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JP4726009B2 - Cardiac catheter - Google Patents

Cardiac catheter Download PDF

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JP4726009B2
JP4726009B2 JP2006294873A JP2006294873A JP4726009B2 JP 4726009 B2 JP4726009 B2 JP 4726009B2 JP 2006294873 A JP2006294873 A JP 2006294873A JP 2006294873 A JP2006294873 A JP 2006294873A JP 4726009 B2 JP4726009 B2 JP 4726009B2
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holding handle
catheter body
catheter
cylinder
adjustment mechanism
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JP2008086729A (en
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幸 西村
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River Seiko Co Ltd
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River Seiko Co Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0136—Handles therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Hematology (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biophysics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Electrotherapy Devices (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Description

本発明は、心臓カテーテルに関する。  The present invention relates to a cardiac catheter.

血管から心臓内に挿入される心臓カテーテルは、可撓性を有する細長いカテーテル本体の先端に設けられた先端電極を心臓内の目標部位に誘導する必要がある。そこで、カテーテル本体に内挿された操作ワイヤーを手元側の操作ハンドル部で牽引操作することにより、カテーテル本体の先端付近を屈曲させることができるように構成されている。
そのため、心臓カテーテルの操作ハンドル部には、カテーテル本体の基端に連結されたカテーテル本体保持ハンドルと操作ワイヤーの基端に連結された操作ワイヤー保持ハンドルとが、相対的にスライド操作できるように配置されている（例えば、特許文献１）。
特開２００３−３１９９１５号公報 A cardiac catheter inserted into a heart from a blood vessel needs to guide a tip electrode provided at the tip of a flexible elongated catheter body to a target site in the heart. In view of this, the distal end of the catheter body can be bent by pulling the operation wire inserted into the catheter body with the operation handle on the hand side.
Therefore, the operation handle portion of the cardiac catheter is arranged so that the catheter body holding handle connected to the proximal end of the catheter body and the operation wire holding handle connected to the proximal end of the operation wire can be relatively slid. (For example, Patent Document 1).
JP 2003-319915 A

特許文献１に記載された心臓カテーテルにおいては、相対的にスライド動作するカテーテル本体保持ハンドルと操作ワイヤー保持ハンドル（ハンドルハウジング１０２とサム制御部１１６）とが意に反して勝手にスライド動作してしまわないよう、両保持ハンドルの相対的スライド動作に対し動作抵抗を付与してその動作抵抗の大きさを外部から調整することができるスライド抵抗調整機構が設けられている。具体的には、動作抵抗を付与するためにカテーテル本体の基部を締め付ける状態に配置されたゴム製のＯリングの潰し量を、一方の保持ハンドルを螺動させることで調整できるようになっている（段落〔００４９〕、図１０、図１１）。  In the cardiac catheter described in Patent Document 1, the catheter body holding handle and the operation wire holding handle (the handle housing 102 and the thumb control unit 116) that slide relative to each other unexpectedly slide. There is provided a slide resistance adjusting mechanism capable of giving an operating resistance to the relative sliding operation of both holding handles and adjusting the magnitude of the operating resistance from the outside. Specifically, the amount of crushing of the rubber O-ring disposed in a state where the base of the catheter body is tightened in order to impart operating resistance can be adjusted by screwing one holding handle. (Paragraph [0049], FIG. 10, FIG. 11).

そのような従来のスライド抵抗調整機構では、動作抵抗の大きさを変化させる調整を行うと、それに伴って両保持ハンドル（ハンドルハウジング１０２とサム制御部１１６）間の隙間の大きさが変化する。しかし、両保持ハンドル間の隙間にまたがる部分は両保持ハンドルを相対的にスライドさせる操作を行う手の指が当たる指当て部になっていて、使用者は操作指に触れる隙間の大きさの感触から、カテーテル本体の先端側の屈曲状態を判断していることが少なくない。そのため従来は、スライド抵抗調整機構で動作抵抗の大きさを変化させるための調整を行うと、両保持ハンドル間の隙間の大きさの変化により、カテーテル本体の先端側の屈曲状態を手元側で正しく判断できなくなってしまう場合があった。  In such a conventional slide resistance adjusting mechanism, when the adjustment for changing the magnitude of the operating resistance is performed, the size of the gap between the holding handles (the handle housing 102 and the thumb control unit 116) changes accordingly. However, the part that spans the gap between the two holding handles is a finger pad where the finger of the hand performing the operation of sliding the two holding handles relatively touches, and the user feels the size of the gap that touches the operating finger. Therefore, it is often the case that the bending state of the distal end side of the catheter body is determined. For this reason, conventionally, when the adjustment for changing the magnitude of the operating resistance is performed by the slide resistance adjusting mechanism, the bending state of the distal end side of the catheter body is correctly corrected at the proximal side due to the change in the size of the gap between the two holding handles. In some cases, it was impossible to judge.

本発明はそのような問題を解決するためになされたものであり、スライド抵抗調整機構で動作抵抗の大きさを変化させるための調整を行っても、使用者の操作指が当たる指当て部の感触に変化がなく、カテーテル本体の先端側の屈曲状態を操作指の感触により手元側で常に正しく判断することができる心臓カテーテルを提供することを目的とする。  The present invention has been made to solve such a problem, and even if an adjustment for changing the magnitude of the operating resistance is performed by the slide resistance adjusting mechanism, the finger contact portion that the user's operation finger touches is adjusted. It is an object of the present invention to provide a cardiac catheter that has no change in touch and can always correctly determine the bent state of the distal end side of the catheter body by the touch of an operation finger.

可撓性を有する細長いカテーテル本体内に操作ワイヤーが内挿され、手元側に設けられた操作ハンドル部で、カテーテル本体の基端に連結されたカテーテル本体保持ハンドルと操作ワイヤーの基端に連結された操作ワイヤー保持ハンドルとを操作ワイヤーの軸方向に相対的にスライド操作することにより、カテーテル本体に対して操作ワイヤーが軸方向にスライドしてカテーテル本体の先端近傍部分が屈曲するように構成された心臓カテーテルにおいて、カテーテル本体保持ハンドルと操作ワイヤー保持ハンドルとの相対的スライド動作に対し動作抵抗を付与してその動作抵抗の大きさを調整することができるスライド抵抗調整機構をカテーテル本体保持ハンドルと操作ワイヤー保持ハンドルの一方に取り付けると共に、スライド抵抗調整機構の調整状態を外部から変えるための調整機構操作筒体を、スライド抵抗調整機構を囲む状態に一方の保持ハンドルに取り付け、スライド抵抗調整機構の調整状態に関係なく、一方の保持ハンドルと調整機構操作筒体との位置関係が変化しないようにした。  An operation wire is inserted into a flexible elongated catheter body, and is connected to the catheter body holding handle connected to the proximal end of the catheter body and the proximal end of the operation wire by an operation handle portion provided on the proximal side. The operation wire holding handle is configured to slide relative to the axial direction of the operation wire so that the operation wire slides in the axial direction with respect to the catheter body and the portion near the distal end of the catheter body is bent. In a cardiac catheter, a slide resistance adjustment mechanism capable of adjusting the magnitude of the operation resistance by applying an operation resistance to the relative slide operation between the catheter body holding handle and the operation wire holding handle is operated with the catheter body holding handle. Attach to one of the wire holding handles and slide resistance adjuster An adjustment mechanism operation cylinder for changing the adjustment state of the slide from the outside is attached to one holding handle so as to surround the slide resistance adjustment mechanism, and the one holding handle and adjustment mechanism are operated regardless of the adjustment state of the slide resistance adjustment mechanism. The positional relationship with the cylinder was not changed.

なお、調整機構操作筒体が、カテーテル本体保持ハンドルと操作ワイヤー保持ハンドルとを相対的にスライドさせるための操作を行う手の指が当たる指当て部に位置しているものであってもよい。そして、調整機構操作筒体が、一方の保持ハンドルに対して軸周りに回転自在であって軸方向への移動が規制された状態に取り付けられていてもよく、スライド抵抗調整機構と係合する係合部が調整機構操作筒体の内面に形成されていてもよい。  In addition, the adjustment mechanism operation cylinder may be located at a finger contact portion where a finger of a hand that performs an operation for sliding the catheter body holding handle and the operation wire holding handle relative to each other hits. The adjustment mechanism operation cylinder may be attached to the one holding handle so as to be rotatable around the axis and restricted in movement in the axial direction, and engages with the slide resistance adjustment mechanism. The engaging portion may be formed on the inner surface of the adjustment mechanism operation cylinder.

本発明の心臓カテーテルによれば、カテーテル本体保持ハンドルと操作ワイヤー保持ハンドルとの相対的スライド動作に対し動作抵抗を付与してその動作抵抗の大きさを調整することができるスライド抵抗調整機構の調整状態に関係なく、保持ハンドルと調整機構操作筒体との位置関係が変化しないので、調整機構操作筒体によりスライド抵抗調整機構における動作抵抗の大きさを変化させるための調整を行っても、使用者の操作指が当たる指当て部の感触に変化がなく、カテーテル本体の先端側の屈曲状態を操作指の感触により手元側で常に正しく判断することができる。  According to the cardiac catheter of the present invention, adjustment of the slide resistance adjusting mechanism capable of adjusting the magnitude of the operation resistance by applying the operation resistance to the relative slide operation between the catheter main body holding handle and the operation wire holding handle. Regardless of the state, the positional relationship between the holding handle and the adjustment mechanism operation cylinder does not change, so it can be used even if the adjustment mechanism operation cylinder is adjusted to change the operating resistance of the slide resistance adjustment mechanism. There is no change in the feel of the finger contact portion where the operator's operation finger hits, and the bending state of the distal end side of the catheter body can always be correctly determined by the touch of the operation finger.

以下、図面を参照して本発明の実施の形態を具体的に説明する。
図５は心臓カテーテルの全体構成を示している。可撓性を有する細長いカテーテル本体１は血管内に通されるものであり、合成樹脂材等からなるマルチルーメンチューブ等で形成されている。カテーテル本体１の先端近傍部分に形成された湾曲部２は、より柔軟に形成されていて、その先端に先端電極部３が連結されている。４は、湾曲部２を屈曲操作するためにカテーテル本体１に内挿された操作ワイヤーであり、その先端が湾曲部２の先端部分（又は、それより先端寄りの位置）の周辺に偏位した位置に連結されている。Embodiments of the present invention will be specifically described below with reference to the drawings.
FIG. 5 shows the overall configuration of the cardiac catheter. An elongated catheter body 1 having flexibility is passed through a blood vessel, and is formed of a multi-lumen tube made of a synthetic resin material or the like. The bending portion 2 formed in the vicinity of the distal end of the catheter body 1 is formed more flexibly, and the distal electrode portion 3 is connected to the distal end. 4 is an operation wire inserted into the catheter body 1 for bending the bending portion 2, and its distal end is displaced to the periphery of the distal end portion (or a position closer to the distal end thereof) of the bending portion 2. It is linked to the position.

心臓カテーテルの手元側に設けられた操作ハンドル部５には、カテーテル本体１の基端に連結されたカテーテル本体保持ハンドル６と操作ワイヤー４の基端に連結された操作ワイヤー保持ハンドル７とが、操作ワイヤー４の軸方向に相対的にスライド自在に配置されている。操作ワイヤー保持ハンドル７は使用者が手で握り込むのに適した略円筒形状に形成され、カテーテル本体保持ハンドル６の指当て環６Ａは、操作ワイヤー保持ハンドル７を握った手の親指の腹で押し引き操作し易いように厚肉の略円盤状に形成されて、操作ワイヤー保持ハンドル７の先端近傍から前方（図５において下方）に突出する状態に配置されている。  The operation handle portion 5 provided on the proximal side of the cardiac catheter includes a catheter body holding handle 6 connected to the proximal end of the catheter body 1 and an operation wire holding handle 7 connected to the proximal end of the operation wire 4. The operation wire 4 is disposed so as to be relatively slidable in the axial direction. The operation wire holding handle 7 is formed in a substantially cylindrical shape suitable for the user to grasp with the hand, and the finger rest ring 6A of the catheter body holding handle 6 is the belly of the thumb of the hand holding the operation wire holding handle 7. It is formed in a thick, substantially disk shape so that it can be easily pushed and pulled, and is disposed in a state of protruding forward (downward in FIG. 5) from the vicinity of the tip of the operation wire holding handle 7.

６Ｂは、カテーテル本体保持ハンドル６のスライド筒部であり、指当て環６Ａと一体に進退動作するように指当て環６Ａに連結されて、操作ワイヤー保持ハンドル７内にスライド自在に嵌合している。９は、操作ワイヤー４の基端に固着されたワイヤー留め口金であり、操作ワイヤー保持ハンドル７の中心軸位置付近に配置されて操作ワイヤー保持ハンドル７に対して固定されている。１０は、カテーテル本体１の基端部分がカテーテル本体保持ハンドル６との連結部付近で急激に曲がって折れるのを防ぐための折れ止め部材であり、弾力性のあるゴム材等により先細りのテーパ筒状に形成され、指当て環６Ａに隣接してカテーテル本体１の基端部分を囲む状態に配置されている。  6B is a slide cylinder part of the catheter main body holding handle 6, and is connected to the finger holding ring 6A so as to move forward and backward integrally with the finger holding ring 6A, and is slidably fitted into the operation wire holding handle 7. Yes. Reference numeral 9 denotes a wire clamp fixed to the proximal end of the operation wire 4, which is disposed near the central axis position of the operation wire holding handle 7 and fixed to the operation wire holding handle 7. Reference numeral 10 denotes a bend-preventing member for preventing the proximal end portion of the catheter body 1 from being bent suddenly in the vicinity of the connecting portion with the catheter body holding handle 6, and is tapered by an elastic rubber material or the like. It is formed in a shape and is arranged adjacent to the finger rest ring 6A so as to surround the proximal end portion of the catheter body 1.

１１は、後述するスライド抵抗調整機構２０を囲む状態に操作ワイヤー保持ハンドル７の先端部分に取り付けられた調整機構操作筒体であり、操作ワイヤー保持ハンドル７の先端領域を全面的に外装する状態に設けられている。調整機構操作筒体１１とカテーテル本体保持ハンドル６の指当て環６Ａとの間には、両保持ハンドル６，７を相対的にスライドさせる操作を行うための手の指が入る隙間が形成され、調整機構操作筒体１１と指当て環６Ａとが、スライド操作を行う手の指（例えば、人指し指と親指）が当たる後側と前側の指当て部になっている。  Reference numeral 11 denotes an adjustment mechanism operation cylinder attached to the distal end portion of the operation wire holding handle 7 so as to surround a slide resistance adjusting mechanism 20 which will be described later, so that the distal end region of the operation wire holding handle 7 is entirely covered. Is provided. Between the adjustment mechanism operation cylinder 11 and the finger rest ring 6A of the catheter body holding handle 6, a gap is formed for inserting a finger of a hand for performing an operation of sliding the holding handles 6 and 7 relatively. The adjustment mechanism operation cylinder 11 and the finger contact ring 6A serve as finger contact portions on the rear side and the front side on which fingers (for example, the index finger and the thumb) that perform the slide operation hit.

図６は、操作ハンドル部５からの遠隔操作で湾曲部２を屈曲させている状態を示しており、操作ワイヤー保持ハンドル７に対してカテーテル本体保持ハンドル６を前方（下方）に押し出す操作を行うことにより、カテーテル本体１に対して相対的に操作ワイヤー４が後方に牽引された状態になって湾曲部２が屈曲する。そして、それと逆の操作を行えば、湾曲部２が図５に示される真っ直ぐな状態に戻る。このようにして、操作ハンドル部５において、カテーテル本体保持ハンドル６と操作ワイヤー保持ハンドル７とを操作ワイヤー４の軸方向に相対的にスライド操作することにより、湾曲部２を任意の角度だけ屈曲させることができ、使用者は操作指に触れる調整機構操作筒体１１と指当て環６Ａとの間の隙間の大きさの感触から、湾曲部２の屈曲状態を判断することができる。  FIG. 6 shows a state in which the bending portion 2 is bent by remote operation from the operation handle portion 5, and an operation of pushing the catheter body holding handle 6 forward (downward) with respect to the operation wire holding handle 7 is performed. Thus, the operation wire 4 is pulled backward relative to the catheter body 1 and the bending portion 2 bends. And if operation opposite to it is performed, the bending part 2 will return to the straight state shown by FIG. In this manner, in the operation handle portion 5, the bending portion 2 is bent by an arbitrary angle by relatively sliding the catheter body holding handle 6 and the operation wire holding handle 7 in the axial direction of the operation wire 4. The user can determine the bending state of the bending portion 2 from the feeling of the size of the gap between the adjustment mechanism operation cylinder 11 that touches the operation finger and the finger rest ring 6A.

図２は、操作ハンドル部５の先寄りの半部を示している。なお、図２を含めて以下の各図において一つの部品として図示されている各部材は、部品製造を容易にするため、組み立てをし易くするため、或いは本発明の内容とは関係のない機能を発揮させるため等に、各々複数の部品に別けて構成することができ、そのように構成したとしても本発明の範囲に属することに何ら変わりがない。  FIG. 2 shows the front half of the operation handle portion 5. In addition, each member illustrated as one component in each of the following drawings including FIG. 2 is a function not easily related to the contents of the present invention, for facilitating the manufacture of the component, for easy assembly. In order to achieve the above, etc., each can be divided into a plurality of parts, and even if configured in this way, it does not change within the scope of the present invention.

カテーテル本体１の基端部は、カテーテル本体保持ハンドル６のスライド筒部６Ｂの軸位置に形成された取付孔１２に通されて接着等でそこに強固に固着されている。そして、カテーテル本体１の基端から引き出された操作ワイヤー４は、取付孔１２の基端部に取付孔１２より小さく形成されたワイヤー通過孔１３を通って、その後方に引き出されている。１４は、操作ワイヤー４とは別にカテーテル本体１内に通されて先端電極部３の各電極に接続されたリード線であり、操作ワイヤー４と並んでワイヤー通過孔１３から後方に伸び出している。  The proximal end portion of the catheter main body 1 is passed through an attachment hole 12 formed at the axial position of the slide cylinder portion 6B of the catheter main body holding handle 6 and is firmly fixed thereto by adhesion or the like. The operation wire 4 drawn from the proximal end of the catheter body 1 is drawn to the rear through a wire passage hole 13 formed smaller than the attachment hole 12 in the proximal end portion of the attachment hole 12. 14 is a lead wire that is passed through the catheter body 1 separately from the operation wire 4 and connected to each electrode of the distal electrode portion 3, and extends rearward from the wire passage hole 13 along with the operation wire 4. .

図３は、図２におけるＡ−Ａ線で切断した状態の断面図であり、操作ワイヤー４の基端にハンダ付け等で固着されたワイヤー留め口金９が、操作ワイヤー保持ハンドル７の内周面に形成された溝に嵌め込み固定された平板状のワイヤー固定板１５にかしめ又はハンダ付け等で固着されている。したがって、操作ワイヤー４はワイヤー固定板１５を介して操作ワイヤー保持ハンドル７の軸位置に動かないように固定された状態になっている。操作ワイヤー保持ハンドル７内に軸方向にスライド自在に内接するカテーテル本体保持ハンドル６のスライド筒部６Ｂには、ワイヤー固定板１５が緩く通過する直線案内溝１７が形成されていて、スライド筒部６Ｂが操作ワイヤー保持ハンドル７に対してスライドすると、ワイヤー固定板１５が直線案内溝１７内をスライドする。なお、図３においてはリード線１４等の図示が省略されている。  FIG. 3 is a cross-sectional view taken along the line AA in FIG. 2, and the wire clasp 9 fixed to the base end of the operation wire 4 by soldering or the like is the inner peripheral surface of the operation wire holding handle 7. It is fixed to the flat wire fixing plate 15 fitted and fixed in the groove formed by crimping or soldering. Therefore, the operation wire 4 is fixed so as not to move to the axial position of the operation wire holding handle 7 via the wire fixing plate 15. A linear guide groove 17 through which the wire fixing plate 15 passes loosely is formed in the slide tube portion 6B of the catheter body holding handle 6 which is inscribed in the operation wire holding handle 7 so as to be slidable in the axial direction, and the slide tube portion 6B. Is slid with respect to the operation wire holding handle 7, the wire fixing plate 15 slides in the linear guide groove 17. In FIG. 3, the lead wires 14 and the like are not shown.

図２に戻って、カテーテル本体保持ハンドル６の指当て環６Ａはスライド筒部６Ｂの先端部分に螺合連結されている。Ｂがその螺合部である。折れ止め部材１０は、指当て環６Ａよりさらに前方に突出するスライド筒部６Ｂの最先端突出部分に着脱自在に取り付けられている。具体的には、折れ止め部材１０を弾性変形させることにより、折れ止め部材１０に形成された内方突起をスライド筒部６Ｂに形成された溝と係脱させることができるようになっている。Ｃがその係合部である。  Returning to FIG. 2, the finger rest ring 6A of the catheter body holding handle 6 is screwed and connected to the distal end portion of the slide cylinder portion 6B. B is the threaded portion. The anti-bending member 10 is detachably attached to the foremost protruding portion of the slide cylinder portion 6B protruding further forward than the finger rest ring 6A. Specifically, the inward projection formed on the anti-bending member 10 can be engaged with and disengaged from the groove formed on the slide cylinder portion 6B by elastically deforming the anti-bending member 10. C is the engaging portion.

調整機構操作筒体１１の内側には、カテーテル本体保持ハンドル６と操作ワイヤー保持ハンドル７との相対的スライド動作に対し動作抵抗を付与してその動作抵抗の大きさを調整することができるスライド抵抗調整機構２０が配置されている。この実施の形態のスライド抵抗調整機構２０は、カテーテル本体保持ハンドル６のスライド筒部６Ｂの外周面に摺接する弾力性のあるゴム材からなるＯリング２１と、そのＯリング２１を押し潰すための抵抗調整筒２２によって構成されている。２３は滑りのよいプラスチック材等で形成された滑りワッシャである。抵抗調整筒２２は、先寄りに形成された小径部の内周面でスライド筒部６Ｂの外周面に緩く嵌合し、それより後側の部分で操作ワイヤー保持ハンドル７の先端外周に形成されたネジ部に対して螺合している。Ｄがその螺合部である。したがって、スライド抵抗調整機構２０は操作ワイヤー保持ハンドル７に取り付けられているということができる。  Inside the adjustment mechanism operation cylinder 11, a slide resistance capable of adjusting the magnitude of the operation resistance by applying an operation resistance to the relative slide operation of the catheter body holding handle 6 and the operation wire holding handle 7. An adjustment mechanism 20 is arranged. The slide resistance adjusting mechanism 20 of this embodiment includes an O-ring 21 made of an elastic rubber material that is in sliding contact with the outer peripheral surface of the slide tube portion 6B of the catheter main body holding handle 6, and for crushing the O-ring 21. The resistance adjusting cylinder 22 is used. Reference numeral 23 denotes a sliding washer formed of a plastic material having good sliding property. The resistance adjusting cylinder 22 is loosely fitted to the outer peripheral surface of the slide cylinder portion 6B at the inner peripheral surface of the small-diameter portion formed toward the front, and is formed on the outer periphery of the distal end of the operation wire holding handle 7 at the rear portion thereof. Screwed into the threaded portion. D is the threaded portion. Therefore, it can be said that the slide resistance adjusting mechanism 20 is attached to the operation wire holding handle 7.

調整機構操作筒体１１は、そのようなスライド抵抗調整機構２０の周囲を完全に囲む筒状（笠状に近い筒状）に形成されていて、その先寄りの部分はスライド筒部６Ｂの外周面に緩く嵌合し、後端部分が操作ワイヤー保持ハンドル７に対して軸周りに回転自在に係合している。調整機構操作筒体１１は強い力を加えれば弾性変形する硬質プラスチック材等で形成されて、その後端内周部に内方に向けて係合突起部２４が突出形成され、その係合突起部２４が操作ワイヤー保持ハンドル７の外周面に全周にわたって形成された係合溝１６に係合している。したがって、調整機構操作簡体１１は操作ワイヤー保持ハンドル７に対して軸周りに回転自在であるが軸方向に移動することはできない。  The adjusting mechanism operation cylinder 11 is formed in a cylindrical shape (cylindrical shape close to a shade) that completely surrounds the slide resistance adjusting mechanism 20, and a tip portion thereof is an outer periphery of the slide cylindrical portion 6 </ b> B. It fits loosely on the surface, and its rear end portion is engaged with the operation wire holding handle 7 so as to be rotatable about its axis. The adjustment mechanism operation cylinder 11 is formed of a hard plastic material or the like that is elastically deformed when a strong force is applied, and an engagement protrusion 24 is formed to protrude inward at the inner peripheral portion of the rear end thereof. 24 is engaged with an engagement groove 16 formed on the outer peripheral surface of the operation wire holding handle 7 over the entire circumference. Therefore, the adjustment mechanism operation simplified body 11 is rotatable around the axis with respect to the operation wire holding handle 7, but cannot move in the axial direction.

そして、Ｅ−Ｅ線で切断した状態の断面図である図４にも示されるように、調整機構操作筒体１１の内面と抵抗調整筒２２の外面には互いに緩く係合するキー溝状の直線溝１８と係合突片２５とが形成されている。直線溝１８は軸方向と平行方向に形成されている。したがって、調整機構操作筒体１１を軸周りに回転操作することにより直線溝１８と係合突片２５との係合を介して抵抗調整筒２２を回転させることができる。その際、調整機構操作筒体１１は回転させても軸方向に移動しないが、抵抗調整筒２２は、螺合部Ｄで操作ワイヤー保持ハンドル７と螺合しているので、回転駆動されるとそれによって軸方向にも移動し、Ｏリング２１の潰し量が変化する。  As shown in FIG. 4 which is a cross-sectional view taken along line E-E, the inner surface of the adjustment mechanism operation cylinder 11 and the outer surface of the resistance adjustment cylinder 22 are key groove-shaped that loosely engage with each other. A straight groove 18 and an engaging protrusion 25 are formed. The straight groove 18 is formed in a direction parallel to the axial direction. Therefore, the resistance adjusting cylinder 22 can be rotated through the engagement between the linear groove 18 and the engaging protrusion 25 by rotating the adjusting mechanism operating cylinder 11 about the axis. At that time, the adjustment mechanism operation cylinder 11 does not move in the axial direction even if it is rotated. However, since the resistance adjustment cylinder 22 is screwed with the operation wire holding handle 7 at the screwing portion D, when the rotation is driven. As a result, the O-ring 21 is moved in the axial direction and the crushing amount of the O-ring 21 changes.

このように構成された実施の形態において、カテーテル本体保持ハンドル６と操作ワイヤー保持ハンドル７との相対的スライド動作に対する動作抵抗の調整は、調整機構操作筒体１１を軸周りに回転操作して抵抗調整筒２２を螺動させ、Ｏリング２１の潰し量を変化させることで行うことができる。図１に示されるように、調整機構操作筒体１１を大きく回転させてＯリング２１の潰し量を大きくすると、Ｏリング２１とスライド筒部６Ｂとの間の摩擦抵抗が増大して、カテーテル本体保持ハンドル６と操作ワイヤー保持ハンドル７との間の動作抵抗が大きくなる。そして、そのような調整に伴って抵抗調整筒２２の位置が移動しても、それを囲む調整機構操作筒体１１の位置（操作ワイヤー保持ハンドル７との位置関係）は変わらないので、使用者の操作指が当たる指当て部の隙間の大きさの感触に変化がなく、湾曲部２の屈曲状態を操作指の感触により手元側で常に正しく判断することができる。  In the embodiment configured as described above, the adjustment of the operation resistance with respect to the relative sliding movement of the catheter main body holding handle 6 and the operation wire holding handle 7 is performed by rotating the adjusting mechanism operating cylinder 11 around the axis. This can be done by screwing the adjusting cylinder 22 and changing the crushing amount of the O-ring 21. As shown in FIG. 1, when the adjustment mechanism operation cylinder 11 is rotated largely to increase the crushing amount of the O-ring 21, the frictional resistance between the O-ring 21 and the slide cylinder 6B increases, and the catheter body The operating resistance between the holding handle 6 and the operation wire holding handle 7 is increased. And even if the position of the resistance adjustment cylinder 22 moves with such adjustment, the position of the adjustment mechanism operation cylinder 11 surrounding it (positional relationship with the operation wire holding handle 7) does not change. There is no change in the feeling of the size of the gap of the finger contact portion where the operating finger hits, and the bending state of the bending portion 2 can always be correctly determined by the touch of the operating finger.

図７は本発明の第２の実施の形態を示しており、スライド抵抗調整機構２０において、Ｏリング２１に代えて図８に単体で図示されるようなスリ割り１２１ａ付きのテーパリング１２１を弾力性のある材料で形成して用い、抵抗調整筒２２もテーパリング１２１を押し潰すのに適した形状に形成したものである。その他の構成は第１の実施の形態と同様である。  FIG. 7 shows a second embodiment of the present invention. In the slide resistance adjusting mechanism 20, a taper ring 121 with a slit 121a as shown in FIG. The resistance adjusting cylinder 22 is also formed in a shape suitable for crushing the taper ring 121. Other configurations are the same as those of the first embodiment.

なお、本発明は上述の各実施の形態に限定されるものではなく、例えば、スライド抵抗調整機構２０と調整機構操作筒体１１とがカテーテル本体保持ハンドル６側に取り付けられた構成等であっても差し支えない。  The present invention is not limited to the above-described embodiments. For example, the slide resistance adjustment mechanism 20 and the adjustment mechanism operation cylinder 11 are attached to the catheter body holding handle 6 side. There is no problem.

本発明の第１の実施の形態に係る心臓カテーテルの動作抵抗調整後における操作ハンドル部の先寄りの部分の側面断面図。FIG. 3 is a side cross-sectional view of the distal portion of the operation handle portion after adjusting the operation resistance of the cardiac catheter according to the first embodiment of the present invention. 本発明の第１の実施の形態に係る心臓カテーテルの操作ハンドル部の先寄りの部分の側面断面図。FIG. 3 is a side cross-sectional view of the distal portion of the operation handle portion of the cardiac catheter according to the first embodiment of the present invention. 本発明の第１の実施の形態に係る心臓カテーテルの操作ハンドル部の図２におけるＡ−Ａ線で切断した状態の断面図。Sectional drawing of the state cut | disconnected by the AA in FIG. 2 of the operation handle part of the cardiac catheter which concerns on the 1st Embodiment of this invention. 本発明の第１の実施の形態に係る心臓カテーテルの操作ハンドル部の図２におけるＥ−Ｅ線で切断した状態の断面図。Sectional drawing of the state cut | disconnected by the EE line in FIG. 2 of the operation handle part of the cardiac catheter which concerns on the 1st Embodiment of this invention. 本発明の第１の実施の形態の心臓カテーテルの全体構成を示す外観図。1 is an external view showing the overall configuration of a cardiac catheter according to a first embodiment of the present invention. 本発明の第１の実施の形態の心臓カテーテルの湾曲部を屈曲させる操作が行われた状態の全体構成を示す外観図。The external view which shows the whole structure of the state by which operation which bends the bending part of the cardiac catheter of the 1st Embodiment of this invention was performed. 本発明の第２の実施の形態に係る心臓カテーテルの操作ハンドル部の先寄りの部分の側面断面図。The side sectional view of the front part of the operation handle part of the cardiac catheter concerning the 2nd embodiment of the present invention. 本発明の第２の実施の形態の心臓カテーテルのテーパリングの単体斜視図。The single-piece | unit perspective view of the tapering of the cardiac catheter of the 2nd Embodiment of this invention.

符号の説明Explanation of symbols

１…カテーテル本体
２…湾曲部
４…操作ワイヤー
５…操作ハンドル部
６…カテーテル本体保持ハンドル
６Ａ…指当て環
６Ｂ…スライド筒部
７…操作ワイヤー保持ハンドル
１１…調整機構操作筒体
１６…係合溝
１８…直線溝（係合部）
２０…スライド抵抗調整機構
２１…Ｏリング
２２…抵抗調整筒
２３…滑りワッシャ
２４…係合突起部
２５…係合突片
１２１…テーパリング
Ｄ…螺合部DESCRIPTION OF SYMBOLS 1 ... Catheter main body 2 ... Curved part 4 ... Operation wire 5 ... Operation handle part 6 ... Catheter main body holding handle 6A ... Finger rest ring 6B ... Slide cylinder part 7 ... Operation wire holding handle 11 ... Adjustment mechanism operation cylinder 16 ... Engagement Groove 18 ... Linear groove (engagement part)
DESCRIPTION OF SYMBOLS 20 ... Slide resistance adjustment mechanism 21 ... O-ring 22 ... Resistance adjustment cylinder 23 ... Sliding washer 24 ... Engagement protrusion 25 ... Engagement protrusion 121 ... Taper ring D ... Screwing part

Claims (4)

可撓性を有する細長いカテーテル本体内に操作ワイヤーが内挿され、手元側に設けられた操作ハンドル部で、前記カテーテル本体の基端に連結されたカテーテル本体保持ハンドルと前記操作ワイヤーの基端に連結された操作ワイヤー保持ハンドルとを前記操作ワイヤーの軸方向に相対的にスライド操作することにより、前記カテーテル本体に対して前記操作ワイヤーが軸方向にスライドして前記カテーテル本体の先端近傍部分が屈曲するように構成された心臓カテーテルにおいて、
前記カテーテル本体保持ハンドルと前記操作ワイヤー保持ハンドルとの相対的スライド動作に対し動作抵抗を付与してその動作抵抗の大きさを調整することができるスライド抵抗調整機構を前記カテーテル本体保持ハンドルと前記操作ワイヤー保持ハンドルの一方に取り付けると共に、前記スライド抵抗調整機構の調整状態を外部から変えるための調整機構操作筒体を、前記スライド抵抗調整機構を囲む状態に前記一方の保持ハンドルに取り付け、前記スライド抵抗調整機構の調整状態に関係なく、前記一方の保持ハンドルと前記調整機構操作筒体との位置関係が変化しないようにしたことを特徴とする心臓カテーテル。An operation wire is inserted into a flexible elongated catheter body, and an operation handle portion provided on the proximal side includes a catheter body holding handle connected to the proximal end of the catheter body and a proximal end of the operation wire. By sliding the connected operation wire holding handle relative to the axial direction of the operation wire, the operation wire slides in the axial direction with respect to the catheter body, and the vicinity of the distal end of the catheter body is bent. A cardiac catheter configured to:
A slide resistance adjusting mechanism capable of adjusting the magnitude of the operation resistance by applying an operation resistance to the relative slide operation between the catheter body holding handle and the operation wire holding handle is provided in the catheter body holding handle and the operation. Attaching to one of the wire holding handles, an adjustment mechanism operating cylinder for changing the adjustment state of the slide resistance adjusting mechanism from the outside is attached to the one holding handle so as to surround the slide resistance adjusting mechanism, and the slide resistance A cardiac catheter characterized in that the positional relationship between the one holding handle and the adjustment mechanism operation cylinder does not change regardless of the adjustment state of the adjustment mechanism. 請求項１に記載された心臓カテーテルにおいて、前記調整機構操作筒体が、前記カテーテル本体保持ハンドルと前記操作ワイヤー保持ハンドルとを相対的にスライドさせるための操作を行う手の指が当たる指当て部に位置している心臓カテーテル。  The cardiac catheter according to claim 1, wherein the adjustment mechanism operation tube body is a finger contact portion to which a finger of a hand that performs an operation for relatively sliding the catheter body holding handle and the operation wire holding handle is applied. Cardiac catheter located in the 請求項１又は２に記載された心臓カテーテルにおいて、前記調整機構操作筒体が、前記一方の保持ハンドルに対して軸周りに回転自在であって軸方向への移動が規制された状態に取り付けられている心臓カテーテル。  The cardiac catheter according to claim 1 or 2, wherein the adjustment mechanism operation cylinder is attached to a state in which the adjustment mechanism operation cylinder is rotatable about an axis with respect to the one holding handle and movement in the axial direction is restricted. A cardiac catheter. 請求項３に記載された心臓カテーテルにおいて、前記スライド抵抗調整機構と係合する係合部が前記調整機構操作筒体の内面に形成されている心臓カテーテル。  The cardiac catheter according to claim 3, wherein an engaging portion that engages with the slide resistance adjusting mechanism is formed on an inner surface of the adjusting mechanism operation cylinder.
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AU2009250619B2 (en) * 2008-05-20 2012-05-17 Japan Lifeline Co., Ltd. Catheter handle
JP4224124B1 (en) 2008-05-21 2009-02-12 日本ライフライン株式会社 Catheter handle
CN103285492B (en) * 2012-02-29 2015-05-06 四川锦江电子科技有限公司 Single bending handle
US9095682B2 (en) * 2013-04-30 2015-08-04 St. Jude Medical Luxembourg Holding S.À.R.L. Control handles for catheters

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US6795721B2 (en) * 2000-01-27 2004-09-21 Biosense Webster, Inc. Bidirectional catheter having mapping assembly
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JP2016529060A (en) * 2013-09-06 2016-09-23 ボストン サイエンティフィック ニューロモデュレイション コーポレイション Lead introducer for implantable electrical stimulation systems

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