JP6808709B2 - Catheter and catheter system - Google Patents

Description

The present invention relates to catheters and catheter systems, in particular catheters and catheter systems used to detect information on tissues in the body. The catheter described in the present application refers to a long member inserted into a biological lumen and used for treatment of an affected area or measurement of an affected area, and a catheter system is a cylindrical long member penetrating the long member. A sheath having a shape, an operating means for moving the sheath connected to the sheath, and an overall configuration including a therapeutic device and a measuring device including a therapeutic tool and an electric device for driving the measuring tool.

Catheter and catheter systems that stimulate tissues in the body include, for example, those used for ablation therapy. This ablation is a technique of destroying nerve cells in a target tissue by heating or cooling the target tissue to block nerves.

Catheter and catheter systems used to detect tissue information in the body have this temperature because the heat of ablation can be transferred to other adjacent organs during ablation of various organs, causing damage. An example is equipped with a temperature sensor for measuring.
For example, when ablation techniques are used on the left atrium, the lesioned tissue of the heart is heated and treated, but the heat generated during ablation also heats the esophagus adjacent to the left atrium of the heart, causing the esophagus. May be hurt. When the ablation technique is used in this way, by measuring the temperature at multiple points on the esophageal wall with a catheter equipped with a temperature sensor, one of the points approaches a temperature that can be damaged. When the temperature sensor detects it, the ablation can be temporarily interrupted to cool the heated part of the esophagus.

For example, in Patent Document 1, the temperature in the esophagus is measured by forming the tip of a catheter (temperature probe) provided with a temperature sensor into a meandering shape, a loop shape, a spiral shape, or the like and arranging it in the esophagus. A catheter (temperature probe) that can be used is described.

Japanese Patent Publication No. 2011-517417

However, when the tip of the catheter has a loop shape or a spiral shape like the sensor catheter described in Patent Document 1, the coiled portion is easily crushed in the tube and the shape is easily collapsed at the time of treatment, which is optional. There is a problem that it is difficult to accurately measure the temperature with respect to the position of.

An object of the present invention has been made in view of such a situation, and even when the tip of the catheter has a deformed shape such as a spiral shape, the shape of the catheter is made difficult to collapse during treatment or the like. It is an object of the present invention to provide a catheter and a catheter system capable of appropriately contacting the provided information detecting means with a target site.

In order to achieve the above object, the catheter of the present invention is provided on the distal end side with a long catheter body in which spiral contact means for contacting a plurality of inner walls of the biological lumen are formed on the distal end side. A catheter operating unit for operating the catheter body, an information detecting means which is arranged at least one in the spiral contact means and acquires information on the biological lumen tissue, and a tip of the catheter body are arranged. A balloon that can be expanded and contracted into a balloon shape by inflow and suction of fluid so as to hold the tip of the catheter body at a position away from the inner wall of the biological lumen, and to be connected to the balloon to drive the balloon. The cartel body and the shaft part are inserted into a hole formed in the longitudinal direction of the catheter operating part, and one of the catheter body and the shaft part is inserted into the long shaft part. fixed to said hole in the catheter operation section and the other is movable within the bore, said helical contact means, previously shaped as threaded旋形shaped helix that Sessu a plurality of positions of the inner wall of the living body lumen The first feature is that it is memorized and deforms when an external force is applied, and returns to the shape memorized in advance when the external force is removed.

Further, the present invention provides a catheter of the first aspect, the catheter operation unit side of the spiral contact means, and a linear portion disposed in a straight line on a substantially central axis of the helical portion, the helical The second feature is that the balloon is attached to the extension portion, which is provided with an extension portion arranged so as to extend linearly on the substantially central axis on the tip end side of the portion.

The third feature of the present invention is that, in the catheter of the first or second feature, the number of the information detecting means is 5 to 8 per spiral of the spiral contact means. ..

Further, the present invention provides a locking mechanism for fixing and releasing the catheter body or the shaft portion, which is movable in the hole, to the catheter operating portion in the catheter having any of the features 1 to 3. The fourth feature is to prepare.

Further, the present invention provides a catheter of a fourth one of features from the first, the information detection means, a fifth feature that it is a temperature sensor for measuring the temperature of the inner wall of the living body lumen ..

Further, the present invention has a long and hollow sheath capable of accommodating the catheter having any of the first to fifth features, the catheter body and the balloon from the distal end side to the inside and exposing them to the outside. A sixth feature is to construct a catheter system including the above.

The catheter and catheter system according to the present invention are for holding the tip of a long catheter body having contact portions in contact with a plurality of inner walls of the biological lumen on the distal end side at a position separated from the inner wall of the biological lumen. By providing a balloon, the tip of the catheter body is held at a position away from the inner wall of the lumen of the living body during treatment, and the shape of the contact portion of the tip of the catheter is hard to be deformed. It is possible to appropriately contact the target site and prevent the tip of the catheter body from being caught in the inner wall of the living lumen.

The whole view of the catheter system by the reference example and the Example of this invention. Enlarged view showing the tip of the catheter according to the reference example and the example. Enlarged view showing the tip of the catheter at the time of operation according to the reference example and the example. The figure explaining the insertion of the ablation catheter into the renal artery by the reference example. The figure explaining the bipolar type and monopolar type electrodes by a reference example. The figure explaining the use and storage of the catheter by a reference example and an Example. The figure explaining the catheter and the catheter guide by a reference example and an Example. The figure explaining the use of the temperature sensor catheter of this Example. The enlarged view of the catheter operation part by a reference example and an Example.

Hereinafter, a reference example when the catheter and the catheter system according to the present invention are applied to the ablation catheter and an example applied to the temperature sensor catheter will be described. First, a reference example when the catheter and the catheter system according to the present invention are applied to the ablation catheter will be described. ..
The catheter and the catheter system according to the present invention can be applied to other than the urethral sensor described in the embodiment. For example, in the treatment of cancer such as the prostate, the heating medium flows in while monitoring the temperature of the tube wall. In the case of hyperthermia treatment that causes cancer tissue to undergo apoptosis or heating and treating the prostate, an extension equipped with a temperature sensor and a cooling tube is applied to the wall surface, and the prostate is intensively heat-treated while protecting the inner surface of the urethra. It can be widely applied, such as prostate treatment that contracts.
[Reference example]

[Constitution]
As shown in FIG. 4, the ablation catheter 2 to which the catheter according to this reference example is applied is a catheter for ablating the renal sympathetic nerve RN from the inside of the renal artery RA, and is a catheter from the humerus artery or the like via the aorta A to the kidney. Ablation is performed by cauterizing the target tissue by supplying a high frequency wave or the like to an electrode which is inserted into the artery RA and is a stimulus applying means provided at the tip of the ablation catheter 2.

As shown in FIGS. 1, 2 and 7, the ablation catheter system 1 is roughly classified into a long ablation in which an electrode 28 for heating a target tissue is arranged at the tip as a stimulus application means for applying a stimulus to a tissue in the body. A catheter 2 and a catheter guide 3 for accommodating the long ablation catheter 2 inside the long cylinder and guiding the electrode 28 attached to the tip of the ablation catheter 2 to the target tissue are provided.

[Explanation of Ablation Catheter 2]
As shown in FIGS. 1 and 7, the ablation catheter 2 has a spiral portion 21a wound in a coil shape, which is a contact portion in contact with a plurality of locations on the inner wall of the biological lumen (renal artery RA in this reference example). A catheter main body 21 in which an electric wire is wired inside a long tubular shape formed on the tip side, a catheter operating portion 23 for operating the catheter main body 21, and a swelling means attached to the tip of the spiral portion 21a. A contractible balloon 24 and a hollow shaft portion 27 for supplying and driving a fluid to the balloon 24 are provided.
The ablation catheter 2 supplies fluid from the fluid supply device 40 to the balloon 24 via the shaft portion 27 to expand and contract, and from the high-frequency power source 25 which is an energy supply device, via an electric wire passing through the inside of the catheter body 21. , A high frequency current is supplied to the electrode 28 provided in the spiral portion 21a.
In this reference example, the energy supplied to the electrode 28 is a high-frequency current, but the energy is not limited to this, and may be, for example, ultrasonic waves, radio waves, laser light, infrared rays, or the like.

The catheter body 21 of the ablation catheter 2 has a long, flexible and hollow shape, and forms a spiral portion 21a wound in a coil shape at the tip thereof. As shown in FIG. 2, the spiral portion 21a is a heating portion for performing ablation, and a plurality of electrodes 28 are arranged on the outside of the spiral shape, and an electric wire arranged from the high frequency power supply 25 to the inside of the catheter body 21. High frequency current is supplied through. The number of electrodes 28 is preferably about 20 in total, preferably 5 to 8 per spiral circumference, and the distance between the electrodes 28 is preferably about 3 mm.

Further, the spiral portion 21a is stored in a spiral shape in advance, deforms when an external force is applied, and returns to the previously stored shape when the external force is removed.
Further, since the spiral portion 21a has a coil shape, the diameter of the spiral portion 21a can be reduced and stored in the sheath 31, and if the spiral portion 21a is taken out of the sheath, it expands to a predetermined diameter. Can be stored in.
Further, as shown in FIG. 2, the spiral portion 21a has a straight portion 21b and a distal end side (catheter body) which are linear so that the proximal end side (catalyst operating portion 23 side) of the spiral portion is on the substantially central axis of the spiral. The side on which the balloon 24 of 21 is attached) has an extension portion 21c that extends linearly on a substantially central axis of the spiral.
The spiral portion 21a is arranged in the renal artery RA and protrudes from the sheath 31 by shape memory molding so that the outer diameter L3 in a state where no external force is applied is slightly larger than the inner diameter L4 of the renal artery RA. At that time, the electrode 28 can be expanded and brought into close contact with the inner wall of the renal artery RA. Further, when the catheter guide 3 is housed inside the sheath 31, it is crushed by the inner wall of the sheath 31 so as to have an inner diameter L1 or less of the sheath 31 and becomes elongated.

In this reference example, the spiral portion 21a is formed at the tip of the catheter main body 21, but the shape is not limited to the spiral shape, and at least the contact portion may be configured to be in contact with a plurality of inner walls of the biological lumen. Good.
Further, in this reference example, the electrode 28 is provided only on the spiral portion 21a, but the present invention is not limited to this, and for example, the electrode 28 may be provided on the tip of the extending portion 21c.

The extending portion 21c extending from the spiral portion 21a to the distal end side is inflated in the tubular living lumen (renal artery RA in this reference example) so as to be separated from the inner wall of the living lumen ( A balloon 24 for holding the extension portion 21c, which is the tip of the catheter body 21, is attached to (on a substantially extension of the central axis of the spiral of the spiral portion 21a).
The balloon 24 has a substantially bag-like shape and can be expanded and contracted, and is inflated by a fluid such as air supplied from the tip of the shaft portion 27 via the hollow shaft portion 27 from the fluid supply device 40 to suck the fluid. Shrinks due to.
The diameter of the balloon 24 can be arbitrary depending on the amount of fluid to be supplied, but as shown in FIG. 3, the diameter L2 at the time of ablation in the renal artery RA is slightly larger than the diameter L4 of the renal artery RA. As a result, the spiral portion 21a is prevented from being excessively compressed and deformed by the renal artery RA, and the balloon 24 is fixed to the renal artery RA to prevent the contact position of the electrode 28 provided on the spiral portion 21a from shifting.

As shown in FIG. 9, the shaft portion 27 is inserted into the hole 23e formed in the catheter operating portion 23 in a non-fixed state so that the shaft portion 27 can slide in the catheter operating portion 23 in the axial direction. The amount of protrusion from the catheter operating unit 23 can be adjusted according to a change in the shape of the spiral portion 21a of the catheter body 21 fixed in the hole 23f of the operating unit 23.
The adjustment of the protrusion amount is preferably performed by the pin 23b fixed to the shaft portion 27, the lateral groove 23c cut out in the longitudinal direction of the catheter operating portion 23 so that the pin 23b can be moved, and the pin 23b. The lock mechanism 52 is provided with a lock groove 23a cut out in the lateral direction so that the position can be fixed. For example, when the spiral portion 21a is inside the sheath 31, the pin 23b is set to the lock groove on the tip side. When the spiral portion 21a is positioned at 23a and the spiral portion 21a protrudes from the tip of the sheath 31, the pin 23b is unlocked and moved along the lateral groove 23c. When the spiral portion 21a has the maximum diameter, the pin 23b is moved to the base end side. The lock groove 23a is selected according to the diameter of the spiral portion 21a, such as being positioned in the lock groove 23a of the above.

Further, the shaft portion 27 is provided with a pilot balloon 50 that expands and contracts in conjunction with the expansion and contraction of the balloon 24 and a valve 51 that adjusts the amount of fluid supplied, and the pilot balloon 50 balloons when the fluid is supplied. Since it expands and contracts in conjunction with 24, it is easy to determine how much the balloon 24 expands and contracts.
In this reference example, the catheter main body 21 is fixed to the catheter operating portion 23 and the shaft portion 27 is not fixed, but conversely, the catheter main body 21 is not fixed and the shaft portion 27 is fixed. good.
Further, the shaft portion 27 is not limited to the above, and may be configured to be adhered adjacent to the catheter main body 21 in a state where the spiral portion 21a is bent to the extent that the shape change is allowed, and the shaft portion is provided. Instead, a fluid supply path may be provided in the catheter body to supply the fluid to the balloon.

In this reference example, an example in which a balloon 24 that expands and contracts by fluid supply is provided as a holding means has been described, but the present invention is not limited to this, and the extending portion 21c is held on the substantially central axis of the spiral portion 21a and has a diameter. Anything that can be expanded and contracted may be used. For example, a expandable wire may be formed into a box shape that can be contracted and expanded to form a cage shape.
The dimensions L1 to L5 differ depending on the size of the internal tube to be applied. For example, in the case of the renal artery RA of this reference example, L1 is 3 to 4 mm, L2 is 6 to 10 mm, and L3 is 6 to 10 mm. L4 can be 5 to 10 mm, and L5 can be 6 to 12 mm.

[Explanation of Catheter Guide 3]
As shown in FIGS. 1 and 7, the catheter guide 3 includes a guide operation unit 34 and a hollow sheath 31 extending along a central axis, and turns a guide bending dial 33 provided on the guide operation unit 34. As a result, the curved portion 31a, which is a flexible portion on the tip end side of the sheath 31, can be curved.
Further, a hole 34a is formed in the guide operation unit 34 in the longitudinal direction so as to communicate with the sheath 31, and the catheter body 21 of the ablation catheter 2 can be inserted through the guide operation unit 34, and the tip of the ablation catheter 2 can be inserted from the tip side of the sheath 31. It is possible to squeeze the side.

Although the structure for bending the curved portion 31a of the catheter guide 3 is not shown, for example, a hole is formed in the longitudinal direction of the sheath 31, a wire is arranged in the hole, and the tip of the wire is fixed to the tip of the sheath 31. , The base end of the wire is wound around a pulley fixed coaxially with the curved dial 33, and the guide curved dial 33 is rotated to pull the wire, so that the curved portion 31a is arranged on the side where the towed wire is arranged. Can be curved.

In this reference example, an example in which the ablation catheter 2 and the catheter guide 3 are combined is shown, but the catheter guide is not limited to this as long as it can reach the affected area while covering the spiral portion 21a. By providing a hollow elongated sheath directly on the ablation catheter so as to cover the catheter body without using 3, and changing the relative position of the sheath and the catheter body in the longitudinal direction by operating the operation unit, the sheath can be used. The tip side of the catheter body may be recessed.

[Explanation of use and storage of ablation catheter system 1]
Next, an example of how to use the ablation catheter and the ablation catheter system according to this reference example will be described with reference to FIGS. 4 and 6.
First, as shown in FIG. 4, the catheter guide 3 is inserted from the brachial artery or the like with the ablation catheter 2 in the contracted state of the balloon 24 housed inside the catheter guide 3, and the catheter guide 3 passes through the aorta A. The tip of the catheter reaches an arbitrary position inside the renal artery RA (for example, a position in front of the affected area).
Next, as shown in FIG. 6A, from the state where the distal end side of the ablation catheter 2 is housed in the sheath 31, only the balloon 24 is projected into the renal artery RA as shown in FIG. 6B. At this time, the balloon 24 may be inflated to the extent that it does not get caught in the renal artery RA.

Then, as shown in FIG. 6C, by supplying the fluid to the balloon 24 via the shaft portion 27, the diameter L2 of the balloon 24 is expanded larger than the diameter L4 of the renal artery RA, and the position of the balloon 24 is fixed. Then, the sheath 31 is pulled to project the spiral portion 21a as shown in FIG. 6D. At this time, since the spiral portion 21a is released from the compressive force in the radial direction by the inner wall of the sheath 31, it returns to the shape stored in advance, and the outer diameter L3 of the spiral portion 21a is slightly larger than the diameter L4 of the renal artery RA. Because of its large diameter, it is in close contact with the renal artery RA, and the electrode 28 can be reliably brought into contact with the renal artery.

Then, an electric current is supplied from the high-frequency power source 25 to the electrode 28 via an electric wire arranged inside the catheter main body 21 to heat the biological tissue in the vicinity of the electrode 28. As a result, for example, necrosis or thermal alteration can occur in the fibers of the renal sympathetic nerve RN located in the vicinity of the electrode 28. At this time, if the balloon 24 is contracted so as to be about the same as or slightly smaller than the diameter L4 of the renal artery RA and the catheter body 21 is moved back and forth in the longitudinal direction, the balloon can be slid appropriately and the electrodes 28 are arranged. It is also possible to heat between the spirals of the spiral portion 21a which is not formed.
In this reference example, all the electrodes 28 are energized, and when the range of the affected area is short, the spiral portion 21a is adjusted by shortening the amount of protrusion from the sheath 31, but the present invention is not limited to this. For example, a configuration in which only one half or one quarter of the tip side of the plurality of electrodes 28 is selectively energized may be used.

After ablation, as shown in FIG. 6 (e), the outer diameter of the balloon 24 is expanded to the diameter L4 at the time of ablation and the diameter L5 larger than the diameter L3 of the spiral portion 21a, and further firmly becomes the renal artery RA. After fixing, the catheter body 21 is pulled toward the operation unit 23 and the sheath 31 is pushed out in that state.
By doing so, a gap is created between the renal artery RA and the spiral portion 21a, and the spiral portion 21a is stretched to reduce its diameter so that it can be easily stored in the sheath 31. After that, the fluid in the balloon 24 is sucked through the shaft portion 27, stored in the sheath 31, and the ablation catheter 2 and the catheter guide 3 are discharged to the outside of the body.

By arranging the balloon 24 at the tip of the spiral portion 21a and inflating it as described above, the spiral portion 21a can be easily maintained at the target position and the compressive force due to the renal artery RA is less likely to be received. The shape of the spiral does not easily collapse, and the electrode 28 can be reliably applied to the inner wall surface. Further, by inflating the balloon 24 to some extent, it is safe because the tip does not swing up and down, left and right, or get caught on the inner wall surface when protruding from the sheath 31 or moving in the renal artery RA.
Further, since the spiral portion 21a can be reached to the affected portion in the state of being housed in the sheath 31, it is safe because it can be moved without damaging the inside of the body tube.

If the affected area in the renal artery RA is wide or extends over a plurality of areas, the spiral portion 21a and the balloon 24 are moved while being housed in the sheath 31 after each treatment at one site, and FIG. By repeating the steps a) to (e), a safe treatment can be performed. If the electrode 28 is not energized, the spiral portion 21a may be moved to another location with the balloon 24 contracted to the extent that it slightly contacts the renal artery RA.

[Explanation of electrodes applied to ablation catheter system 1]
As shown in FIG. 5A, the electrodes 28 provided on the ablation catheter 2 according to this reference example have a positive electrode 90 and a negative electrode 91 arranged in pairs in one electrode, and an insulating material 93 is provided between them. It is also possible to ablate the affected area by a bipolar method in which electricity is applied through a device, and as shown in FIG. 5 (b), a monopolar method is used in which the electrode is only the positive electrode 94 and the counter electrode is attached to the opposite surface of the patient to energize. The affected area can also be ablated. In this reference example, an electrode using a high frequency will be described, but the present invention is not limited to this, and for example, a microwave or the like may be used.

In this reference example, a plurality of electrodes 28 are provided, and in the case of the monopolar method, the electrodes are paired with the counter electrode plate attached to the opposite surface of the patient, so that there is no problem even if the electrodes 28 come into contact with each other. However, when the bipolar method is used, if the electrodes 28 come into contact with each other, a short circuit occurs, so that the electrodes 28 cannot be brought into contact with each other.
In this regard, according to this reference example, by providing the balloon 24 on the tip side of the spiral portion 21a and inflating it, the shape of the spiral portion 21a becomes a shape crushed by the compressive force of the renal artery RA. It is safe because the electrodes 28 do not come into contact with each other.

Next, an example will be described when the catheter and the catheter system according to the present invention are applied to a temperature sensor catheter arranged in the esophagus. In the figure, the same reference numerals are used for sites having the same functions as the ablation catheter system 1 described in the above-mentioned reference example, and the reference numerals in parentheses in the figure are used for sites that are not the same.

[Structure of the temperature sensor catheter of the first embodiment]
As shown in FIG. 8, the temperature sensor catheter 200 to which the catheter according to the present embodiment is applied is a catheter for measuring the temperature in the esophagus D, and is inserted into the esophagus D and adjacent to the esophagus D in the left atrium. An ablation technique is used for E, which is a catheter for measuring the temperature at multiple points on the inner wall of the esophagus D when the lesion tissue of the heart is heated.
In this embodiment, an example in which a temperature sensor catheter is used for measuring the temperature in the esophagus will be described, but the present invention is not limited to this, and in order to measure the temperature of adjacent organs during ablation other than the heart. It can also be used.

As shown in FIGS. 1 and 7, the temperature sensor catheter system 100 is roughly classified into a length in which a sensor 280 for measuring the temperature of a target tissue, which is an information detecting means for detecting information on tissues in the body, is arranged at the tip. A rectangular temperature sensor catheter 200 and a catheter guide 3 for accommodating the elongated temperature sensor catheter 200 and guiding the temperature sensor 280 attached to the tip of the temperature sensor catheter 200 to the target tissue are provided.

[Explanation of temperature sensor catheter 200]
As shown in FIGS. 1 and 7, the temperature sensor catheter 200 is wound in a coil shape which is a contact portion in contact with a plurality of locations on the inner wall of the biological lumen (esophagus D in this embodiment) as in the reference example. A long and hollow catheter body 21 having a formed spiral portion 21a formed on the distal end side, a catheter operating portion 23 for operating the catheter main body 21, and a holding means attached to the distal end of the spiral portion 21a. An inflatable balloon 24 and a hollow shaft portion 27 for supplying a fluid to the balloon 24 are provided.

Further, the temperature sensor catheter 200 is expanded and contracted by supplying fluid from the fluid supply device 40 to the balloon 24 via the shaft portion 27, and is detected by the temperature sensor 280 which is an information detecting means provided in the spiral portion 21a. The temperature is displayed on a monitor (not shown) mounted on the sensor power supply 250 via an electric wire passing through the inside of the catheter body 21, the catheter operating unit 23, and the cable 41.
The dimensions L1 to L5 differ depending on the size of the internal tube to be applied. For example, in the case of the esophagus D of this embodiment, L1 is 5 to 6 mm, L2 is 16 to 20 mm, L3 is 16 to 22 mm, and L4. Can be 16 to 18 mm, and L5 can be 18 to 22 mm.

Since the configuration of the catheter guide 3 is the same as that of the reference example, the description thereof will be omitted.

[Explanation of use and storage of temperature sensor catheter system 100]
Next, an example of how to use the temperature sensor catheter 200 according to this embodiment will be described with reference to FIGS. 4 and 6.
First, with the temperature sensor catheter 200 in which the balloon 24 is contracted housed inside the catheter guide 3, the catheter guide 3 is inserted into the esophagus D, and the tip of the catheter guide 3 is placed at an arbitrary position inside the esophagus D. To reach.
Next, from the state where the distal end side of the temperature sensor catheter 200 of FIG. 6 (a) is housed in the sheath 31, only the balloon 24 is projected into the esophagus D as shown in FIG. 6 (b). At this time, the balloon 24 may be inflated to the extent that it does not get caught in the esophagus D.

Then, as shown in FIG. 6C, by supplying the fluid to the balloon 24 via the shaft portion 27, the diameter L2 of the balloon 24 is expanded larger than the diameter L4 of the esophagus D, and the position of the balloon 24 is fixed. After that, the sheath 31 is pulled to project the spiral portion 21a as shown in FIG. 6 (d). At this time, since the spiral portion 21a is released from the compressive force in the radial direction by the inner wall of the sheath 31, it returns to the shape stored in advance, and the outer diameter L3 of the spiral portion 21a is slightly larger than the diameter L4 of the esophagus D. Due to its large size, it adheres to the inner wall of the esophagus D, and the temperature sensor 280 can be reliably brought into contact with the inner wall of the esophagus D.

After the temperature sensor 280 came into contact with the inner wall of the esophagus D, power was supplied from the sensor power supply 250 to the sensor 280 via an electric wire arranged inside the catheter body 21, and the temperature inside the esophagus D was measured and measured. The temperature is displayed on the monitor mounted on the sensor power supply 250. There are various methods for displaying the temperature. For example, by displaying the highest temperature among the plurality of sensors 280, when even one of the sensors 280 approaches a temperature that may cause damage to the esophagus, , Ablation to the heart can be stopped to avoid damage to the esophagus.
After the temperature measurement is completed, as shown in FIG. 6E, the outer diameter of the balloon 24 is expanded to a diameter L4 at the time of temperature measurement and a diameter L5 larger than the diameter L3 of the spiral portion 21a to further strengthen the balloon 24. In this state, the catheter body 21 is pulled toward the operation unit 23 and the sheath 31 is pushed out while being fixed to the inner wall of the esophagus D.

When the catheter body 21 is pulled while firmly fixing the balloon 24 to the inner wall of the esophagus D in this way, a gap is created between the esophagus D and the spiral portion 21a, and the spiral portion 21a is stretched to reduce its diameter. , Can be easily stored in the sheath 31. After that, the fluid in the balloon 24 is sucked through the shaft portion 27, stored in the sheath 31, and the temperature sensor catheter 200 and the catheter guide 3 are discharged to the outside of the body.

By arranging the balloon 24 at the tip of the spiral portion 21a and inflating it as described above, the spiral portion 21a can be easily maintained at a target position, and the compressive force due to the inner wall of the esophagus D is less likely to be received. Therefore, the shape of the spiral does not easily collapse, and the temperature sensor 280 can be reliably applied to the inner wall surface. Further, by inflating the balloon 24 to some extent, it is safe because the tip does not swing up, down, left and right, or get caught on the inner wall surface when protruding from the sheath 31 or moving in the esophagus D.
Further, since the spiral portion 21a can be reached to the affected portion in a state of being housed in the sheath 31, it is safe because it can be moved without damaging the esophagus.

If it is desired to change the measurement location from the location once arranged in the esophagus D, the balloon 24 and the spiral portion 21a may be stored in the sheath 31 again and then moved, and the balloon 24 slightly contacts the esophagus D. The spiral portion 21a may be moved in a state of being contracted to such an extent.

1 ablation catheter system, 2 ablation catheter,
3 catheter guide, 21 catheter body, 21a spiral part,
23 catheter operation part, 24 balloons, 27 shaft parts, 28 electrodes,
31 sheath, 31a bend, 100 temperature sensor catheter system,
200 temperature sensor catheter, 280 temperature sensor

Claims (6)

A long catheter body with spiral contact means formed on the distal end side to contact multiple points on the inner wall of the living lumen.
A catheter operating unit provided on the proximal end side for operating the catheter body,
An information detecting means, which is arranged in at least one of the spiral contact means and acquires information on the living luminal tissue,
A balloon that is arranged at the tip of the catheter body and can be expanded and contracted like a balloon by inflow and suction of fluid so as to hold the tip of the catheter body at a position away from the inner wall of the biological lumen.
A long shaft portion connected to the balloon and for driving the balloon,
With
The cartel body and the shaft portion are inserted into holes formed in the longitudinal direction of the catheter operating portion.
One of the catheter body and the shaft portion is fixed to the hole of the catheter operating portion, and the other is movable in the hole.
Shape the spiral contact means are pre-shaped memory as a threaded旋形shaped helix that Sessu a plurality of positions of the inner wall of the living body lumen, is deformed and applied an external force, the previously stored when the external force is removed A catheter characterized in that it is configured to return to. The catheter according to claim 1.
The catheter body, the catheter operation unit side of the spiral contact means, and a linear portion disposed in a straight line on a substantially central axis of the helical portion, the straight line on the distal end side substantially central axis of the spiral portion It has an extension part that is arranged so as to extend
A catheter characterized in that the balloon is attached to the extension portion.
The catheter according to claim 1 or 2, wherein the number of the information detecting means is 5 to 8 per spiral circumference of the spiral contact means. The catheter according to any one of claims 1 to 3 .
A catheter comprising a locking mechanism for fixing and releasing the catheter body or the shaft portion that can move in the hole to the catheter operating portion. The catheter according to any one of claims 1 to 4 .
A catheter characterized in that the information detecting means is a temperature sensor for measuring the temperature of the inner wall of a biological lumen. The catheter according to any one of claims 1 to 5 ,
A long and hollow sheath capable of accommodating the catheter body and the balloon from the distal end side and exposing them to the outside.
A catheter system characterized by comprising.

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