JP6243691B2 - Stent delivery device - Google Patents

Description

  The present invention relates to a stent delivery device for placing a tube stent at a desired position such as a tubular organ.

  For some time, stents have been placed in stenosis and occlusions of tubular organs such as the bile duct, ureter, trachea, and blood vessels to expand the part to facilitate the flow of bile and blood, or an aneurysm has occurred A treatment using a stent has been performed, such as placing a stent in a place where it has been prevented to prevent its rupture.

  As this type of stent, a tube stent made of synthetic resin and a metal stent made of metal are known. In the case of the latter metal stent, it is not basically recovered after being placed in the body, but in the case of the former tube stent, it is generally left in the body for a short period of time and is appropriately recovered as needed. Is.

  When the tube stent is placed in the body, for example, a stent delivery system including a pusher catheter that pushes the tube stent and an inner catheter that is slidably inserted into the tube stent and the pusher catheter is used. However, in this system, although the tube stent can be pushed in with the pusher catheter, the tube stent cannot be pulled back to be corrected when the tube stent is displaced from a predetermined position.

  For this reason, the following patent document 1 includes a tube stent, a pusher catheter, and an inner catheter, and a filamentous body having a knurled body is attached to one of the pusher catheter and the tube stent. A stent delivery system is described which is attached and provided on the other side with a hooking hole for loosely fitting the hump.

  When the inner catheter is inserted into the pusher catheter and the tube stent in a state where the hump is loosely fitted in the latching hole, the inner catheter is in a loosely fitted state between the hump and the latching hole. Since the pusher catheter and the tube stent are connected to each other, the displacement of the tube stent can be appropriately corrected.

Japanese Patent No. 4913251

  In the system of Patent Document 1, the tube stent is placed at a desired position, and then the inner catheter is pulled out from the tube stent and the pusher catheter, so that the knot-like body is removed from the hooking hole, and the tube stent and the pusher catheter are separated. The connection is released and the pusher catheter can be removed from the body.

  However, when the inner catheter is pulled out from the pusher catheter, the hump-like body may be caught on the inner periphery of the hooking hole without being detached from the hooking hole. In this case, if the pusher catheter is to be removed, the pusher catheter may move to the tube stent together, and the tube stent may be displaced from a desired position in the body.

  Accordingly, an object of the present invention is to provide a stent delivery device capable of accurately placing a tube stent at a desired position in the body.

  In order to achieve the above object, a stent delivery device of the present invention includes a tube stent made of a synthetic resin tube, a pusher catheter disposed on the proximal end side of the tube stent, and the pusher catheter and the tube stent. An inner catheter that is removably inserted around the periphery and supports the tube stent; a connection member that is connected to the tube stent at one end; and a second end of the connection member that is provided at a distal end of the pusher catheter Gripping means for releasably gripping, the gripping means being disposed on the outside of the tongue, and a tongue piece formed so as to be able to bend inward with the distal end side of the pusher catheter as a free end. In the state where the inner catheter is disposed inside the tongue piece, the tongue piece is pressed. It closed, when the inner catheter is withdrawn from the inside of the tongue, wherein the tongue is configured to be able to open away from the outer wall.

  In the stent delivery device of the present invention, it is preferable that the tongue piece is shaped in a direction away from the outer wall portion.

  In the stent delivery device of the present invention, it is preferable that a protrusion is provided on the surface of the tongue piece on the outer wall side.

  In the stent delivery device of the present invention, it is preferable that when the inner catheter is inserted into the pusher catheter, a portion corresponding to the tongue piece of the inner catheter is formed thicker than the other portions.

  In the stent delivery device of the present invention, it is preferable that the gripping means is attached to the distal end portion of the pusher catheter separately from the pusher catheter.

  According to the present invention, the other end of the connecting member connected to the tube stent is disposed between the tongue piece of the gripping means and the outer wall portion, and the inner catheter is inserted inside the tongue piece, thereby providing a tongue piece. Is pressed and closed, so that the other end of the connecting member can be held between the tongue piece and the outer wall portion. For this reason, the tube stent is connected to the pusher catheter via the connecting member. In this state, the pusher catheter and the inner catheter are inserted into the tubular organ in the body and pushed forward, thereby pushing the tube stent into the tubular organ. It can be inserted at a desired position.

  At that time, when the tube stent is pushed too far and it is desired to correct the position by pulling back, the tube stent can be pulled back through the connecting member by pulling back the pusher catheter and the inner catheter.

  Then, when the tube stent is arranged at the correct position, the tongue piece can be bent inward by pulling out the inner catheter from the inside of the tongue piece, so that the tongue piece opens away from the outer wall portion, and the connecting member Is released, the tube stent can be left in the body, and the pusher catheter and inner catheter can be withdrawn from the body. At this time, since the tongue piece is opened with respect to the outer wall portion and the connecting member is opened, it is possible to prevent the tube stent from moving due to the connecting member being caught by the pusher catheter.

It is a perspective view which shows one Embodiment of the stent delivery apparatus of this invention. It is a principal part expansion perspective view of the same apparatus. It is a principal part expanded sectional perspective view of the same apparatus. FIG. 6 is an explanatory cross-sectional view showing a state in which the connection member is released from the gripping means in the apparatus. FIG. 7 is an explanatory cross-sectional view showing a state in which the connection member is gripped by gripping means in the apparatus. In the same apparatus, it is an expanded sectional explanatory view which shows the base end part side of a pusher catheter and an inner catheter. In the same apparatus, it is a cross-sectional explanatory drawing which shows the other shape of an inner catheter. The usage method of the apparatus is shown and it is explanatory drawing of the 1st procedure. It shows the method of using the same device and is an explanatory diagram of the second procedure. It shows the method of using the same device and is an explanatory diagram of the third procedure. It is a perspective view which shows other embodiment of the stent delivery apparatus of this invention. It is a principal part expansion perspective view of the same apparatus. It is a principal part enlarged plan view of the same apparatus. FIG. 6 is an explanatory cross-sectional view showing a state in which the connection member is released from the gripping means in the apparatus. FIG. 7 is an explanatory cross-sectional view showing a state in which the connection member is gripped by gripping means in the apparatus. The other embodiment of the stent delivery apparatus of this invention is shown, (a) is the disassembled perspective view, (b) is the principal part expansion perspective view. FIG. 6 is an explanatory cross-sectional view showing a state in which the connection member is released from the gripping means in the apparatus. FIG. 7 is an explanatory cross-sectional view showing a state in which the connection member is gripped by gripping means in the apparatus.

  Hereinafter, with reference to FIGS. 1-10, one Embodiment of the stent delivery apparatus of this invention is described.

  As shown in FIG. 1, this stent delivery device 10 (hereinafter simply referred to as “delivery device 10”) includes a tube stent 20, a pusher catheter 30, an inner catheter 40, a connection member 25, and the connection member 25. Gripping means for gripping the other end.

  The tube stent 20 has a cylindrical shape made of synthetic resin, and flaps 21 for engaging with inner walls of tubular organs, body cavities and the like are formed from the outer circumferences at both ends. . Each flap 21 has a shape in which one end located on the corresponding end side of the tube stent 20 is connected to the tube stent 20 and the other end is bent to be a free end protruding outward. The tube stent 20 is not limited to this shape, and various shapes including means for locking to a tubular organ or the like can be employed. Since such a tube stent 20 is well known, a detailed description thereof will be omitted. And the tube stent 20 in this delivery apparatus 10 has a long hole-like insertion hole 22 formed in the peripheral wall on the base end side.

  A string-like connection member 25 is inserted into the insertion hole 22 of the tube stent 20 and both ends thereof are connected to each other so as to form an annular loop. The connection member 25 is connected to the tube stent 20 at one end (the end locked to the insertion hole 22) in the above-described manner, and detachably connected to the pusher catheter 30 at the other end in a manner described later. This is for releasably connecting the stent 20 and the pusher catheter 30.

  The length of the connecting member 25 is such that the proximal end of the tube stent 20 is positioned on the distal end surface of the pusher catheter 30 when the other end is gripped by the gripping means of the pusher catheter 30 (see FIG. 5). It is as long as possible. If the connecting member 25 is too long, a large gap is generated between the tube stent 20 and the pusher catheter 30 when the pusher catheter 30 is pulled, so that the proximal end of the tube stent 20 is the distal end surface of the pusher catheter 30. In addition, it is preferable to adjust the length to be arranged through a gap of 0 to 5 mm.

  In addition, the connection member 25 in this embodiment is an annular string-like body that is inserted into the insertion hole 22 of the tube stent 20 as described above. For example, one end thereof may be fixed to the tube stent 20 by an adhesive, welding, or the like, and is not particularly limited.

  A pusher catheter 30 for pushing the tube stent 20 in a predetermined direction as necessary is disposed on the proximal end side of the tube stent 20. As shown in FIGS. 1 and 6, the pusher catheter 30 is cylindrical and extends a predetermined length, and a hub 32 for gripping and operation is attached to the proximal end portion thereof.

  As shown in FIGS. 1 and 6, an inner catheter 40 is removably inserted into the inner periphery of the pusher catheter 30 and the tube stent 20. The tube stent 20 is supported by inserting the inner catheter 40 into the tube stent 20.

  The inner catheter 40 in this embodiment is cylindrical and has a predetermined length, like the pusher catheter 30, and has a structure in which a hub 42 for gripping and operation is attached to the base end portion thereof. Yes. The guide wire 1 is inserted through the inner circumference of the inner catheter 40 (see FIG. 6).

  In addition, although it changes with uses, when using it for uses, such as indwelling of the tube stent to a bile duct stenosis part, it is preferable that the internal diameter A (refer FIG. 4) of the pusher catheter 30 is 1.5-4 mm. More preferably, it is 8 to 2.5 mm. Further, the outer diameter B (see FIG. 4) of the inner catheter 40 is preferably 1.3 to 3.8 mm, and more preferably 1.6 to 2.3 mm. Furthermore, the difference (clearance) between the inner diameter A of the pusher catheter 30 and the outer diameter B of the inner catheter 40 is preferably 0.1 to 3 mm in consideration of the slidability and stability of the inner catheter 40. More preferably, it is 0.1 to 0.3 mm.

  The distal end portion of the pusher catheter 30 is provided with a gripping means for gripping the other end of the connection member 25 so as to be openable.

  In this embodiment, a gripping member 50 made of a synthetic resin, which is separate from the pusher catheter 30, is attached to the distal end portion of the pusher catheter 30.

  As shown in FIGS. 2 to 5, the gripping member 50 has an inner diameter that matches the outer diameter of the pusher catheter 30, and its proximal end is bonded to the outer periphery of the distal end portion of the pusher catheter 30 by means such as adhesion or welding. It has a joined cylindrical outer wall portion 51 and a tongue piece 55 provided inside the outer wall portion 51. A rectangular insertion hole 51 a is formed through the outer wall 51 at a predetermined position in the circumferential direction of the outer wall 51. The insertion hole 51a may be circular or elliptical, and is not particularly limited.

  The outer wall 51 is formed with an outer diameter larger than the inner diameter of the tube stent 20 and an inner diameter smaller than the outer diameter of the tube stent 20, and with the gripping means gripping the other end of the connecting member 25, As shown in FIG. 5, the proximal end surface of the tube stent 20 is disposed in contact with or close to the distal end surface of the outer wall portion 51, and when the pusher catheter 30 is pushed out, the distal end surface of the outer wall portion 51 becomes the base of the tube stent 20. The tube stent 20 can be pushed in by pushing the end face.

  Further, the tongue piece 55 has a base end side located in the back of the outer wall portion 51 connected to the inner side of the outer wall portion 51 and a distal end side located on the opening side of the outer wall portion 51 as a free end. It is possible to bend inward. In this embodiment, when there is no external force, the tongue piece 55 is shaped so as to open toward the inside of the outer wall portion 51, and the inner catheter 40 is inserted inside and pressed from the inside. The free end side is closed and is pressed toward the outer wall portion 51.

  In this case, when the inner catheter 40 is inserted inside the tongue piece 55, the outer diameter of the inner catheter 40 or the inner side surface when the tongue piece 55 is closed so that the tongue piece 55 is pressed against the outer wall portion 51. Adjust the position of.

  In addition, a protrusion 57 that is removably inserted into an insertion hole 51 a formed in the outer wall 51 is provided on the surface of the outer wall 51 on the free end side of the tongue piece 55. Yes. The protrusion 57 of this embodiment has a rectangular convex shape that is slightly smaller than the insertion hole 51a, and both longitudinal ends thereof are rounded in an R shape. (See FIG. 3 and FIG. 4). Therefore, this protrusion 57 is easy to be inserted into the insertion hole 51a and easily removed. The shape of the protrusion 57 is an example, and may be a cylindrical shape, a hemispherical shape, an elliptical shape, an oval shape, or the like, and is not particularly limited.

  The other end of the connecting member 25 can be gripped between the tongue piece 55 and the outer wall portion 51. That is, in this embodiment, the “tongue piece 55” and the “outer wall portion 51” form the “gripping means” in the present invention.

  In the case of this embodiment, the gripping member 50 is an integrally formed resin molded product with the outer wall portion 51 and the tongue piece 55 being separated from each other by injection molding (see FIG. 4). The tongue piece 55 is shaped in a direction away from the outer wall portion 51. In addition, as a material of the holding member 50, for example, polyethylene, polyoxymethylene, polypropylene, nylon resin, polyester resin, ABS resin, polycarbonate resin, polyether ether ketone (PEEK), polyimide resin, or the like can be used. However, it is not limited to these.

  Further, as shown in FIG. 2, the width W of the tongue piece 55 (distance perpendicular to the axial direction of the pusher catheter 30) is preferably 0.5 to 4 mm, and more preferably 1 to 3 mm. Further, as shown in FIG. 4, the length L1 of the tongue piece 55 (distance along the axial direction of the pusher catheter 30) is preferably 3 to 15 mm, and more preferably 4 to 10 mm.

  The gripping member 50 having the above-described structure has a position where the proximal end side of the outer wall portion 51 is covered with the outer periphery of the distal end portion of the pusher catheter 30 and the distal end portion of the pusher catheter 30 contacts the proximal end portion of the tongue piece 55 In this state, the gripping means composed of the tongue piece 55 and the outer wall portion 51 is provided at the distal end portion of the pusher catheter 30 (FIGS. 4 and 5). reference).

  In this delivery device 10, when the inner catheter 40 is inserted into the pusher catheter 30 and the inner catheter 40 is disposed inside the tongue piece 55 of the gripping member 50, the tongue piece 55 is pressed and closed, The other end of the connecting member 25 is sandwiched between the tongue piece 55 and the outer wall portion 51 (see FIG. 5). On the other hand, when the inner catheter 40 is extracted from the inside of the tongue piece 55, the tongue piece 55 becomes the outer wall portion 51. The connecting member 25 is configured to be opened away from the other end of the connecting member 25 (see FIG. 4).

  In this embodiment, the inner catheter 40 has a cylindrical shape with a constant diameter, but may have a shape as shown in FIG. 7, for example. That is, when the inner catheter 40 is inserted into the pusher catheter 30, the portion corresponding to the tongue piece 55 of the inner catheter 40 is defined as a large-diameter portion 44 formed thicker than the other portions. The tongue piece 55 may be pressed.

  Next, an example of a method for using the delivery device 10 of the present invention having the above configuration will be described.

  As shown in FIG. 8, a nipple N is provided below the duodenum V1, from which a bile duct V2 and a pancreatic duct V3 branch and extend. Here, a procedure for placing the tube stent 20 through the teat N and in the stenosis S generated in the bile duct V2 will be described. In addition, this delivery apparatus 10 can also be used when moving a tube stent into tubular organs such as pancreatic duct, ureter, trachea, and other body cavities, and is not limited to the above embodiment. Absent.

  First, as shown in FIG. 4, the inner catheter 40 is extracted from the inside of the tongue piece 55, and the inside of the loop of the other end of the connection member 25 connected to the tube stent 20 is connected to the tongue piece 55 and the outer wall portion of the gripping member 50. 51.

  In this state, as shown in FIG. 5, when the inner catheter 40 is inserted into the pusher catheter 30, the tongue piece 55 is pressed by the inner catheter 40 and closes toward the outer wall 51 side. As a result, the protrusion 57 provided on the free end side of the tongue piece 55 is inserted into the insertion hole 51 a of the outer wall portion 51, and the loop inside of the other end of the connecting member 25 is between the tongue piece 55 and the outer wall portion 51. As a result, the pusher catheter 30 and the tube stent 20 can be connected by the loop at the other end of the connecting member 25 engaging with the protrusion 57 of the tongue piece 55.

  Then, the guide wire 1 is inserted into the inner catheter 40, and the tube stent 20, the pusher catheter 30 and the inner catheter 40 are accommodated in a lumen (not shown) of the endoscope 5.

  In this state, the endoscope 5 is moved from the oral cavity to the duodenum V1 through the stomach or the like by a known method, the guide wire 3 is inserted from the opening 5a at the distal end of the endoscope, and the position is confirmed under fluoroscopy. It passes through the nipple N and is inserted into the bile duct V2. And as shown in FIG. 8, the front-end | tip part of the guide wire 1 is inserted until it reaches the position which passed the narrowed part S in the bile duct V2.

  Thereafter, the inner catheter 40, the pusher catheter 30 and the tube stent 20 are pushed in along the guide wire 1. At this time, the tube stent 20 is supported by inserting the inner catheter 40 on the inner side thereof, and the distal end surface of the outer wall portion 51 of the gripping member 50 of the pusher catheter 30 is pressed against the proximal end surface thereof. . Then, the tube stent 20 is inserted into the bile duct V2 through the nipple N, passed through the stenosis S, and pushed to a position where the distal end side flap 21 exits from the stenosis S.

  Note that the guide wire 1 is inserted into the bile duct V2 in advance, and the distal end of the guide wire 1 reaches a desired position. Thereafter, the inner catheter 40 is inserted into the proximal end side of the guide wire 1, and the tube stent 20 and the pusher catheter 30 are inserted. May be moved.

  In this delivery device 10, since the pusher catheter 30 and the tube stent 20 are connected via the connecting member 25, the tube stent 20 is pushed too much by the pusher catheter 30 and is displaced from a desired position. However, by pulling back the pusher catheter 30 to the proximal side, the tube stent 20 can be pulled back via the connecting member 25 and can be placed at a desired position.

  In this embodiment, the flap 21 on the distal end side of the tube stent 20 is locked to the inner wall at the back of the narrowed portion S of the bile duct V2, and the flap 21 on the proximal end is locked to the peripheral edge of the nipple N. The tube stent 20 is indwelled, and the stenosis S is pushed and expanded from the inside.

  Then, after the tube stent 20 is placed at a desired position, the pusher catheter 30 is held and fixed, the inner catheter 40 is pulled back to the proximal side, and the inner catheter 40 is pulled out from the inside of the tongue piece 55. Then, the tongue piece 55 becomes deflectable and opens inwardly away from the outer wall portion 51, and the other end of the connecting member 25 is opened (see FIG. 4). The pusher catheter 30 can be withdrawn while indwelling in position. In addition, by pulling out the inner catheter 40, the guide wire 1 and the endoscope 5 from the body, only the tube stent 20 can be placed at a desired position in the body as shown in FIG.

  At this time, in this delivery device 10, the inner catheter 40 is extracted from the inside of the tongue piece 55, so that the tongue piece 55 is opened with respect to the outer wall portion 51 and the other end of the connection member 25 is opened. The member 25 is caught by the pusher catheter 30 to prevent the tube stent 20 once placed at the desired position from being displaced, and the tube stent 20 can be placed accurately at the desired position.

  In this embodiment, the gripping member 50 is integrally formed with the outer wall portion 51 and the tongue piece 55 by injection molding, and the tongue piece 55 is shaped in a direction away from the outer wall portion 51. When the inner catheter 40 is pulled out from the inside of the piece 55, the tongue piece 55 is positively opened in a direction away from the outer wall portion 51, and the other end of the connecting member 25 can be opened more reliably.

  Furthermore, in this embodiment, since the protrusion 57 is provided on the surface of the tongue piece 55 on the outer wall 51 side, the inner catheter 40 is disposed inside the tongue piece 55 and the tongue piece 55 is pressed. When closed, the other end of the connection member 25 can be more reliably held between the tongue piece 55 and the outer wall portion 51. Here, since the other end of the connecting member 25 forming the ring-shaped string is caught by the protrusion 57, it can be reliably prevented from coming off between the tongue piece 55 and the outer wall portion 51. As a result, when the pusher catheter 30 is pulled back to the proximal side in order to correct the indwelling position of the tube stent 20, the pusher catheter 30 can be reliably moved, and the positional shift can be performed with higher accuracy.

  Further, in this embodiment, an insertion hole 51a through which the protrusion 57 is inserted / removed is formed in the outer wall 51 corresponding to the protrusion 57 provided on the tongue 55, and the tongue 55 is the inner catheter. Since the projection 57 is inserted into the insertion hole 51a when closed by being pressed by 40, the connection member 25 can be made difficult to come off.

  Furthermore, in this embodiment, the gripping means is a separate member from the pusher catheter 30 and is composed of a gripping member 50 attached to the distal end portion of the pusher catheter 30. Therefore, only the gripping member 50 can be manufactured separately from the pusher catheter 30. For example, as described above, the tongue piece 55 and the outer wall portion 51 can be integrally formed by injection molding. The tongue piece 55 and the outer wall portion 51 covering the tongue piece 55 can be manufactured relatively easily.

  Further, as shown in FIG. 7, the portion corresponding to the tongue piece 55 of the inner catheter 40 is used as a large diameter portion 44 formed thicker than the other portions, and the tongue piece 55 is pressed by the large diameter portion 44. In such a case, the following effects can be obtained.

  That is, since the large-diameter portion 44 that is a portion corresponding to the tongue piece 55 of the inner catheter 40 is formed thicker than the other portions, the tongue piece 55 can be pressed more strongly toward the outer wall portion 51. The other end of the connecting member 25 can be more reliably held between the tongue piece 55 and the outer wall portion 51. Further, since the inner catheter 40 other than the large-diameter portion 44 corresponding to the tongue piece 55 is formed thin, the increase in sliding resistance when the inner catheter 40 is moved in the pusher catheter 30 is suppressed. Can do.

  FIGS. 11 to 15 show another embodiment of the stent delivery device of the present invention. Note that substantially the same parts as those of the above-described embodiment are denoted by the same reference numerals, and description thereof is omitted.

  The stent delivery device 10a of this embodiment (hereinafter simply referred to as “delivery device 10a”) is different from the previous embodiment in the structure of the gripping means.

  That is, in this embodiment, a pair of slits 33, 33 parallel to each other are formed from the distal end of the pusher catheter 30, and a deflectable tongue piece 35 is formed through the pair of slits 33, 33. The tongue piece 35 is directly provided at the distal end of the pusher catheter 30.

  A cylindrical outer wall portion 37 is attached to the outer periphery of the distal end of the pusher catheter 30 and is disposed outside the tongue piece 35. Between the tongue piece 55 and the outer wall portion 51, the connecting member 25 is provided. The other end can be gripped. As the outer wall portion 37, for example, a heat-shrinkable tube such as urethane can be used, and this can be attached to the outer periphery of the distal end portion of the pusher catheter 30 by heat shrinkage. However, the outer wall portion 37 can be formed by adhering or welding a resin tube to the pusher catheter 30 with an adhesive or the like, and the forming method is not particularly limited.

  As shown in FIG. 13, the length L2 of the slit 33 for forming the tongue piece 35 is preferably 4 to 16 mm, more preferably 5 to 11 mm. Moreover, it is preferable that the width W of the tongue piece 35 is 1-5 mm, and it is preferable that it is 1.5-4 mm.

  Further, the tongue piece 35 in this embodiment is shaped in a direction away from the outer wall portion 37. For example, an adhesive is applied to the inside of the tongue piece 35 in a state of being separated from the outer wall portion 37 and the shape is maintained, or a resin member formed in a “shape” is placed on the inside of the tongue piece 35. The tongue piece 35 can be shaped by adhering or other means.

  Further, a protrusion 36 is provided on the surface of the tongue piece 35 on the free end side and on the outer wall 37 side. As shown in FIGS. 12 and 14, the protrusion 36 protrudes from the tip of the tongue piece 35 at a constant height, and has a slope 36 a whose base side (base end side of the pusher catheter 30) gradually decreases. Is formed. The protrusion 36 can be provided by a method such as fixing a separate resin molded product to the tongue piece 35 or potting resin on the tongue piece 35.

  In this embodiment, when the inner catheter 40 is inserted into the pusher catheter 30, the tongue piece 35 is pressed and closed by the inner catheter 40 as shown in FIG. 15, and the protrusion 36 abuts against the outer wall portion 37. Thus, the other end of the connecting member 25 is sandwiched and held between the tongue piece 35 and the outer wall portion 37. On the other hand, when the inner catheter 40 is pulled out from the pusher catheter 30, the inner catheter 40 is pulled out from the inside of the tongue piece 35 as shown in FIG. 14, and the tongue piece 35 opens away from the outer wall portion 37 to open the connecting member. The other end of 25 is opened.

  Further, in this embodiment, since the tongue piece 35 is provided at the distal end portion of the pusher catheter 30 via the pair of slits 33, 33, the tongue piece 35 can be formed relatively easily, and the manufacturing cost is increased. Can be reduced.

  16 to 18 show still another embodiment of the stent delivery device of the present invention. Note that substantially the same parts as those of the above-described embodiment are denoted by the same reference numerals, and description thereof is omitted.

  The stent delivery device 10b of this embodiment (hereinafter simply referred to as “delivery device 10b”) is different from the previous embodiment in the structure of the gripping means.

  That is, in this embodiment, as shown in FIG. 16A, an elongated notch 38 is formed along the axial direction from the distal end of the pusher catheter 30, and a gripping member 50a is attached to the notch 38. (See FIG. 16B).

  The holding member 50a has an outer wall portion 52 having an elongated plate shape adapted to the notch 38, and a tongue piece 56 is connected to the inner side of the outer wall portion 52 via a thin hinge 56a so as to be bent. Has been. An elongated plate-like support plate 52 a extends from the base end side of the outer wall portion 52.

  And while inserting the outer wall part 52 of the holding member 50a in the said notch 38, the said support plate 52a is arrange | positioned on the outer periphery of the pusher catheter 30, and also on the outer periphery of the same support plate 52a, a heat-shrinkable tube or a resin molded product A cylindrical holding member 39 made of, for example, is disposed and fixed to the pusher catheter 30 with heat shrinkage or an adhesive, so that the gripping member 50a is attached to the distal end portion of the pusher catheter 30. .

  In this embodiment, when the inner catheter 40 is inserted into the pusher catheter 30, as shown in FIG. 18, the tongue piece 56 is pressed against the inner catheter 40 and closed, and the projection 57 abuts against the outer wall 52. The other end of the connecting member 25 is sandwiched and held between the tongue piece 56 and the outer wall portion 52. On the other hand, when the inner catheter 40 is pulled out from the pusher catheter 30, the inner catheter 40 is pulled out from the inside of the tongue piece 56, and the tongue piece 56 opens away from the outer wall portion 52, as shown in FIG. The other end of 25 is opened.

  In this embodiment, since the gripping member 50a is composed of the thin inner plate-shaped outer wall portion 52a, the tongue piece 56, and the support plate 52a, the gripping member 50a can be formed in a relatively compact size. Even a pusher catheter or the like having a small outer diameter can be easily applied and the manufacturing cost can be reduced.

10, 10a, 10b Stent delivery device (delivery device)
20 Tube stent 25 Connection member 30 Pusher catheter 35 Tongue piece 36 Protruding part 37 Outer wall part 40 Inner catheter 44 Large diameter part 50, 50a Grasping member 51, 52 Outer wall part 55, 56 Tongue piece 57 Protruding part

Claims (5)

A tube stent made of a synthetic resin tube;
A pusher catheter disposed on the proximal side of the tube stent;
An inner catheter that is removably inserted into an inner periphery of the pusher catheter and the tube stent, and supports the tube stent;
A connecting member having one end connected to the tube stent;
Provided at the distal end portion of the pusher catheter, and comprising a gripping means for gripping the other end of the connection member so as to be openable,
The grasping means has a tongue piece formed to be bent inward with the distal end side of the pusher catheter as a free end, and an outer wall portion arranged outside the tongue piece,
In a state where the inner catheter is disposed inside the tongue piece, the tongue piece is pressed and closed, and the other end of the connection member is gripped between the tongue piece and the outer wall portion, and the inner catheter When the tongue piece is extracted from the inside of the tongue piece, the tongue piece can be opened away from the outer wall portion so that the tip of the tongue piece is located inside the outer wall portion. A stent delivery device. A tube stent made of a synthetic resin tube;
A pusher catheter disposed on the proximal side of the tube stent;
An inner catheter that is removably inserted into an inner periphery of the pusher catheter and the tube stent, and supports the tube stent;
A connecting member having one end connected to the tube stent;
Provided at the distal end portion of the pusher catheter, and comprising a gripping means for gripping the other end of the connection member so as to be openable,
The grasping means has a tongue piece formed to be bent inward with the distal end side of the pusher catheter as a free end, and an outer wall portion arranged outside the tongue piece,
A protrusion is provided on the surface of the tongue piece on the outer wall side,
In a state where the inner catheter is disposed inside the tongue piece, the tongue piece is pressed and closed, and the other end of the connection member is gripped between the tongue piece and the outer wall portion, and the inner catheter When the tongue piece is extracted from the inside of the tongue piece, the tongue piece is configured to be able to open away from the outer wall portion so that the protrusion is located inside the outer wall portion. Stent delivery device. A tube stent made of a synthetic resin tube;
A pusher catheter disposed on the proximal side of the tube stent;
An inner catheter that is removably inserted into an inner periphery of the pusher catheter and the tube stent, and supports the tube stent;
A connecting member having one end connected to the tube stent;
Provided at the distal end portion of the pusher catheter, and comprising a gripping means for gripping the other end of the connection member so as to be openable,
The grasping means has a tongue piece formed to be bent inward with the distal end side of the pusher catheter as a free end, and an outer wall portion arranged outside the tongue piece,
When the inner catheter is inserted into the pusher catheter, the portion corresponding to the tongue piece of the inner catheter is formed thicker than the other portions,
In a state where the inner catheter is arranged inside the tongue piece, the tongue piece is pressed and closed, and when the inner catheter is extracted from the inside of the tongue piece, the tongue piece is separated from the outer wall portion. A stent delivery device configured to be openable.   The stent delivery device according to any one of claims 1 to 3, wherein the tongue piece is shaped in a direction away from the outer wall portion. The stent delivery device according to any one of claims 1 to 4, wherein the gripping means is a separate body from the pusher catheter and is attached to a distal end portion of the pusher catheter.