area is reduced. It becomes large and the permeability of the suction catheter becomes extremely bad. In particular, when a foreign substance is present in the peripheral blood vessel, the problem that the suction catheter inserted into the guide catheter cannot reach the target site of the peripheral blood vessel becomes significant.
本発明は、このような事情を鑑みてなされたものであり、湾曲した状態のガイドカテーテルに吸引カテーテルを挿入する際、ガイドカテーテルと吸引カテーテルとの接触面積を減少させて、吸引カテーテルの通過性を向上させた吸引カテーテル組立体を提供することを課題とする。 The present invention has been made in view of such circumstances, and when the suction catheter is inserted into the curved guide catheter, the contact area between the guide catheter and the suction catheter is reduced, and the passage of the suction catheter is reduced. It is an object of the present invention to provide an aspiration catheter assembly with improved performance.
上記課題は、以下に列挙される手段により解決される。 The above problems are solved by the means listed below.
本発明の態様１は、第一筒状体と、前記第一筒状体の後端部に接合されたコアシャフトと、からなる吸引カテーテルと、前記吸引カテーテルを挿入可能な第二筒状体からなるガイドカテーテルと、を備えた吸引カテーテル組立体において、前記第一筒状体が、第一外径を有した本体部と、前記第一外径よりも大きく前記第二筒状体の内径よりも小さな第二外径を有した第一膨隆部と、を備えており、前記第一膨隆部は、前記コアシャフトの先端と前記第一筒状体の前記後端部とを接合していることを特徴とした吸引カテーテル組立体。 Aspect 1 of the present invention includes a suction catheter including a first cylindrical body, a core shaft joined to a rear end portion of the first cylindrical body, and a second cylindrical body into which the suction catheter can be inserted. A suction catheter assembly comprising: a main body having a first outer diameter; and an inner diameter of the second cylindrical body larger than the first outer diameter. A first bulge portion having a smaller second outer diameter, wherein the first bulge portion joins the tip end of the core shaft and the rear end portion of the first tubular body. A suction catheter assembly characterized by comprising:
本発明の態様２は、前記第一膨隆部は、放射線不透過性物質を含んでいることを特徴とした態様１に記載の吸引カテーテル組立体。 According to a second aspect of the present invention, in the suction catheter assembly according to the first aspect, the first bulging portion includes a radiopaque material.
本発明の態様３は、前記第一筒状体は、前記第一膨隆部よりも先端側に、前記コアシャフトに接合されていない第二膨隆部を備えており、前記第二膨隆部は、前記第一外径よりも大きく前記第一膨隆部の前記第二外径よりも小さな第三外径を有していることを特徴とした態様１又は態様２に記載の吸引カテーテル組立体。 In the aspect 3 of the present invention, the first tubular body includes a second bulge portion that is not joined to the core shaft on the tip side of the first bulge portion, and the second bulge portion includes: The suction catheter assembly according to aspect 1 or 2, wherein the suction catheter assembly has a third outer diameter that is larger than the first outer diameter and smaller than the second outer diameter of the first bulge portion .
本発明の態様１の吸引カテーテル組立体では、第一筒状体が、本体部と、本体部の外径よりも大きく第二筒状体の内径よりも小さな外径を有した第一膨隆部と、からなる。そのため、第一筒状体と第二筒状体とのクリアランスは、本体部では広いのに対して、第一膨隆部では狭くなっている。これにより、血管内に挿入された第二筒状体が湾曲した状態にあっても、第一筒状体と第二筒状体との接触部分を主に第一膨隆部とすることができ、第一筒状体と第二筒状体との摩擦抵抗を低減することができる。その結果、第一筒状体の通過性が向上して、吸引カテーテルを目的部位まで到達させることが容易となる。また、第一膨隆部が、コアシャフトの先端と第一筒状体の後端部とを接合している。そのため、第一膨隆部がコアシャフトの先端と本体部の後端部とを接合する接着剤としての機能を有しており、コアシャフトの先端が本体部の後端部から外れてしまうという恐れを低減することができる。また、コアシャフトの先端を本体部の後端部に接合する際に、別途部材を用いる必要がないため、製造上簡略化することもできる。 In the suction catheter assembly of aspect 1 of the present invention, the first tubular body has a main body portion and a first bulge portion having an outer diameter larger than the outer diameter of the main body portion and smaller than the inner diameter of the second tubular body. And consist of For this reason, the clearance between the first tubular body and the second tubular body is wide in the main body portion but narrow in the first bulge portion. Thereby, even if the second cylindrical body inserted into the blood vessel is in a curved state, the contact portion between the first cylindrical body and the second cylindrical body can be mainly used as the first bulge portion. The frictional resistance between the first cylindrical body and the second cylindrical body can be reduced. As a result, the passability of the first cylindrical body is improved, and it is easy to reach the suction catheter to the target site. Moreover, the 1st swelling part has joined the front-end | tip of a core shaft, and the rear-end part of a 1st cylindrical body. Therefore, the first bulging portion has a function as an adhesive that joins the tip end of the core shaft and the rear end portion of the main body, and the tip of the core shaft may come off from the rear end portion of the main body portion. Can be reduced. In addition, when the tip of the core shaft is joined to the rear end of the main body portion, there is no need to use a separate member, and therefore the manufacturing can be simplified.
本発明の態様２の吸引カテーテル組立体では、第一膨隆部が放射線不透過性物質を含んでいる。これにより、手技者は放射線透視画像下で第一筒状体の後端部の位置を把握することができ、第一筒状体が第二筒状体から飛び出してしまう恐れを低減できる。 In the suction catheter assembly according to aspect 2 of the present invention, the first bulge includes a radiopaque material. Thereby, the operator can grasp the position of the rear end portion of the first cylindrical body under the radiographic image, and can reduce the possibility that the first cylindrical body jumps out of the second cylindrical body.
本発明の態様３の吸引カテーテル組立体では、第一筒状体が、第一膨隆部よりも先端側に、コアシャフトに接合されていない第二膨隆部を備えており、この第二膨隆部は、第一外径よりも大きく第一膨隆部の第二外径よりも小さな第三外径を有している。これにより、第一膨隆部及び第二膨隆部以外による第一筒状体と第二筒状体との摩擦抵抗の増加を防ぐことができ、かつ、ガイドカテーテルの先端口から第二膨隆部が突出した場合でも第一筒状体の外径はそれほど大きくならず、かつ、コアシャフトを前後方向に移動させることで第二膨隆部により血管内に付着している異物を削り落とすこともできる。 In the suction catheter assembly according to the third aspect of the present invention, the first tubular body includes a second bulge portion that is not joined to the core shaft on the tip side of the first bulge portion, and the second bulge portion. Has a third outer diameter that is larger than the first outer diameter and smaller than the second outer diameter of the first bulge portion . Thereby, it is possible to prevent an increase in frictional resistance between the first tubular body and the second tubular body other than the first bulge and the second bulge, and the second bulge is formed from the distal end of the guide catheter. Even when protruding, the outer diameter of the first cylindrical body does not increase so much, and the foreign matter adhering to the inside of the blood vessel can be scraped off by the second bulging portion by moving the core shaft in the front-rear direction.
まず、図１〜図３を参照しながら、本実施の形態の吸引カテーテル組立体１について、説明する。なお、図１、図２において、左側が体内に挿入される先端側（遠位側）を、右側が医師等の手技者によって操作される後端側（近位側、基端側）を、表している。 First, the suction catheter assembly 1 of the present embodiment will be described with reference to FIGS. 1 and 2, the left side is the distal end side (distal side) to be inserted into the body, the right side is the rear end side (proximal side, proximal end side) operated by an operator such as a doctor, Represents.
図１に示したように、吸引カテーテル組立体１は、第一内腔１１を有する第一筒状体１０を備えた吸引カテーテル２と、吸引カテーテル２を挿入することができる第二内腔２１を有する第二筒状体２０を備えたガイドカテーテル３と、からなる。 As shown in FIG. 1, the suction catheter assembly 1 includes a suction catheter 2 having a first tubular body 10 having a first lumen 11 and a second lumen 21 into which the suction catheter 2 can be inserted. A guide catheter 3 having a second cylindrical body 20 having
吸引カテーテル２は、第一筒状体１０と、第一筒状体１０の後端部に固着されたコアシャフト１２と、を有している。第一筒状体１０には、血管内の異物を吸引する第一先端口１６と、吸引した異物を第一内腔１１から排出する第一後端口１４と、が設けられている。なお、第一筒状体１０とコアシャフト１２とは、接合部１５で接着剤、溶着、又は溶接等により接合されている。 The suction catheter 2 includes a first tubular body 10 and a core shaft 12 fixed to the rear end portion of the first tubular body 10. The first cylindrical body 10 is provided with a first front end port 16 for sucking foreign matter in the blood vessel and a first rear end port 14 for discharging the sucked foreign matter from the first lumen 11. The first cylindrical body 10 and the core shaft 12 are joined at the joint 15 by an adhesive, welding, welding, or the like.
ガイドカテーテル３の第二筒状体２０には、吸引カテーテル２を挿入する又は引き抜くための第二後端口２２と、挿入された吸引カテーテル２が先端側（図１の左側）に突出可能な第二先端口２６と、異物を体外に排出する排出口２４と、が設けられている。排出口２４には、吸引カテーテル２により血管内の異物を吸引する際に、吸引手段が接続される（図示せず）。なお、吸引手段は、シリンジ等の公知のものを用いることができる。 The second cylindrical body 20 of the guide catheter 3 has a second rear end port 22 for inserting or withdrawing the suction catheter 2 and a second rear end port 22 through which the inserted suction catheter 2 can protrude toward the distal end side (left side in FIG. 1). A two-end port 26 and a discharge port 24 for discharging foreign matter out of the body are provided. A suction means (not shown) is connected to the discharge port 24 when sucking foreign matter in the blood vessel with the suction catheter 2. In addition, a well-known thing, such as a syringe, can be used for a suction means.
図１に示したように、吸引カテーテル２を第二後端口２２から第二筒状体２０の第二内腔２１に挿入して、吸引カテーテル組立体１を組み立てたとき、第一筒状体１０の第一先端口１６は第二筒状体２０の第二先端口２６よりも先端側に突出する一方、第一筒状体１０の第一後端口１４は第二内腔２１内に位置するように構成されている。この状態で、排出口２４に吸引手段を接続して作動させることで、血管内の異物が、吸引カテーテル２の第一先端口１６から、第一筒状体１０の第一内腔１１と、第一後端口１４と、第二筒状体２０の第二内腔２１と、を経由して、排出口２４から吸引手段に排出される。なお、手技者は、コアシャフト１２を先端方向（図１の左側方向）に押し込むことで、吸引カテーテル２の第一先端口１６を目的部位まで到達させることができる。 As shown in FIG. 1, when the suction catheter 2 is inserted into the second lumen 21 of the second cylindrical body 20 from the second rear end port 22 and the suction catheter assembly 1 is assembled, the first cylindrical body is assembled. The first front end port 16 of the second cylindrical body 20 protrudes more to the front end side than the second front end port 26 of the second cylindrical body 20, while the first rear end port 14 of the first cylindrical body 10 is located in the second lumen 21. Is configured to do. In this state, the suction means is connected to the discharge port 24 and operated, so that the foreign matter in the blood vessel can pass from the first distal end port 16 of the suction catheter 2 to the first lumen 11 of the first cylindrical body 10, The first rear end port 14 and the second lumen 21 of the second cylindrical body 20 are discharged from the discharge port 24 to the suction means. Note that the operator can cause the first distal end 16 of the suction catheter 2 to reach the target site by pushing the core shaft 12 in the distal direction (left side in FIG. 1).
図２は、図１のＡ部を拡大した断面図である。吸引カテーテル２の第一筒状体１０は、半径方向に内側から順に内層３４と補強体としてのブレード３６と外層３８とからなる本体部１００と、本体部１００の外周に形成された膨隆部４０と、を備えている。一方、ガイドカテーテル３の第二筒状体２０は、半径方向に内側から順に内層４４と補強体としてのブレード４６と外層４８と、を備えている。 FIG. 2 is an enlarged cross-sectional view of part A of FIG. The first tubular body 10 of the suction catheter 2 includes a main body portion 100 including an inner layer 34, a blade 36 as a reinforcing body, and an outer layer 38 in order from the inner side in the radial direction, and a bulging portion 40 formed on the outer periphery of the main body portion 100. And. On the other hand, the second cylindrical body 20 of the guide catheter 3 includes an inner layer 44, a blade 46 as a reinforcing body, and an outer layer 48 in order from the inside in the radial direction.
内層３４は、樹脂から形成され、内部にガイドワイヤ（図示せず）を挿入するための第一内腔１１を構成している。同様に、内層４４は、樹脂から形成され、内部に吸引カテーテル２を挿入するための第一内腔２１を構成している。内層３４、４４を形成する樹脂材料は、特に限定されるものではないが、本実施の形態では、共にＰＴＦＥ（ポリテトラフルオロチレン）が用いられる。 The inner layer 34 is made of resin, and constitutes the first lumen 11 for inserting a guide wire (not shown) therein. Similarly, the inner layer 44 is formed of a resin and constitutes the first lumen 21 for inserting the suction catheter 2 therein. The resin material for forming the inner layers 34 and 44 is not particularly limited, but PTFE (polytetrafluoroethylene) is used in the present embodiment.
内層３４の外周には、補強体としてのブレード３６が形成されている。ブレード３６は、金属からなる第一素線３６ａと金属からなる第二素線３６ｂとが網目状（メッシュ状）に編み込まれたものである。同様に、内層４４の外周には、補強体としてのブレード４６が形成されている。ブレード４６は、金属からなる第一素線４６ａと金属からなる第二素線４６ｂとが網目状（メッシュ状）に編み込まれたものである。 A blade 36 as a reinforcing body is formed on the outer periphery of the inner layer 34. The blade 36 is formed by braiding a first strand 36a made of metal and a second strand 36b made of metal in a mesh shape. Similarly, a blade 46 as a reinforcing body is formed on the outer periphery of the inner layer 44. The blade 46 is made by braiding a first strand 46a made of metal and a second strand 46b made of metal in a mesh shape.
ブレード３６の外周には、樹脂からなる外層３８が形成され、内層３４とブレード３６とを被覆する。同様に、ブレード４６の外周には、樹脂からなる外層４８が形成され、内層４４とブレード４６とを被覆する。外層３８、４８を形成する樹脂材料は、特に限定されるものではなく、ポリアミド、ポリアミドエラストマ、ポリエステル、ポリウレタン等が用いられる。 An outer layer 38 made of a resin is formed on the outer periphery of the blade 36 to cover the inner layer 34 and the blade 36. Similarly, an outer layer 48 made of a resin is formed on the outer periphery of the blade 46 to cover the inner layer 44 and the blade 46. The resin material for forming the outer layers 38 and 48 is not particularly limited, and polyamide, polyamide elastomer, polyester, polyurethane and the like are used.
図２に示したように、第一筒状体１０の本体部１００の後端部には、外層３８の外周に膨隆部４０が形成されている。本体部１００の外径をＤ１とし、膨隆部４０の外径をＤ２とすると、膨隆部４０の外径Ｄ２は、本体部１００の外径Ｄ１よりも大きくなる（Ｄ２＞Ｄ１）。一方、吸引カテーテル２の第一筒状体１０は、ガイドカテーテル３の第二筒状体２０に挿入されるため、第二筒状体２０の内径をＤ３とすると、膨隆部４０の外径Ｄ２は、第二筒状体２０の内径Ｄ３よりも小さくなる（Ｄ２＜Ｄ３）。そのため、吸引カテーテル２をガイドカテーテル３に挿入した際、膨隆部４０が形成されていない本体部１００では、第一筒状体１０と第二筒状体２０とのクリアランスが広いのに対して（クリアランス＝Ｄ３−Ｄ１）、膨隆部４０では、第一筒状体１０と第二筒状体２０とのクリアランスが狭くなっている（クリアランス＝Ｄ３−Ｄ２）。 As shown in FIG. 2, a bulging portion 40 is formed on the outer periphery of the outer layer 38 at the rear end portion of the main body portion 100 of the first tubular body 10. When the outer diameter of the main body 100 is D1 and the outer diameter of the bulging portion 40 is D2, the outer diameter D2 of the bulging portion 40 is larger than the outer diameter D1 of the main body 100 (D2> D1). On the other hand, since the first cylindrical body 10 of the suction catheter 2 is inserted into the second cylindrical body 20 of the guide catheter 3, assuming that the inner diameter of the second cylindrical body 20 is D3, the outer diameter D2 of the bulging portion 40. Is smaller than the inner diameter D3 of the second cylindrical body 20 (D2 <D3). Therefore, when the suction catheter 2 is inserted into the guide catheter 3, the main body portion 100 where the bulging portion 40 is not formed has a large clearance between the first tubular body 10 and the second tubular body 20 ( (Clearance = D3-D1), in the bulging portion 40, the clearance between the first cylindrical body 10 and the second cylindrical body 20 is narrow (clearance = D3-D2).
なお、膨隆部４０は、樹脂単独で形成してもよいし、金属からなる管状チューブ体を樹脂で被覆したものでよい。但し、ガイドカテーテル３の第二筒状体２０に吸引カテーテル２の第一筒状体１０を挿入する際、膨隆部４０の外周は第二筒状体２０の第二内腔２１と接触するため、第二筒状体２０の第二内腔２１内を潤滑に進むことができるように、膨隆部４０の外周はコーティング剤で被膜することが好ましい。コーティング剤として、例えば、疎水性の滑り性向上剤（シリコーンオイルやフッ素系樹脂等）や親水性の滑り性向上剤（ポリビニルアルコールやヒアルロン酸等）を用いることができる。 In addition, the bulging portion 40 may be formed of a resin alone, or a tubular tube body made of metal may be coated with a resin. However, when the first tubular body 10 of the suction catheter 2 is inserted into the second tubular body 20 of the guide catheter 3, the outer periphery of the bulging portion 40 comes into contact with the second lumen 21 of the second tubular body 20. The outer periphery of the bulging portion 40 is preferably coated with a coating agent so that the inside of the second lumen 21 of the second cylindrical body 20 can proceed to lubrication. As the coating agent, for example, a hydrophobic slip improver (silicone oil, fluorine resin, etc.) or a hydrophilic slip improver (polyvinyl alcohol, hyaluronic acid, etc.) can be used.
また、膨隆部４０は、金、白金、タングステン、これらの元素からなる合金など放射線不透過性物質を含んでいる。これは、手技者が放射線透視画像下で第一筒状体１０の後端部の位置を把握することで、第一筒状体１０が第二筒状体２０の第二先端口２６から飛び出してしまうという恐れを低減するためである。 The bulging portion 40 includes a radiopaque material such as gold, platinum, tungsten, or an alloy made of these elements. This is because the first tubular body 10 jumps out from the second front end opening 26 of the second tubular body 20 by grasping the position of the rear end portion of the first tubular body 10 under the radiographic image. This is in order to reduce the fear of being lost.
上述したように、膨隆部４０の外径Ｄ２は、本体部１００の外径Ｄ１よりも大きくなっているため（Ｄ２＞Ｄ１）、吸引カテーテル２を第二筒状体２０に挿入した際に、第二内腔２１と接触する部分は膨隆部４０となる。本体部１００の外周に膨隆部４０が形成されていることで、第一筒状体１０と第二筒状体２０とのクリアランスが軸方向に一定ではなく、膨隆部４０が形成されていない本体部１００では広くなっているのに対して、膨隆部４０では狭くなっている。そのため、図３に示したように、血管内に挿入されて湾曲した状態にある第二筒状体２０に、第一筒状体１０を挿入したときに、第一筒状体１０と第二筒状体２０との接触部分を、第一筒状体１０の外層３８ではなく膨隆部４０とすることができるため、第一筒状体１０と第二筒状体２０との摩擦抵抗を低減することができる。その結果、第一筒状体１０の通過性が向上して、吸引カテーテル２を目的部位まで到達させることが容易となる。 As described above, since the outer diameter D2 of the bulging portion 40 is larger than the outer diameter D1 of the main body portion 100 (D2> D1), when the suction catheter 2 is inserted into the second tubular body 20, A portion in contact with the second lumen 21 becomes a bulging portion 40. Since the bulging portion 40 is formed on the outer periphery of the main body portion 100, the clearance between the first cylindrical body 10 and the second cylindrical body 20 is not constant in the axial direction, and the bulging portion 40 is not formed. The portion 100 is widened, whereas the bulging portion 40 is narrowed. Therefore, as shown in FIG. 3, when the first cylindrical body 10 is inserted into the second cylindrical body 20 that is inserted into the blood vessel and is in a curved state, the first cylindrical body 10 and the second cylindrical body 10 Since the contact portion with the cylindrical body 20 can be the bulging portion 40 instead of the outer layer 38 of the first cylindrical body 10, the frictional resistance between the first cylindrical body 10 and the second cylindrical body 20 is reduced. can do. As a result, the passability of the first tubular body 10 is improved, and the suction catheter 2 can easily reach the target site.
なお、図１〜３では、膨隆部４０を本体部１００の後端部に設けていたが、特に、これに限定されない。例えば、膨隆部４０を本体部１００の先端部あるいは中央部に設けることもできる（図示せず）。但し、膨隆部４０を本体部１００の後端部に設けた場合、吸引カテーテル組立体１を組み立てたときに、ガイドカテーテル３の第二先端口２６から本体部１００よりも大きな外径Ｄ２を有した膨隆部４０が突出する恐れが低減され、膨隆部４０よりも小さな外径Ｄ１を有した本体部１００の第一先端口１６を更に末梢まで到達させることができるので、より好ましい。 1 to 3, the bulging portion 40 is provided at the rear end portion of the main body portion 100, but is not particularly limited thereto. For example, the bulging portion 40 can be provided at the distal end portion or the central portion of the main body portion 100 (not shown). However, when the bulging portion 40 is provided at the rear end portion of the main body portion 100, the outer diameter D2 larger than that of the main body portion 100 is provided from the second distal end 26 of the guide catheter 3 when the suction catheter assembly 1 is assembled. The possibility that the bulged portion 40 protrudes is reduced, and the first tip 16 of the main body portion 100 having an outer diameter D1 smaller than the bulged portion 40 can be further reached to the periphery, which is more preferable.
また、図２に示したように、膨隆部４０は、コアシャフト１２の先端を覆うように本体部１００の後端部に形成されている。 Further, as shown in FIG. 2, the bulging portion 40 is formed at the rear end portion of the main body portion 100 so as to cover the tip end of the core shaft 12.
このとき、コアシャフト１２を金属で形成する場合、樹脂からなる膨隆部４０と樹脂からなる外層３８とを溶着する、あるいは、接着剤を用いて接合することにより、コアシャフト１２の先端を本体部１００と接合して、コアシャフト１２が本体部１００から外れてしまうという恐れを低減する。接着剤を用いずに、コアシャフト１２の先端を覆う状態で、膨隆部４０と本体部１００の外層３８とを溶着した場合、膨隆部４０はコアシャフト１２と本体部１００とを接合する接着剤としての機能を有することになる。そのため、コアシャフト１２の先端を本体部１００の外層３８に接合する際に、接着剤やクリップなど別部材を用いる必要がないため、製造上簡略化することもできる。また、コアシャフト１２と本体部１００と接合強度が十分でないときは、本体部１００の外層３８を一部除去して、金属からなるコアシャフト１２の先端と金属からなるブレード３６の後端とを溶接してもよい。あるいは、金属からなる管状チューブ体を樹脂で被膜して膨隆部４０を形成し、金属からなるコアシャフト１２の先端と膨隆部４０を構成する金属からなる管状チューブ体とを溶接して、コアシャフト１２が本体部１００から外れないようにしてもよい。 At this time, when the core shaft 12 is formed of metal, the bulging portion 40 made of resin and the outer layer 38 made of resin are welded or bonded using an adhesive, whereby the tip of the core shaft 12 is joined to the main body portion. Joining to 100 reduces the risk that the core shaft 12 will come off the main body 100. When the bulging portion 40 and the outer layer 38 of the main body portion 100 are welded in a state where the tip of the core shaft 12 is covered without using an adhesive, the bulging portion 40 is an adhesive that joins the core shaft 12 and the main body portion 100. It has the function as. Therefore, when joining the front-end | tip of the core shaft 12 to the outer layer 38 of the main-body part 100, since it is not necessary to use another members, such as an adhesive agent and a clip, it can also simplify on manufacture. When the bonding strength between the core shaft 12 and the main body 100 is not sufficient, a part of the outer layer 38 of the main body 100 is removed, and the tip of the core shaft 12 made of metal and the rear end of the blade 36 made of metal are connected. You may weld. Alternatively, the tubular tube body made of metal is coated with a resin to form the bulging portion 40, and the tip of the core shaft 12 made of metal and the tubular tube body made of metal constituting the bulging portion 40 are welded to form the core shaft. 12 may not be detached from the main body 100.
また、コアシャフト１２を高強度な繊維樹脂（アラミド繊維、炭素繊維、又はセルロースナノファイバー等）で形成する場合、樹脂からなる膨隆部４０と樹脂からなる外層３８と樹脂からなるコアシャフト１２とを溶着することで、コアシャフト１２が本体部１００から外れてしまうという恐れを更に低減することができる。 Further, when the core shaft 12 is formed of a high-strength fiber resin (aramid fiber, carbon fiber, cellulose nanofiber or the like), the bulging portion 40 made of resin, the outer layer 38 made of resin, and the core shaft 12 made of resin By welding, the fear that the core shaft 12 may come off from the main body 100 can be further reduced.
なお、第一筒状体１０及び第二筒状体２０の断面形状は、特に限定されない。円形状でも楕円形状でもよい。また、本実施の形態では、膨隆部４０は、外層３８の外周に周方向に均一な厚みで形成しているが、特に限定されず、第一筒状体１０の本体部１００とコアシャフト１２とを接合する側（図２の上側）の膨隆部４０を厚くする一方、反対側（図２の下側）の膨隆部４０を薄くしても良い。これにより、コアシャフト１２と第二筒状体２０の第二内腔２１とのクリアランスが広くなり、コアシャフト１２が湾曲した場合でも、コアシャフト１２が第二内腔２１と接触する恐れを低減することができる。 In addition, the cross-sectional shape of the 1st cylindrical body 10 and the 2nd cylindrical body 20 is not specifically limited. It may be circular or elliptical. In the present embodiment, the bulging portion 40 is formed on the outer periphery of the outer layer 38 with a uniform thickness in the circumferential direction, but is not particularly limited, and the main body portion 100 and the core shaft 12 of the first tubular body 10. The bulging part 40 on the side (upper side in FIG. 2) to be joined may be thickened, while the bulging part 40 on the opposite side (lower side in FIG. 2) may be thinned. Thereby, the clearance between the core shaft 12 and the second lumen 21 of the second cylindrical body 20 is widened, and even when the core shaft 12 is curved, the risk of the core shaft 12 coming into contact with the second lumen 21 is reduced. can do.
次に、図４を参照しながら、第２の形態の吸引カテーテル組立体１ａについて、説明する。なお、図４は、図１と同様に、左側が体内に挿入される先端側（遠位側）を、右側が医師等の手技者によって操作される後端側（近位側、基端側）を、表している。 Next, the suction catheter assembly 1a according to the second embodiment will be described with reference to FIG. 4, as in FIG. 1, the left side is the distal end side (distal side) inserted into the body, and the right side is the rear end side (proximal side, proximal end side) operated by a doctor or other operator. ).
図１〜３に示した吸引カテーテル組立体１との相違点のみを説明すると、吸引カテーテル組立体１ａでは、第一筒状体１０の軸方向に、膨隆部４０が複数設けられている。具体的には、第一筒状体１０は、第一筒状体１０の後端側に最も大きな外径を有した膨隆部４０ｃと、膨隆部４０ｃよりも先端側により小さな外径を有した膨隆部４０ｂと、膨隆部４０ｂよりも先端側により小さな外径を有した膨隆部４０ａと、を備えている。吸引カテーテル組立体１と異なり、膨隆部４０が複数あるため、第一筒状体１０の外層３８が第二筒状体２０の第二内腔２１と接触しないようにすることができる。そのため、意図しない第一筒状体１０と第二筒状体２０との摩擦抵抗の増加を防止することができる。また、複数の膨隆部４０は、外径が後端ほど大きく先端ほど小さくなっている（膨隆部４０の外径：４０ｃ＞４０ｂ＞４０ａ）ため、ガイドカテーテル３の第二先端口２６から先端側の膨隆部４０ａが突出した場合でも、第一筒状体１０の外径はそれほど大きくならないため、吸引カテーテル２の第一先端口１６が末梢の目的部位まで到達できないという恐れを低減することができる。更に、手技者は、コアシャフト１２を前後方向に移動させることで、ガイドカテーテル３の第二先端口２６から突出した膨隆部４０ａを利用して、血管内に付着している異物を削り落とすこともできる。 Explaining only the differences from the suction catheter assembly 1 shown in FIGS. 1 to 3, the suction catheter assembly 1 a is provided with a plurality of bulging portions 40 in the axial direction of the first tubular body 10. Specifically, the first cylindrical body 10 has a bulging portion 40c having the largest outer diameter on the rear end side of the first cylindrical body 10, and a smaller outer diameter on the tip side than the bulging portion 40c. A bulging portion 40b and a bulging portion 40a having a smaller outer diameter on the tip side than the bulging portion 40b are provided. Unlike the suction catheter assembly 1, since there are a plurality of the bulging portions 40, the outer layer 38 of the first tubular body 10 can be prevented from contacting the second lumen 21 of the second tubular body 20. Therefore, an unintended increase in frictional resistance between the first tubular body 10 and the second tubular body 20 can be prevented. Further, the plurality of bulging portions 40 have an outer diameter that is larger at the rear end and smaller at the distal end (outer diameter of the bulging portion 40: 40c> 40b> 40a). Even when the bulging portion 40a protrudes, the outer diameter of the first tubular body 10 does not increase so much, so that the possibility that the first distal end 16 of the suction catheter 2 cannot reach the peripheral target site can be reduced. . Further, the operator uses the bulging portion 40a protruding from the second distal end 26 of the guide catheter 3 to scrape off the foreign matter adhering to the blood vessel by moving the core shaft 12 in the front-rear direction. You can also.
なお、図４では、第一筒状体１０の軸方向に膨隆部４０を３個設けたが、個数は特に限定されない。 In FIG. 4, three bulging portions 40 are provided in the axial direction of the first cylindrical body 10, but the number is not particularly limited.
また、吸引カテーテル組立体１、１ａでは、コアシャフト１２の先端を本体部１００の外層３８の外周に接合させたが、特に限定されない。例えば、コアシャフト１２の先端を本体部１００の内層３４の内周に接合させて良い。この場合、吸引した血管内の異物がコアシャフト１２の先端に引っ掛かる可能性があるため、コアシャフト１２の先端を別途樹脂などで覆っておくことが好ましい。 In the suction catheter assemblies 1 and 1a, the tip of the core shaft 12 is joined to the outer periphery of the outer layer 38 of the main body 100, but is not particularly limited. For example, the tip of the core shaft 12 may be joined to the inner periphery of the inner layer 34 of the main body 100. In this case, since the sucked foreign substance in the blood vessel may be caught on the tip of the core shaft 12, it is preferable to cover the tip of the core shaft 12 with a resin or the like separately.
以上で述べたように、吸引カテーテル組立体１において、吸引カテーテル２の第一筒状体１０に膨隆部４０を設けることで、血管内に挿入されたガイドカテーテル３の第二筒状体２０が湾曲した状態にあっても、吸引カテーテル２の第一筒状体１０とガイドカテーテル３の第二筒状体２０との接触部分を膨隆部４０とすることができ、吸引カテーテル２とガイドカテーテル３との摩擦抵抗を低減することができる。その結果、吸引カテーテル２の通過性が向上して、吸引カテーテル２を目的部位まで到達させることが容易となる。 As described above, in the suction catheter assembly 1, the second tubular body 20 of the guide catheter 3 inserted into the blood vessel is provided by providing the bulging portion 40 on the first tubular body 10 of the suction catheter 2. Even in the curved state, the contact portion between the first tubular body 10 of the suction catheter 2 and the second tubular body 20 of the guide catheter 3 can be the bulging portion 40, and the suction catheter 2 and the guide catheter 3 And frictional resistance can be reduced. As a result, the passability of the suction catheter 2 is improved, and the suction catheter 2 can easily reach the target site.
１、１ａ 吸引カテーテル組立体
２ 吸引カテーテル
３ ガイドカテーテル
１０ 第一筒状体
１１ 第一内腔
１２ コアシャフト
１４ 第一後端口
１５ 接合部
１６ 第一先端口
２０ 第二筒状体
２１ 第二内腔
２２ 第二後端口
２４ 排出口
２６ 第二先端口
３４、４４ 内層
３６、４６ ブレード
３８、４８ 外層
４０ 膨隆部
１００ 本体部
1, 1a Suction catheter assembly 2 Suction catheter 3 Guide catheter 10 First cylindrical body 11 First lumen 12 Core shaft 14 First rear end port 15 Joint 16 First front end port 20 Second cylindrical body 21 Second inner Cavity 22 Second rear end port 24 Discharge port 26 Second front end ports 34, 44 Inner layer 36, 46 Blade 38, 48 Outer layer 40 Swelling portion 100
Claims (3)
前記吸引カテーテルを挿入可能な第二筒状体からなるガイドカテーテルと、を備えた吸引カテーテル組立体において、
前記第一筒状体が、第一外径を有した本体部と、前記第一外径よりも大きく前記第二筒状体の内径よりも小さな第二外径を有した第一膨隆部と、を備えており、
前記第一膨隆部は、前記コアシャフトの先端と前記第一筒状体の前記後端部とを接合していることを特徴とした吸引カテーテル組立体。 A suction catheter comprising a first tubular body and a core shaft joined to a rear end portion of the first tubular body;
In a suction catheter assembly comprising a guide catheter composed of a second tubular body into which the suction catheter can be inserted,
The first cylindrical body has a main body portion having a first outer diameter, and a first bulge portion having a second outer diameter larger than the first outer diameter and smaller than the inner diameter of the second cylindrical body; , And
The suction catheter assembly according to claim 1, wherein the first bulging portion joins the tip end of the core shaft and the rear end portion of the first cylindrical body.
前記第二膨隆部は、前記第一外径よりも大きく前記第一膨隆部の前記第二外径よりも小さな第三外径を有していることを特徴とした請求項１又は請求項２に記載の吸引カテーテル組立体。 The first cylindrical body includes a second bulge portion that is not joined to the core shaft on the tip side of the first bulge portion,
The second bulging portion has a third outer diameter that is larger than the first outer diameter and smaller than the second outer diameter of the first bulging portion. A suction catheter assembly according to claim 1.
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| JP2006087643A (en) * | 2004-09-24 | 2006-04-06 | Terumo Corp | Apparatus for sucking foreign substance from blood vessel |
| JP5619426B2 (en) * | 2007-12-26 | 2014-11-05 | テルモ株式会社 | Medical long body, method for manufacturing the same, and apparatus for manufacturing the same |
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