JP5597737B2 - Aspiration catheter - Google Patents

Description

  The present invention relates to an aspiration catheter that can be easily aspirated while suppressing stagnation of a thrombus aspirated into the aspiration lumen.

  As is well known, when a thrombotic occlusion occurs in a blood vessel, for example, a dissolved drug solution is ejected from the side hole formed in the thrombolysis catheter toward the intravascular thrombus to mechanically destroy the thrombus and enter the thrombus. A method is used in which a thrombus is dissolved by promoting dissolution of a dissolved drug solution, and the thrombus is aspirated and removed by a suction catheter to release the thrombotic occlusion.

  In such a method for sucking and removing a thrombus, the suction performance is determined by how large the lumen of the suction lumen is secured. Therefore, in order to improve the suction performance, for example, a guide wire lumen is attached to the suction lumen. A technique is disclosed in which the suction passage area is increased by extending the suction opening of the suction lumen in the longitudinal direction of the lumen while being disposed only on the distal end side (see, for example, Patent Document 1).

On the other hand, in order to improve the suction force, it is conceivable to increase the suction force of the suction source, but in order to prevent the suction catheter from being crushed by the negative pressure of the suction source, the thickness of the suction catheter should be increased. As a result, the outer shape of the suction catheter is increased.
Therefore, it is easy to inhale the thrombus by forming a flow in the direction opposite to the jet flow for crushing the thrombus generated in the catheter and sucking the thrombus, or forming a jet in the suction direction on the liquid supplied to the catheter Techniques for achieving this are disclosed (see, for example, Patent Document 2 and Patent Document 3).

JP 2007-7388 A JP 2005-152095 A JP 2003-10194 A

  However, when the suction catheter reaches the vascular lesion and the thrombus is sufficiently sucked, depending on the thrombus properties, etc., the thrombus may be clogged in the suction catheter and the suction cannot be continued. It was necessary to remove the suction catheter from the body by removing the clogging of the suction catheter.

  The present invention has been made in consideration of such circumstances, and it is an object of the present invention to provide a suction catheter capable of stably and continuously sucking a thrombus sucked by a suction lumen without stagnation in the suction lumen. .

In order to solve the above-described problems, the invention according to claim 1 is directed to an outer tube having a first opening formed at a tip and constituting a suction lumen, and along a longitudinal direction of the outer tube. An aspiration catheter comprising an inner tube provided in the outer tube and a guide wire for guiding the outer tube, wherein a suction opening leading to the aspiration lumen is in a longitudinal direction of the outer tube The guide wire is removably accommodated in the inner tube and is liquid-tightly inserted into a second opening formed at the tip of the inner tube. A side wall portion is arranged along the longitudinal direction of the inner tube so as to allow the inside of the inner tube and the suction lumen to flow. The through-hole is formed, and the liquid injected into the inner tube is ejected from the through-hole, and the thrombus sucked into the suction lumen is crushed stepwise in the suction lumen. It is characterized by being.

According to the suction catheter of the present invention, a plurality of through holes are formed in the side wall portion of the inner tube provided in the outer tube along the longitudinal direction of the outer tube, and the liquid injected into the inner tube from the injection source Can be injected into the suction lumen from the through hole, so that the thrombus sucked into the suction lumen is finely crushed by the injected liquid. As a result, stagnation of the thrombus in the suction lumen is suppressed, and the thrombus can be sucked stably.
Further, since the guide wire is removably accommodated in the inner tube, a dedicated storage space for the guide wire is not required, and an increase in the size of the suction catheter can be suppressed.
Further, since the guide wire is not exposed in the suction lumen, the guide wire does not become a resistance to the flow of the thrombus, and the guide wire can be easily operated regardless of the thrombus property and the stagnation state. .
Further, since the guide wire is liquid-tightly inserted into the second opening formed at the tip of the inner tube, the pressure of the liquid injected into the inner tube can be maintained and stably ejected from the through hole. it can.

The invention according to claim 2 is the suction catheter according to claim 1 , wherein the inner tube is integrally formed on an inner wall of the outer tube.

According to the suction catheter according to the present invention, since the inner tube is integrally formed on the inner wall of the outer tube and is biased to one side of the suction lumen, a large suction path area can be secured, It is possible to insert the outer tube integrally and stably along the guide wire.

The invention according to claim 3 is the suction catheter according to claim 1 , wherein the inner tube is detachably accommodated in the outer tube.

According to the suction catheter according to the present invention, since the inner tube is detachable with respect to the outer tube , it is possible to advance and retract the inner tube and crush the thrombus located in front of the distal end of the suction lumen in advance. Is done.

The invention according to claim 4 is the suction catheter according to any one of claims 1 to 3 , wherein the inner tube and the through hole are formed to protrude from the distal end of the outer tube. To do.

According to the suction catheter according to the present invention, since the inner tube and the through hole are formed so as to protrude from the distal end of the outer tube , an intravascular thrombus can be crushed.

  According to the suction catheter according to the present invention, liquid can be ejected from the through-hole of the inner tube to finely crush the thrombus in the suction lumen. Stable suction is possible.

It is a figure which shows the suction catheter which concerns on the 1st Embodiment of this invention, (A) is a front view which shows the outline of a suction catheter, (B) is the IB arrow line view of the front-end | tip part in (A), (C) These are IC-IC sectional drawings in (A). It is a figure explaining the effect | action of this invention. It is a figure which shows the suction catheter which concerns on the 2nd Embodiment of this invention, (A) is a front view which shows the outline of a suction catheter, (B) is IIIC-IIIC sectional drawing in (A). It is a figure which shows the suction catheter which concerns on the reference example of this invention, (A) is a front view which shows the outline of a suction catheter, (B) is IVB arrow directional view of the front-end | tip part in (A), (C) is (A). It is IVC-IVC sectional drawing in).

Hereinafter, a first embodiment of the present invention will be described with reference to the drawings.
FIG. 1 is a schematic view showing a suction catheter according to the first embodiment, and reference numeral 10 denotes a suction catheter.

The suction catheter 10 includes a cylindrical member (hereinafter referred to as an outer tube) 11, an inner tube 13, a guide wire 16, and a connection portion C1, and the connection portion C1 is connected to the first Y connector Y1 from the distal end side. The second Y connector Y2 and the straight connector S1 are arranged in this order.

The outer tube 11 has, for example, a substantially cylindrical shape made of high-density polyethylene, constitutes a suction lumen 11a for sucking a thrombus, and has a first opening 11b on the distal end side.
The first opening 11b is formed by obliquely cutting the tip of the outer tube 11 , and the thrombus is easily sucked by increasing the suction path area.

Further, a first Y connector Y1 is connected to the proximal end side of the outer tube 11 , and a suction source (not shown) is circulated with a suction lumen 11a in a portion extending to the side of the first Y connector Y1. And the second Y connector Y2 is connected to the base end side (rear side) of the first Y connector Y1.

The inner tube 13, for example, is a generally cylindrical distal end side is reduced in diameter made of high-density polyethylene, in Fu John guidewire while being arranged along the longitudinal direction of the outer tube 11 to the inside of the outer tube 11 A lumen (inside the inner tube) 13a is formed, and a second opening 13b is formed at the tip.
Further, the inner tube 13 and the outer tube 11 are integrally formed, for example, so that a part of the outer wall portion of the inner tube 13 is integrally formed with the inner wall portion of the outer tube 11 , and as a result, the inner tube 13 is The suction lumen 11a is offset from the center of the suction lumen 11a.

The infusion guide wire lumen 13a is formed with a through hole 14 through which the infusion guide wire lumen 13a and the suction lumen 11a can circulate in the side wall portion on the distal end side. For example, a physiological saline solution or a thrombolytic agent solution L injected into the wire lumen 13 a can be ejected from the through-hole 14.
In the suction catheter 10 of the first embodiment, the through-holes 14 have, for example, a diameter of 0.1 mm and a pitch of 5 mm, and are arranged in a straight line along the longitudinal direction of the inner tube 13 and the suction lumen 11a. It opens toward the center.

  A guide wire 16 is inserted into the second opening 13b, and the guide wire 16 can be moved back and forth with respect to the inner tube 13. The second opening 13b is sealed in a liquid-tight manner with the outer periphery of the guide wire 16. It is mated.

  A portion extending to the side of the second Y connector Y2 connected to the proximal end side of the inner tube 13 circulates with the infusion guidewire lumen 13a. For example, physiological saline or a thrombolytic agent solution (liquid ) An infusion port P2 to which an injection source (not shown) for injecting L under pressure can be connected is formed, and a straight connector S1 is connected to the base end side (rear side) of the second Y connector Y2. A guide wire port P3 is formed behind S1.

The guide wire 16 is formed of, for example, a fine line of SUS material and has a diameter of 0.35 mm to 0.46 mm.
The guide wire 16 can be removably accommodated in the infusion guide wire lumen 13 a of the inner tube 13.

Next, the operation of the suction catheter 10 according to the first embodiment will be described.
(1) Insert the guide wire 16 into the guide wire port P3.
(2) The suction catheter 10 with the guide wire 16 inserted is inserted into the blood vessel by a percutaneous approach.
(3) The guide wire 16 is pushed and placed until the tip of the guide wire 16 passes through the thrombotic occlusion site.
(4) The suction catheter 10 is advanced along the guide wire 16 to the occlusion site.
(5) A suction device (not shown) is connected to the suction port P1 to suck the suction lumen 11a.
(6) An infusion device (not shown) is connected to the infusion port P2 to inject the physiological saline or the thrombolytic agent solution L continuously or intermittently. At this time, the guide wire 16 is projected from the second opening 13 b at the tip of the inner tube 13.
(7) As shown in FIG. 2, the physiological thrombus or the thrombolytic agent solution L is ejected from the through hole 14 of the inner tube 13 and the thrombus K sucked into the suction lumen 11a is staged in the suction lumen 11a. Crush finely, suck and remove.

According to the suction catheter 10 according to the first embodiment, since the thrombus is finely crushed by ejecting the casting chamber 20DL from the through-hole 14, stable suction is continuously performed, and the treatment for removing the thrombus is interrupted. Can be done without.
Moreover, since the through-holes 14 are linearly arranged, the thrombus can be efficiently and finely crushed step by step.

In addition, since suction can be performed at a low negative pressure (the pressure difference with respect to the atmosphere is small), bleeding during treatment can be suppressed.
Further, since suction can be performed at a low negative pressure, a flexible material can be used, and the performance of the suction catheter 10 to reach the lesioned part can be improved.
Further, since the suction performance is improved, the outer shape can be reduced by reducing the diameter of the suction lumen 10.
Further, since the guide wire 16 is accommodated in the inner tube 13, the suction catheter 10 is reduced in size, and the guide wire 16 is not exposed in the suction lumen 11a, so that it is possible to prevent the thrombus from being hindered.

  Further, the guide wire 16 is liquid-tightly inserted into the second opening 13b formed at the tip of the inner tube 13, and the pressure of the physiological saline or the thrombolytic agent solution L injected into the inner tube 13 is maintained. Therefore, the physiological saline or the thrombolytic agent solution L can be stably ejected from the through hole 14.

Further, a large suction passage so the inner tube 13 outer tube 11 while being disposed biased to one of the aspiration lumen 11a is integrally formed on the inner wall of the outer tube 11 is inclined wall portion is formed near the distal end An area is ensured and a thrombus can be easily sucked.
Further, by forming the inner tube 13 and the through hole 14 so as to protrude from the first opening 11b of the outer tube 11 , the intravascular thrombus can be crushed.

Next, a suction catheter 20 according to a second embodiment of the present invention will be described.
The suction catheter 20 according to the second embodiment is different from the catheter 10 according to the first embodiment in that an outer tube 21 and an inner tube 23 are used instead of the outer tube 11 and the inner tube 13, and the inner tube 23 is used. Is that it is removably inserted into the first opening 21b of the outer tube 21 .
Hereinafter, the same parts as those of the catheter 10 are denoted by the same reference numerals and description thereof is omitted.

The suction catheter 20 includes an outer tube 21 , an inner tube 23, a guide wire 16, and a connection portion C2. The connection portion C2 includes a first Y connector Y1, a second Y connector Y2, and the like from the distal end side. The straight connector S1 is arranged in this order, and the second Y connector Y2 is detachable with respect to the first Y connector Y1 together with the inner tube 23.

The outer tube 21 has, for example, a substantially cylindrical shape made of high-density polyethylene (with stainless steel braid). The outer tube 21 constitutes a suction lumen 21a for sucking a thrombus and has a first opening 21b at the tip.
Further, the outer tube 21 has an inclined wall portion 21c whose diameter is reduced toward the first opening 21b in the vicinity of the distal end, and a plurality of suction openings 22 are formed in the inclined wall portion 21c so that thrombus can be sucked. It is said that.

The inner tube 23, for example, is a generally cylindrical distal end side is reduced in diameter made of high density polyethylene or polyamide, in Fu John while being arranged along the longitudinal direction of the outer tube 21 to the inside of the outer tube 21 A guide wire lumen (inner tube interior) 23a is configured and the tip is a second opening 23b.

  The infusion guidewire lumen 23a is formed with a through-hole 24 through which the infusion guidewire lumen 23a and the suction lumen 21a can be circulated in the side wall portion on the distal end side, and injected into the infusion guidewire lumen 23a. The physiological saline or the thrombolytic agent solution L can be ejected from the through hole 24.

  In the suction catheter 20 of the second embodiment, the through holes 24 have, for example, a diameter of 0.1 mm and a pitch of 5 mm, are arranged along the longitudinal direction of the inner tube 23, and the adjacent through holes 24 are The inner tubes 23 are positioned on opposite surfaces and open toward the inner wall of the suction lumen 21a. The adjacent through holes 24 may be sequentially positioned on a surface rotated by a predetermined angle, for example, 90 degrees in the circumferential direction of the inner tube 23.

The inner tube 23 is inserted into the first opening 21b, and the first opening 21b is seal-fitted to the outer periphery of the inner tube 23 (except for the through hole 24).
The guide wire 16 is inserted into the second opening 23 b, and the second opening 23 b is sealed with the outer periphery of the guide wire 16.

Next, the operation of the suction catheter 20 according to the second embodiment will be described.
(1) Insert the inner tube 23 into the suction lumen 21a, and then insert the guide wire 16 into the guide wire port P3.
(2) The suction catheter 20 in which the guide wire 16 is inserted is inserted into the blood vessel by a percutaneous approach.
(3) The guide wire 16 is pushed and placed until the tip of the guide wire 16 passes through the thrombotic occlusion site.
(4) The suction catheter 20 is advanced along the guide wire 16 to the occlusion site.
(5) A suction device (not shown) is connected to the suction port P1 to suck the inside of the suction lumen 21a.
(6) An injection device (not shown) is connected to the infusion port P2 to inject the physiological saline or the thrombolytic agent solution L continuously or intermittently. At this time, the guide wire 16 is projected from the second opening 23 b at the tip of the inner tube 23.
(7) The physiological saline or the thrombolytic agent solution L is ejected from the through hole 24 of the inner tube 23 to crush the thrombus sucked into the suction lumen 21a.
(8) If necessary, the distal end of the inner tube 23 protrudes from the first opening 21b at the distal end of the suction lumen 21a while the pressurized physiological saline or thrombolytic agent solution L is ejected from the through-hole 24, and the blood vessel Internal thrombus is crushed.

According to the suction catheter 20 according to the second embodiment, since the inner tube 23 can be moved forward and backward with respect to the outer tube 21 , the inner tube 23 is advanced to remove a thrombus located in front of the distal end of the suction lumen 21a. Can be crushed in advance.
Further, since the through holes 24 are arranged along the longitudinal direction of the inner tube 23 and the adjacent through holes 24 are located on the opposite surfaces of the inner tube 23, thrombus that passes through the suction lumen 21a is prevented. Regardless of the passing position, it can be crushed and made finer.

Next, a suction catheter 30 according to a reference example of the present invention will be described.
The suction catheter 30 according to the reference example is different from the catheter 10 according to the first embodiment in that the outer tube 31 and the inner tube 33 are used instead of the outer tube 11 and the inner tube 13 and the guide wire 16 is It is a point that it is removably inserted into a guide wire lumen 35 formed at the distal end portion of the outer tube 31 via the outside of the tube 31.
Hereinafter, the same parts as those of the catheter 10 are denoted by the same reference numerals and description thereof is omitted.

The suction catheter 30 includes an outer tube 31 , an inner tube 33, a guide wire 16, and a Y connector Y4.

The outer tube 31 has, for example, a substantially cylindrical shape made of high-density polyethylene, constitutes a suction lumen 31a for sucking a thrombus, and has a first opening 31b at the tip.
The outer tube 31 has a guide wire lumen 35 into which the guide wire 16 is inserted at the tip, and the first opening 31b is formed by obliquely cutting the tip of the outer tube 31 and has a suction path area. The blood clot is easily aspirated so that it can be aspirated.

Inner tube 33, for example, is a generally cylindrical distal end side is reduced in diameter made of high density polyethylene, together with the in-Fu John lumens are disposed along the longitudinal direction of the outer tube 31 to the inside of the outer tube 31 ( Inner tube interior) 33a is formed and the tip side is closed.
The inner tube 33 and the outer tube 31 are formed such that a part of the outer wall portion of the inner tube 33 is formed integrally with the inner wall portion of the outer tube 31 , and the inner tube 33 is biased to one side from the center of the suction lumen 31a. Has been placed.

  The infusion lumen 33a has a through-hole 34 through which the infusion lumen 33a and the suction lumen 31a can be circulated in the side wall portion on the distal end side. Can be ejected from the through hole 34.

In the suction catheter 30 of the reference example , the through-holes 34 have a diameter of 0.1 mm and a pitch of 5 mm, for example, are arranged in a straight line along the longitudinal direction of the inner tube 33 and are directed toward the center of the suction lumen 31a. Is open.

  The guide wire 16 is inserted into a guide wire lumen 35, and the guide wire 16 can be moved back and forth and inserted / removed with respect to the guide wire lumen 35.

The Y connector Y4 is connected to the base end sides of the outer tube 31 and the inner tube 33, and a suction port P1 is disposed at a portion extending to the side of the Y connector Y4, and an infusion port P2 is disposed at a rear end portion.

Next, the operation of the suction catheter 30 according to the reference example will be described.
(1) Insert the guide wire 16 into the guide wire lumen.
(2) The suction catheter 30 in which the guide wire 16 is inserted is inserted into the blood vessel by a percutaneous approach.
(3) The guide wire 16 is pushed and placed until the tip of the guide wire 16 passes through the thrombotic occlusion site.
(4) The suction catheter 30 is advanced along the guide wire 16 to the occlusion site.
(5) A suction device (not shown) is connected to the suction port P1 to suck the inside of the suction lumen 31a.
(6) An infusion device (not shown) is connected to the infusion port P2 to continuously or intermittently inject the physiological saline or thrombolytic agent solution L and to dissolve the physiological saline or thrombus from the through-hole 34 of the inner tube 33. The agent solution L is ejected to crush the thrombus of the suction lumen 31a.

According to the suction catheter 30, since the guide wire 16 is inserted into the guide wire lumen 35 formed at the distal end portion of the outer tube 31 , the structure of the suction catheter 30 is simplified, and the outer tube 31 can be easily attached to the guide wire 16. It can be attached and is easy to handle.

In addition, this invention is not limited to the said embodiment, In the range which does not deviate from the meaning, it can change suitably.
For example, regarding the shape and material of the outer tubes 11 , 21 , 31 and the inner tubes 13, 23, 33, and the combination of the outer tubes 11 , 21 , 31 , the inner tubes 13, 23, 33, and the guide wire 16, It can be changed freely.
Further, the size, number and arrangement of the through holes 14, 24 and 34 can be freely set.

  In the above embodiment, the case where the proximal end sides of the suction catheters 10, 20, and 30 are configured by the Y connector has been described. However, the combination of the Y connectors on the proximal end sides of the suction catheters 10, 20, and 30 can be freely performed. In addition to the Y connector, various connection means can be used.

10, 20, 30 Suction catheter 11, 21, 31 Outer tube 11a, 21a, 31a Suction lumen 11b, 21b, 31b First opening 13, 23, 33 Inner tube 13a, 23a Infusion guide wire lumen (inner tube interior) )
21c Inclined wall 22 Suction opening 33a Infusion lumen (inner tube)
14, 24, 34 Through-hole 16 Guide wire 35 Guide wire lumen L Saline or thrombolytic solution (liquid)

Claims (4)

An outer tube having a first opening formed at the tip and constituting a suction lumen;
An inner tube provided in the outer tube along the longitudinal direction of the outer tube;
A suction wire comprising a guide wire for guiding the outer tube,
The suction opening leading to the suction lumen is inclined and opened with respect to the longitudinal direction of the outer tube,
The guide wire is
The inner tube is removably accommodated and inserted in a liquid-tight manner into the second opening formed at the tip of the inner tube,
A plurality of through holes arranged along the longitudinal direction of the inner tube are formed in the side wall portion of the inner tube so as to be able to flow through the inner tube and the suction lumen, and are injected into the inner tube. A suction catheter configured to eject the liquid that has been discharged from the through-hole and to crush the thrombus sucked into the suction lumen in a stepwise manner in the suction lumen. A suction catheter according to claim 1 ,
The suction catheter, wherein the inner tube is formed integrally with an inner wall of the outer tube. A suction catheter according to claim 1 ,
The inner tube is
A suction catheter that is removably accommodated in the outer tube. The aspiration catheter according to any one of claims 1 to 3 ,
The suction catheter, wherein the inner tube and the through hole are formed so as to protrude from a distal end of the outer tube.

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