JPH0336364Y2 - - Google Patents

Description

[Detailed description of the invention] <Industrial field of application> The present invention relates to the improvement of catheter introduction guide devices used in angiography examinations, and is particularly concerned with the improvement of the catheter introduction guide device used in angiography examinations, and in particular, the invention relates to the improvement of catheter introduction guide devices used in angiography examinations. Selective treatment for the primary, secondary, and tertiary limbs of the aorta.
When inserting under super-selective operation, the degree of exposure of the guidewire tip to the catheter should be adjusted.
In addition to ensuring that it is always held constant and correct,
The operation force to push, pull, and even rotate the guide wire can be done reliably and safely without any loss.
It has been devised so that it can be applied smoothly.

<Prior art> When performing angiography based on DSA or other computer images, puncture holes made in the femoral artery or cubital artery are used to enter the aorta, and from the aorta into the primary, secondary, and tertiary limbs. It is necessary to introduce a catheter into the limb and inject the contrast medium through the catheter, but since the catheter is in the form of a long and flexible tube, it is pushed in from the hand and the tip is inserted into the aorta. It is impossible to introduce the catheter smoothly and safely while correctly changing the direction according to the bending of its various limbs. This becomes noticeable when superselectively introducing the catheter or when operating a very long and thin catheter over a long distance from the puncture hole in the cubital artery to various limbs of the aorta.

Therefore, conventionally, a guide wire whose tip is bent in an F-shape or J-shape is used as an aid for introducing the catheter, and after passing this into the hollow interior of the catheter, the guide wire is pushed. The catheter is guided to the target position by pulling, pulling, or even twisting the catheter.

<Problem that the invention aims to solve> However, the guide wire is usually about
For safety reasons, it is extremely thin (0.021 to 0.038 inches) and has a smooth surface, so it is difficult to grip it stably and firmly, especially if the surface is even slightly wet due to moisture or blood. This causes the fingertips of the operating hand to slip and cause the machine to spin idly.

Also, the length of the guy wire is usually 120 to 150 mm.
In particular, when used in conjunction with a catheter to be introduced into various limbs of the aorta from the puncture hole in the cubital artery, the guide wire must be extremely long and thin, so one person can insert the guide wire into the catheter. In order to perform the insertion work correctly, safely and quickly, a high level of skill and a wealth of experience are required.

As a result, during the operation of introducing the catheter into the blood vessel, the catheter often falls out of the wire, or conversely, the wire is passed through the catheter excessively and the catheter is forgotten to be pulled out from the blood vessel afterwards, or even worse. This can result in a wrong direction change, endangering the inner wall of the blood vessel.

In this regard, as well-known techniques for preventing the above-mentioned omissions, there are
No. 84441 has been proposed, but the former stopping member 1
2 and the latter fixing members 15 and 32 merely stop the catheter by positioning and fixing the longitudinal movement of the probe 10 and mandolin 13, which correspond to the catheter introduction guide wire. First, the direction of the catheter is not changed by applying a twisting force to the probe 10 or the mandolin 13.

In other words, the stopping member 12 and the fixing members 15, 3
2 rotates idly relative to the probe 10 and mandolin 13, and it is not possible to apply rotational operating force to the probe 10 and mandolin 13, so the above-mentioned problem still occurs.

<Means for Solving the Problems> In view of the above problems, the present invention has been proposed to apply not only the force for pushing and retracting the guide wire along its longitudinal direction (back and forth direction), but also its rotation. In order to be able to apply the operating force (rotational torque) appropriately, we used a straight angiography catheter that does not have a tendency to bend at its tip due to its structure, and an internal structure of the catheter as an introduction guide device for the angiography catheter. A catheter introduction guide wire is inserted into the catheter and has a J-shaped bending tendency that can be restored and deformed only at the distal end. An operating tool that serves as a grip handle for applying rotational operating force and forward/backward operating force; and an operating tool that is elastically fitted to the proximal portion of the guide wire in order to keep the operating tool and the catheter from coming off the guide wire. a hollow truncated cone-shaped holding tube in which a plurality of grooves that can be contracted and deformed in diameter are cut in a radially symmetrical distribution, and a conical shape of the holding tube. It is an assembly with a sheath tube that is screwed together so that it can move forward and backward along the surface, and when the holding tube is fitted into the proximal part of the guide wire and the sheath tube is tightened and rotated, the holding tube is tightened and rotated. It is characterized in that the holding tube is crimped and integrated with the surface of the guide wire without relative slippage or displacement due to the contraction and deformation action of the grooves.

<Example> Hereinafter, the specific configuration of the present invention will be explained based on the illustrated example. In FIGS. 1 and 2, 10 is a straight angiography having no inherent bent shape (curvature) at the distal end. The catheter 11 is a guide wire for catheter introduction that is longer than the catheter 10 and has moderate flexibility, and only its tip 11a is highly flexible and always has a unique J-shaped bending shape (curving tendency). It is beginning to be restored and transformed. And the guide wire 11
The catheter 10 is inserted into the hollow interior of the catheter 10 so as to be freely inserted and removed, and the catheter 10 is inserted into the aorta B through the puncture hole 12 made in the femoral artery or the cubital artery A, and further into the aorta B, as shown in FIG. 11, which will be described later. Various branches C and D derived from the aorta B
We will guide you through the smooth introduction.

In that case, connect the guide wire 11 to the catheter 1.
0, by fitting the positioning stopper 13 to the straight proximal portion 11b of the wire 11, the catheter 10 is prevented from accidentally falling off from the wire 11, and is exposed from the tip of the catheter 10. The length L of the tip of the wire 11 is always kept constant.

For this purpose, the stopper 13 is made of an elastic material such as rubber or synthetic resin and has an O-shaped or C-shaped cross section with an outer diameter W larger than the diameter S1 of the catheter 10, as shown in FIGS. 3 to 5. The wire 11 is made of wire 11, and is adapted to be fitted onto the wire 11 in a compressive manner. That stopper 1
It is also possible to set the surface of No. 3 to have an overall spherical shape as shown in FIG.

In other words, the positioning stopper 13 is attached to the proximal portion 11b of the wire 11, and there is no risk of the positioning stopper 13 being accidentally displaced in the natural state of fitting. By performing a sliding operation, the fitting position can also be changed. This means that the wire 11
The purpose is to make it possible to adjust the exposed length L of the tip portion 11a. Further, by maintaining the pressure state with the wire 11, the surface of the wire 11 is not damaged.

Moreover, the positioning stopper 13 is located at the seventh to
11 As shown in Figure 11, the proximal part 1 of the guide wire 11
It is also designed to prevent the operating tool G fitted into 1b from falling off.

The operating tool G functions as a grip handle for operating the guide wire 11, and as is clear from FIGS. It consists of an assembly with a sheath tube 15 that is freely screwed together, and when the sheath tube 15 is tightened and rotated as shown in FIGS. 9 and 10, the holding tube 14 acts to close from its split groove 16. By deforming into a contracted state with the diameter size S2, the wire 11 is strongly crimped and integrated with the surface of the wire 11 so as to prevent relative slippage and displacement.

That is, the holding tube 14 is shaped like a truncated cone with a central opening O, and the male thread 14a carved in the conical surface is carved in the corresponding conical opening surface of the sheath tube 15. In addition to being screwed together with the female thread 15a, the holding tube 14 also has a plurality of split grooves 16 for diameter contraction by a certain length from the tip and arranged in a radially symmetrical distribution state. Because of its closing action, the guide wire 1
It sticks evenly and stably to the entire surface of 1.

Therefore, as shown in FIG. 11, while holding the operating tool G as a so-called grip handle, it is possible to reliably apply forward/backward operating force to push or pull the wire 11 from the hand portion 11b, as well as twisting/rotating operating force to change direction. In addition, the distal end portion 11a can be placed along the curve of the blood vessel and can be introduced accurately, smoothly, and safely without any loss.

On the other hand, when the sheath tube 15 is rotated in the direction of loosening it as shown in FIGS. can freely rotate freely and slide forward and backward, and therefore the fitting position of the holding tube 14 with respect to the wire 11 can also be changed.

The outer diameter W of the positioning stopper 13 is set in advance to be larger than the diameter S2 of the holding tube 14 forming the operating tool G. Therefore, after fitting the operating tool G to the straight proximal portion 11b of the wire 11, by further fitting the stopper 13 from the proximal side (backward) as described above, it is possible to prevent the device from accidentally coming off. .

<Function> In the present invention, a longer guide wire 11 is inserted and set into the vascular catheter 10,
The bent tip part 11a is appropriately exposed from the tip part of the catheter 10, and the operating tool G and the stopper 13 are sequentially fitted from behind to the exposed proximal part 11b of the wire 11. The direction of the tip portion 11a of is changed as follows.

That is, with respect to the guide wire 11 passing through the center opening O of the holding tube 14 in the operating tool G,
Similarly, the holding tube 14 is manually operated by rotating or pushing the sheath tube 15 of the operating tool G to slide it.
is bitten and crimped onto the surface of the wire 11, and then, while holding the operating tool G as a grip handle, a twisting and turning operating force is applied to the wire 11 from its hand portion 11b.

Then, since the guide wire 11 is integrated with the operating tool G, its tip 11a
The direction of the aorta B is changed reliably without any loss, and it is smoothly and safely introduced into the aorta B and its various limbs C and D, as shown in FIG. As a result, the catheter 10 can also be advanced correctly under the guiding action of the wire 11, and after that, it is only necessary to pull out the guide wire 11 and pour the contrast medium into the remaining catheter 10. .

<Effects of the Invention> As described above, the present invention serves as an introduction guide device for an angiography catheter, and includes a straight angiography catheter 10 that does not have a bending tendency at the distal end due to its structure, and a straight angiography catheter 10 that is inserted into the catheter 10. , and a catheter introduction guide wire 11 having a J-shaped bending tendency that can be restored and deformed only at the distal end portion 11a.
and an operating tool G that becomes a grip handle for applying a twisting rotation operating force and an advancing/retracting operating force to the guide wire 11 by being fitted into the straight proximal portion 11b of the guide wire 11.
and a positioning stopper 13 that is elastically fitted onto the proximal portion 11b of the guide wire 11 in order to keep the operating tool G and the catheter 10 from coming off the guide wire 11. , a hollow truncated cone-shaped holding tube 14 in which a plurality of contraction-deformable split grooves 16 having a diameter size S2 are cut in a radially symmetrical distribution state, and a conical surface of the holding tube 14 along the front-rear direction. It is an assembly with a sheath tube 15 screwed together so that it can move forward and backward, and when the holding tube 14 is fitted into the proximal portion 11b of the guide wire 11 and the sheath tube 15 is tightened and rotated, the holding tube 15 is held. Because the tube 14 is designed to be crimped and integrated with the surface of the guide wire 11 by the contraction and deformation of the groove 16 without relative slippage or displacement, the problem of the prior art described at the beginning can be overcome. It has a completely reversible effect.

That is, in the case of the present invention, the operating tool G is fitted to the introduction guide wire 11 of the catheter 10, and the operating tool G is particularly comprised of a truncated cone-shaped holding tube 14 and a conical portion of the holding tube 14. It consists of an assembly with a sheath pipe 15 screwed to the surface, and the sheath pipe 15
When the holding tube 14 is tightened and rotated, the holding tube 14 closes from its radially symmetrically distributed grooves 16,
As the caliber size S2 shrinks and deforms, it is crimped and integrated with the entire surface of the guide wire 11 as if tightening the neck, and the catheter 10 is strongly bitten against relative slippage and displacement. Even if the guide wire 11 for introduction into the blood vessel is thin and long, it is possible to maintain the forward and backward operation force and the twisting and rotation operation force (rotation) without any loss up to the tip 11a. torque) can be applied, thereby making it possible to accurately redirect the catheter 10 to the target position in the blood vessel.

In that case, the sheath tube 15 is tightened and moved along the conical surface of the holding tube 14, so that the split groove 16 acts to close, and both tubes 1
4 and 15 are in a screwed state between the male screw 14a and the female screw 15a provided on the conical surface, so even though they are tightened with a smooth diameter contraction effect,
After tightening, there is no risk of it loosening accidentally, and therefore it can be said to be extremely effective in the rotation operation for changing the direction.

In addition, since the guide wire 11 of the present invention has a J-shaped bend only at its distal end 11a, and the proximal portion 11b is formed straight, the operating tool G and the stopper can be connected from the proximal portion 11b. 13 can be fitted sequentially and extremely easily, and this effect becomes more pronounced as the guide wire 11 becomes longer.

Furthermore, if the sheath tube 15 is rotated in the direction of loosening it with respect to the holding tube 14, the crimped state with the guide wire 11 is released, so the fitting position of the operating tool G can be changed freely. It can also be adjusted. Even at this time, since the stopper 13 is fitted onto the proximal portion 11b of the guide wire 11 in a resilient manner, there is no risk of the operating tool G accidentally falling out from the proximal portion 11b of the guide wire 11.

In this sense, anyone can perform the procedure over long distances from the puncture hole 12 of the cubital artery A to the various limbs C and D of the aorta B without requiring advanced techniques or extensive experience.
The straight catheter 10 can be introduced accurately, and the target location of the blood vessel can be efficiently contrasted.

[Brief explanation of the drawing]

Figure 1 is an overall schematic side view showing the state of insertion of an angiography catheter and its introduction guide wire, Figure 2 is a side cross-sectional view that is a partial enlargement of Figure 1, and Figure 3 is an extracted positioning stopper. Figure 4 is a sectional view taken along line 4-4 in Figure 3, Figure 5 is a front view shown as
The figure is a front view of a modified example corresponding to FIG. 3, FIG. 6 is a sectional view of another modified example corresponding to FIG. 4, and FIG. , FIG. 8 is an enlarged sectional view taken along line 8-8 in FIG. 7, FIG. 9 is a side sectional view corresponding to FIG. FIG. 11, an enlarged sectional view taken along the line -10, is an explanatory view showing the action of introducing the operating tool into the blood vessel. DESCRIPTION OF SYMBOLS 10...Angiography catheter, 11...Introducing guide wire, 11a...Tip part, 11b...
Hand part, 13... Positioning stopper, 14...
Holding tube, 15... Sheath tube, 16... Division groove, G... Operation tool, S1, S2... Bore size.

Claims (1)

[Claims for Utility Model Registration] A straight angiography catheter 10 that has no bending tendency at its distal end, and a J-shaped bending tendency that can be restored and deformed only at the distal end 11a, which is inserted into the catheter 10. Provided catheter introduction guide wire 11
and an operating tool G that becomes a grip handle for applying a twisting rotation operating force and an advancing/retracting operating force to the guide wire 11 by being fitted into the straight proximal portion 11b of the guide wire 11.
and a positioning stopper 13 that is elastically fitted onto the proximal portion 11b of the guide wire 11 in order to keep the operating tool G and the catheter 10 from coming off the guide wire 11. , a hollow truncated conical holding tube 14 in which a plurality of contractile and deformable split grooves 16 having a diameter S2 are cut in a radially symmetrical distribution state, and a holding tube 14 extending along the conical surface of the holding tube 14 in the front-rear direction. It is an assembly with a sheath tube 15 which is screwed together so that it can move forward and backward, and when the holding tube 14 is fitted into the hand part lead 11b of the guide wire 11 and the sheath tube 15 is tightened and rotated, the holding tube 14 is attached. The holding pipe 14 is connected to the above-mentioned split groove 1.
6. An angiography catheter introduction guide device, characterized in that it is crimped and integrated with the surface of a guide wire 11 by the contraction and deformation action of No. 6 so as to prevent relative slippage and positional displacement.