Source: https://patents.google.com/patent/JP4112911B2/en
Timestamp: 2019-11-22 10:57:10
Document Index: 778024335

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JP4112911B2 - Intravascular foreign matter removal wire and medical device - Google Patents
Intravascular foreign matter removal wire and medical device Download PDF
JP4112911B2
JP4112911B2 JP2002179090A JP2002179090A JP4112911B2 JP 4112911 B2 JP4112911 B2 JP 4112911B2 JP 2002179090 A JP2002179090 A JP 2002179090A JP 2002179090 A JP2002179090 A JP 2002179090A JP 4112911 B2 JP4112911 B2 JP 4112911B2
JP2002179090A
JP2004016668A (en
圭司 岡田
昌宏 竹内
武司 金丸
隆 金子
2002-06-19 Application filed by テルモ株式会社, マルホ発條工業株式会社 filed Critical テルモ株式会社
2002-06-19 Priority to JP2002179090A priority Critical patent/JP4112911B2/en
2004-01-22 Publication of JP2004016668A publication Critical patent/JP2004016668A/en
2008-07-02 Publication of JP4112911B2 publication Critical patent/JP4112911B2/en
The present invention relates to an intravascular foreign matter removing wire and a medical instrument for removing an embolus in a blood vessel.
According to the Ministry of Health, Labor and Welfare's demographic statistics, the first cause of death in Japan is cancer, the second is heart disease, the third is stroke, and deaths and sequelae are especially urgent. It has become.
In recent years, thrombolytic therapy using a thrombolytic agent has been developed for treating cerebral infarction in the acute phase in the treatment of stroke, and its therapeutic effect has been raised, but its limitations are also pointed out. In other words, from the experience of doctors, thrombolytic agents require a long time for thrombolysis, smaller thrombi fly further to form new emboli sites, and there are thrombi that do not dissolve with thrombolytic agents. It recognized.
In the case of cerebral infarction, if the blood flow can be resumed within 3 hours after the onset of the infarction, not only will the survival rate increase, but it has been proved in the United States and Europe that it can be inserted into the cerebral blood vessels and directly takes a thrombus. There is a strong demand for the development of medical devices that can be used.
Conventionally, as a device for removing a thrombus or a foreign substance in a blood vessel, a Fogarty catheter such as Fogarty US Pat. No. 3,435,826 or an inflatable thrombectomy balloon, a water flow type thrombus suction device, US Pat. No. 4,842 No. 579, an atheroma cutter has been put into practical use. These have a complicated structure and a large diameter and require a single guide catheter or a thick guide catheter, and those that can be inserted into a microcatheter have not been put to practical use.
For example, a resection catheter having a wire basket, which is typically disclosed in Japanese Patent Laid-Open No. 5-137729 (EP472368), has an acute angle portion in a part of a wire cage for resecting tissue from the inner wall of a blood vessel. Since it has the wire guide which supports a wire cage in the center, it has the fault that it cannot essentially make the magnitude | size below this wire guide. The wire guide is indispensable for rotating the wire cage and performing tissue excision, and therefore it is impossible to make the diameter smaller than that of the wire guide.
In Japanese Patent No. 2620881 (US Pat. No. 4,890,611), an intra-arterial extraction device having a wire loop is disclosed, but it is designed for scraping off arteriosclerotic deposits, and it is not possible to grasp a thrombus closing a blood vessel. Structurally difficult. The central wire and the spiral loop cannot form a large grasping space, but only provide a narrow space for grasping the scraped tissue. That is, the central wire gets in the way and the thrombus is hard to be stored in the spiral loop. Only a small amount of ablated tissue can be sandwiched between the central wire and the helical loop.
Japanese National Patent Publication No. 8-509411 (WO95 / 31149) discloses a single-loop medical recovery tool composed of a snare coil. This is used for rearranging or taking out a foreign object with a single loop having an adjustable diameter. Although the structure is simple and the diameter can be reduced, the type conventionally known as a single-loop gooseneck snare captures and grips foreign objects by pinching the target foreign object in the wire ring and tightening the loop. Yes, it is suitable for capturing slender rod-like objects, but it is difficult to slip and grasp foreign substances such as blood clots. This is equivalent to fixing a single wire loop on an egg, and in principle it can be used, but there is a problem that it is difficult to grasp a foreign body unless it is a very skilled operator.
Japanese Unexamined Patent Publication No. 2000-126303 discloses a multifunctional wire for blood vessel treatment that can be inserted into a microcatheter. This is a type that has been conventionally referred to as a basket cannula, which forms a flange that can be contracted and expanded by a wire, and is a type in which a conventional basket cannula has been made thinner and more refined. In this case, since it is integrally provided with a huge working part that is radially dispersed and concentrated and fixed at the convergence point, the degree of freedom of the structural thin line is deprived, and it is inconvenient to put a thrombus in the cage It is feared to become.
In addition, Japanese National Publication No. 7-504595 (WO94 / 00178) discloses an inflatable wire mesh attached to the distal end of the catheter. This is because of the structure in which the wire mesh is attached to the distal end of the catheter. There is a problem that it is difficult to meridize below the catheter.
Japanese Patent Application Laid-Open No. 7-171156 (US Pat. No. 5,370,653) proposes an apparatus that takes a thrombus with a wire brush. This is useful for entwining fibrin soft occlusions such as glue, but it is difficult to remove hard thrombi etc. that are embolizing blood vessels, rather, in the case of fibrin soft occlusions, Releasing with a solubilizing agent such as streptokinase or urokinase is more suitable for removal than forcibly removing it.
On the other hand, Pierre Govern et al. Of UCLA and others are developing a wire having a screw structure that can be inserted into a microcatheter as a method for removing a hard clot that is blocked. The screw part is screwed into the thrombus with a cork borer, and the thrombus is recovered by pulling out the wine cork stopper. It has the problem of being easy to use and has not yet been put into practical use.
Japanese Patent Publication No. 4-47574 (US Pat. No. 5,933,196) proposes a wire basket type medical retriever having a coaxial central sheath. This is characterized by forming a bulbous foreign matter capture space with a large number of wires, but it is essential to have a shaft sheath at the center, and the shaft sheath can be a hindrance and provide a large capture space. Have the problem of not.
An object of the present invention is to provide a simple structure that is advantageous for reducing the diameter in a reduced diameter state, and that can securely capture and remove an embolus in a blood vessel without damaging the blood vessel. An object of the present invention is to provide a foreign substance removing wire and a medical instrument.
Such purposes are as follows (1) to(19)This is achieved by the present invention.
(1) an elongated wire body having flexibility;
At least two branch wire portions branched from the tip of the wire body;
Having at least three filament parts installed between the branch wire parts,
The branching wire part and the filament part form a capturing part including a foreign substance capturing space for capturing a foreign substance in a blood vessel,
At the tip of the wire body, at least three loop wires extending in a loop shape from the tip are formed,
These loop wires are separated from each other at least at the tip side,The distance increases in a direction perpendicular to the central axis of the wire body in a side view.Arranged side by side, constituting the filament part, and the proximal end part constituting the branch wire part, the loop wire excluding the loop wire located in the center of them has radiopacity The loop wire located at the center is located on a plane passing through the central axis of the wire body, and is wound around at least a part of the outer periphery of the wire and the wire that has no radiopacity. It is made up of a coil that has been rotated and has radiopacity, and functions as a radiopaque contrast unit,The distance between the distal-side portions of each loop wire is narrowed, and the distance between the proximal-side portions is narrowed. It can take a diameter expansion state that expands eachAn intravascular foreign matter removing wire characterized by the above.
(2)The blood vessel according to (1), wherein the trapping unit is configured to store the foreign matter in the foreign matter trapping space from either side in a direction in which the filament portions are arranged when capturing the foreign matter. Internal foreign matter removal wire.
(3)The intravascular foreign matter removing wire according to (1) or (2) above, wherein a second contrast portion having radiopacity is provided at a distal end portion of the wire body.
(4) The contrast portion is at least near the base end portion and the tip end portion of the foreign substance capturing space.(1) to (3) aboveThe wire for removing a foreign substance in a blood vessel according to any one of the above.
(5) The contrast section has a core material made of a material having radiopacity.(1) to (4) aboveThe wire for removing a foreign substance in a blood vessel according to any one of the above.
(6) The contrast section is composed of a plurality of contrast sections, and the plurality of contrast sections are scattered in the longitudinal direction of the capturing section.(1) to (5) aboveThe wire for removing a foreign substance in a blood vessel according to any one of the above.
(7)The intravascular foreign body according to any one of the above (1) to (6), wherein one base end side portion and the other base end side portion of the plurality of loop wires are respectively twisted together. Removal wire.
(8)One base end side portion and the other base end side portion of the plurality of loop wires are respectively bundled for removing foreign matter in a blood vessel according to any one of the above (1) to (6) Wire.
(9)Each said branch wire part is a wire for a foreign substance removal in a blood vessel as described in said (7) or (8) whose rigidity is higher than each said filament part, respectively.
(10) All or a part of the plurality of filament portions are inclined so that the distance from the extension line of the central axis of the wire body increases in the distal direction.(1) to (9) aboveThe wire for removing a foreign substance in a blood vessel according to any one of the above.
(11) The inclined filament part has a bent part that bends so that the inclination angle becomes larger in the middle thereof.Above (10)The wire for removing a foreign substance in a blood vessel according to 1.
(12) having a net-like body provided to close a gap between the filament parts(1) to (11) aboveThe wire for removing a foreign substance in a blood vessel according to any one of the above.
(13) The mesh body has a bag shape and is fixed to a tip of the wire body,
The branch wire portion and / or the filament portion has a function of maintaining the shape of the mesh body.Above (12)The wire for removing a foreign substance in a blood vessel according to 1.
(14) having at least one second filament portion installed between the filament portions(1) to (13) aboveThe wire for removing a foreign substance in a blood vessel according to any one of the above.
(15) A plurality of the second filament parts are arranged in parallel to each other.Above (14)The wire for removing a foreign substance in a blood vessel according to 1.
(16) Near the distal end of the wire body, a radiopaque contrast portion and a non-contrast portion that is adjacent to the proximal end side of the contrast portion and does not have radiopacity are formed.(1) to (15) aboveThe wire for removing a foreign substance in a blood vessel according to any one of the above.
(17) At least a part of the branch wire portion and the filament portion is made of an alloy that exhibits superelasticity in vivo.(1) to (16) aboveThe wire for removing a foreign substance in a blood vessel according to any one of the above.
(18)(1) to (17) aboveA medical device comprising the intravascular foreign matter removing wire according to any one of the above and a catheter having a lumen capable of accommodating the intravascular foreign matter removing wire.
(19) When the wire body is retracted in the lumen from the state in which the wire body is housed in the lumen and the branch wire portion is protruded from the distal end opening of the lumen, the branch wire portion is The space between the branch wire portions is reduced by contacting the tip opening.Above (18)Medical device as described in.
DETAILED DESCRIPTION OF THE INVENTION Hereinafter, the intravascular foreign matter removing wire and medical device of the present invention will be described in detail based on preferred embodiments shown in the accompanying drawings.
FIGS. 1 and 2 are a plan view and a side view, respectively, showing a first embodiment of the intravascular foreign matter removing wire of the present invention, and FIG. 3 is a capture in the intravascular foreign matter removing wire shown in FIGS. FIG. 4 to FIG. 7 are views for explaining step by step how to use the intravascular foreign matter removing wire shown in FIGS. 1 and 2, respectively.
In the following description, the right side in FIGS. 1 to 7 is referred to as “base end”, and the left side is referred to as “tip”.
The intravascular foreign matter removing wire 1A shown in FIGS. 1 to 3 captures and removes foreign matters (hereinafter referred to as “emboli”) that cause embolization such as blood clots and blood clots in blood vessels. .
This intravascular foreign matter removing wire 1 </ b> A has a long wire main body 2 and a capturing portion 3 provided at the tip of the wire main body 2 and capable of capturing the embolus 200 in the blood vessel 100. Hereinafter, the configuration of each unit will be described.
The wire body 2 has appropriate rigidity and elasticity (flexibility) over the entire length. The structure of the wire main body 2 is not particularly limited. For example, a single wire, a bundle of a plurality of wires, a hollow shape, a multilayer structure, a core and a coil wound around the outer periphery thereof are used. It may have what it has, what combined these, etc.
Moreover, it does not specifically limit as a constituent material of the wire main body 2, Various metal materials, various plastics, etc. can be used individually or in combination.
As the wire body 2, a commercially available (existing) guide wire (a wire that guides a catheter or the like to a target site in a living body) or a known guide wire can be used. For example, a plastic type guide wire (for example, “Radio Focus Guide Wire” manufactured by Terumo Co., Ltd.) using a taper wire of a super elastic alloy as a core wire, or a super elastic material described in Tokuhei Hei 9-508538 A guide wire having a far end can be suitably used.
The preferred value of the length of the wire body 2 varies depending on the case of the position and thickness of the blood vessel to be applied, but is usually preferably about 500 to 4000 mm, more preferably about 1500 to 2200 mm.
Further, the wire body 2 is located on the proximal end side, the first part that is relatively hard, the third part that is located on the distal end side and is relatively flexible, the first part, and the third part. And a second portion where the flexibility changes. In other words, the wire body 2 is preferably such that the rigidity (bending rigidity, torsional rigidity, etc.) gradually decreases from the proximal end toward the distal end. As a result, the operation at hand is reliably transmitted to the distal end, and the traveling performance in the blood vessel and the operability at the bent portion are excellent, and the flexibility of the distal end can be improved and the blood vessel can be prevented from being damaged. . That is, it is possible to ensure higher safety while maintaining the torque transmission performance, pushability (pushability), and kink resistance (bending resistance) of the wire body 2.
The preferable value of the outer diameter (thickness) of the wire body 2 varies depending on the case of the position and thickness of the blood vessel to be applied, but it is usually preferable that the average outer diameter is 0.1 to 2.0 mm. 0.25 to 0.9 mm is more preferable.
In particular, in the case of the intravascular foreign matter removing wire 1A used by being inserted into a microcatheter, the average outer diameter of the wire body 2 is about 0.1 to 0.53 mm (0.004 to 0.021 inches). It is preferably about 0.25 to 0.46 mm (0.010 to 0.018 inch).
Here, the microcatheter means an outer diameter of 4 Fr. (French) refers to a catheter for intravascular treatment diagnosis. It is clearly distinguished from the above angiographic catheters, guiding catheters and the like. 4Fr. = About 1.33 mm.
Needless to say, the present invention is not limited to the one adapted to the microcatheter, but can be applied to a foreign body collecting unit for collecting a large blood vessel adapted to a contrast catheter or a guiding catheter, for example.
A coating layer that reduces frictional resistance with the inner surface of the catheter 8 may be provided on the outer surface (surface) of the wire body 2. Thereby, insertion / extraction with respect to the catheter 8 can be performed more smoothly. Examples of the coating layer include a coating layer (Teflon coating) of a fluororesin such as polytetrafluoroethylene, and a hydrophilic polymer coating having lubricity when wet.
At the distal end side of such a wire body 2, a capturing part 3 is provided. In the natural state, the capturing unit 3 is in an expanded (open) state as shown in FIGS. 1 to 3 (this state is hereinafter referred to as an “expanded state”). In this expanded diameter state, a foreign substance capturing space 31 capable of capturing the embolus 200 in the blood vessel 100 is formed inside the capturing unit 3.
The capturing part 3 can be deformed from an expanded state to a state in which it is folded to a size (width) that can be accommodated in the catheter 8 (this state is hereinafter referred to as a “reduced diameter state”). ing.
Such a capturing part 3 can be deformed (restored) from the reduced diameter state to the expanded diameter state by its own elasticity.
In the following, unless otherwise specified, the description of the shape and size of the capturing portion 3 is in an expanded state (natural state).
As shown in FIGS. 1 to 3, the capture portion 3 includes two branch wire portions 4 a and 4 b extending so as to branch from the tip of the wire body 2 (so as to be separated from each other), and a branch wire portion. It consists of three filament parts 51, 52, 53 installed between 4a and the branch wire part 4b.
The proximal end portions of the branch wire portions 4 a and 4 b (loop wires 61, 62, and 63) are fixed (fixed) to the distal end portion of the wire body 2, respectively. The fixing method is not particularly limited. For example, the base end portions of the branch wire portions 4a and 4b are respectively knitted (wrapped) to the tip end portion of the wire body 2, brazed, welded, and bonded with an adhesive. Can be fixed.
In the present embodiment, a coil 21 that covers a fixing portion (a brazing portion) of the branch wire portions 4 a and 4 b with respect to the wire body 2 is provided at the distal end portion of the wire body 2. The outer surface of the coil 21 is smooth, and thereby higher safety is obtained.
Three filament parts 51, 52, and 53 that form a line are provided between the tip of the branch wire part 4 a and the tip of the branch wire part 4 b. These filament parts 51, 52, and 53 connect the tip part of the branch wire part 4a and the tip part of the branch wire part 4b, respectively, curving so that the center part protrudes to the tip side. In other words, the branch wire portions 4a and 4b and the filament portions 51, 52, and 53 are arranged so as to draw a substantially ellipse (oval) in a plan view shown in FIG. In the present embodiment, since the tips of the filament parts 51, 52, 53 are smoothly curved, damage to the inner wall of the blood vessel 100 can be prevented, and higher safety can be obtained. It is done.
As shown in FIG. 2, the filament part 51 is located on a plane (a plane perpendicular to the paper surface of FIG. 2) that passes through an extension of the central axis of the wire body 2. That is, the filament part 51 appears to substantially overlap the extension of the central axis of the wire body 2 in a side view shown in FIG.
Moreover, the filament parts 52 and 53 are inclined so that the distance from the extension line of the central axis of the wire body 2 increases in the distal direction. That is, in the side view shown in FIG. 2, the filament portion 52 is inclined to the left and the filament portion 53 is inclined to the left.
In the capturing part 3, a foreign substance capturing space 31 for capturing the embolus 200 is formed so as to be surrounded by the branch wire parts 4 a and 4 b and the filament parts 51, 52 and 53. In other words, the filament-shaped foreign substance holding part is formed by the filament parts 51, 52 and 53. As shown in FIG. 7, the intravascular foreign matter removing wire 1 </ b> A captures the embolus 200 in the foreign matter capturing space 31. In such a capture part 3, the embolus 200 once captured does not fall off (detach), and the embolus 200 can be reliably removed.
In the present embodiment, the embedding object 200 can be captured (accommodated) in the foreign substance capturing space 31 from the upper side or the lower side in FIG. Thereby, the embolus 200 can be more reliably captured by an easier operation.
In the present embodiment, the branch wire portions 4a, 4b and the filament portions 51, 52, 53 are formed from three loop wires 61, 62, 63 provided in a loop shape (annular) from the tip of the wire body 2. Is formed. Each of the loop wires 61, 62, and 63 is provided so as to extend from the distal end of the wire body 2 in the distal end direction, draw a loop, bend back in the proximal direction, and return to the distal end of the wire body 2.
As shown in FIG. 3, one base end portion of each of the loop wires 61, 62, 63 is twisted together to integrally form a stranded portion, and this stranded portion forms the branch wire portion 4a. It is composed. Further, the other proximal end portions of the loop wires 61, 62, 63 are twisted together to form a stranded wire portion, and this stranded wire portion constitutes the branch wire portion 4b. Since the branch wire portions 4a and 4b are formed of stranded wires, the shape of the capturing portion 3 is prevented from being deformed more effectively, and the embolus 200 can be captured more easily and reliably.
In addition, the loop wires 61, 62, and 63 constituting the branch wire portions 4a and 4b do not have to be twisted, but may be simply assembled (bundled).
The portions on the distal end side of the loop wires 61, 62, 63 are separated from each other to form filament portions 51, 52, 53, respectively. That is, in the side view shown in FIG. 2, each of the loop wires 62 and 63 is bent (or curved) toward the outside (upper and lower in FIG. 2). The portions form filament portions 52 and 53, respectively.
In the present embodiment, three filament parts (loop wires) are installed, but the number of installed filaments is not particularly limited, and is preferably 2-20, more preferably 4-10. preferable.
In the present embodiment, the branch wire portions 4a, 4b and the filament portions 51, 52, 53 are formed by continuous loop wires 61, 62, 63. The part and the filament part may be formed by connecting (connecting) separate parts. In that case, any method may be used for fixing the filament portion to the branch wire portion, and examples thereof include a method such as brazing, welding, and adhesion using an adhesive. Further, when the branch wire portion is composed of a stranded wire formed by twisting a plurality of linear bodies, the fixing portion of the filament portion with respect to the branch wire portion is fixed in a state of being sandwiched in the stranded wire portion. It may be. Thereby, a filament part and a branch wire part can be connected firmly and reliably by a simple method.
As a constituent material (material) of such a capturing part 3 (loop wires 61, 62, 63), for example, stainless steel (SUS304, etc.), β titanium steel, Co—Cr alloy, piano wire, platinum-iridium alloy ( Pt90/ Ir10, Pt80/ Ir20Etc.) Other metal materials such as other noble metal spring alloys, alloys having spring properties such as nickel titanium alloys, and mono-multi fibers made of resin are preferable.
Among the various metal materials, as the constituent material of the capturing part 3, an alloy exhibiting superelasticity in vivo is particularly preferable. As a result, the deformation (displacement) of the capturing portion 3 from the reduced diameter state to the enlarged diameter state can be caused more reliably, and a more accurate restored shape can be obtained in the expanded diameter state.
Here, an alloy exhibiting superelasticity in a living body is almost in its original shape even if it is deformed (bent, pulled, compressed) to a region where normal metal undergoes compositional deformation at least at a living body temperature (around 37 ° C.). It has a property of recovering and is also called a shape memory alloy, a super elastic alloy, or the like.
Although it does not specifically limit as a shape memory alloy and a superelastic alloy, For example, a titanium type (Ti-Ni, Ti-Pd, Ti-Nb-Sn, etc.) and a copper type alloy are preferable. The preferred composition includes, for example, about 30-52 atomic percent titanium, remaining nickel, and 10 atomic percent or less of one or more additional alloy elements. Although it does not specifically limit as said additional alloy element, For example, iron, cobalt, platinum, palladium, or chromium can each be selected from the group which consists of 3 atomic% or less, each of copper or vanadium 10 atomic% or less.
Superelastic alloys are those that are austenitic at normal temperature or body temperature (around 37 ° C.) and transform to martensite when subjected to stress (stress-induced austenite-martensitic phase transformation near body temperature) Is particularly preferred.
In such a capturing section 3, the loop wires 62 and 63 are made of a material that does not have radiopacity (X-ray opaqueness) and do not have X-ray contrast properties.
On the other hand, the loop wire 61 has X-ray contrast properties. Therefore, the filament part 51 comprised by the part of the front end side of this loop wire 61, and the branch wire parts 4a and 4b comprised by the strand wire containing the loop wire 61 also have X-ray contrast property. That is, in the capturing unit 3, the filament part 51 and the branch wire parts 4a and 4b are contrast parts having X-ray contrast properties, and the filament parts 52 and 53 do not have X-ray contrast properties. In other words, in the capturing unit 3, the contrast unit is located at the branch wire units 4 a and 4 b and the filament unit 51 located at the center of the three filament units.
In the present embodiment, the loop wire 61 uses a wire made of the same material as the loop wires 62 and 63 as a core, and a coil (not shown) made of a material having radiopacity on the outer periphery of the core. Z) is wound (wound) so that it has radiopacity. With such a configuration, the loop wire 61 can be made more elastic (superelastic) than the case where the entire loop wire 61 is made of a material having radiopaque properties. Further improvement of the shape restoring property from the reduced diameter state to the expanded diameter state can be achieved.
The material having radiopacity (X-ray contrast property) is not particularly limited, but for example, gold, platinum (platinum), platinum-iridium alloy, tungsten, tantalum, palladium, lead, silver, or these Examples include alloys and compounds containing at least one of them. In the present invention, the contrast portion may be formed by forming a thin film of a material having radiopacity on the surface of a core material having no radiopacity, for example, by plating.
As shown in FIG. 2, the branch wire portions 4 a and 4 b and the filament portion 51, which are contrast portions, extend in the longitudinal direction of the capturing portion 3 (longitudinal direction of the wire body 2) and It is on a plane passing through the central axis (on a plane perpendicular to the plane of FIG. 2) or in the vicinity thereof. In the intravascular foreign matter removing wire 1A, since the contrast portion is in this position, the capturing state of the embolus 200 in the capturing portion 3 can be easily confirmed under fluoroscopy such as X-rays. That is, when an operation is performed while observing the state as shown in FIG. 7 under radioscopy such as X-rays, the branched wire portions 4a and 4b and the filament portion 51 to be imaged are located above and below the embolus 200 in FIG. If it can be visually recognized that it overlaps the central portion in the direction, the central axis of the embolus 200 and the central axis of the foreign substance capturing space 31 are substantially coincident with each other. It can be confirmed that it is contained. On the other hand, if it can be visually recognized that the branched wire portions 4a and 4b and the filament portion 51 to be contrasted are positioned in the gap between the embolus 200 and the inner wall of the blood vessel 100, the embolus 200 is still sufficiently in the foreign substance capturing space. It turns out that it is not in 31.
In the present invention, the entire capturing unit 3 may have radiopacity.
Moreover, in this embodiment, the coil 21 provided in the front-end | tip part of the wire main body 2 is formed, for example by winding a platinum alloy wire etc., and has radiopacity. Thereby, in the wire main body 2, the part of the coil 21 is a contrasting part having radiopacity, and the part adjacent to the proximal end side of the coil 21 is a non-contrast part having no radiopacity. 22 Thereby, when the situation as shown in FIG. 6 is obtained under fluoroscopy such as X-ray, the diameter of the capturing part 3 is completely exposed from the distal end opening 81 by relatively pulling the catheter 8 in the proximal direction. At this time, when the catheter 8 is pulled until the distal end of the catheter 8 reaches the non-contrast part 22 while observing the fluoroscopic image, the capturing part 3 is completely exposed from the catheter 8. In this way, it is possible to easily confirm that the capturing unit 3 is exposed from the catheter 8, and it is possible to perform an operation to ensure that the capturing unit 3 is in a diameter-expanded state.
The length of the contrast portion (coil 21) provided in the vicinity of the tip of the wire body 2 is not particularly limited, but is preferably 1 to 30 mm, and more preferably 5 to 15 mm.
The method of forming the contrast portion of the wire body 2 is not limited to the method of providing the coil 21 and may be a method of forming a thin film of a material having radiopacity, for example, by plating.
Although the outer diameter of branch wire part 4a, 4b is not specifically limited, It is preferable that it is 0.05-0.9 mm, and it is more preferable that it is 0.1-0.5 mm. Here, the outer diameter of the branch wire portions 4a and 4b refers to the entire outer diameter of the stranded wire portion.
Moreover, the outer diameter (wire diameter) of the filament parts 51, 52, and 53 (loop wires 61, 62, and 63) is not particularly limited, but is preferably 0.025 to 0.2 mm, and 0.05 to 0. More preferably, it is 1 mm.
In the present invention, the size of the capturing unit 3 can be freely set, and the preferable size varies depending on the case of the blood vessel to be applied, but is usually as follows. The total length of the capturing part 3 indicated by L in FIG. 1 in the diameter-expanded state is preferably 2 to 40 mm, and more preferably 4 to 20 mm. Moreover, it is preferable that the outer diameter (width | variety) in the diameter-expanded state of the capture part 3 shown by W in FIG. 1 is 1-30 mm, and it is more preferable that it is 2-5 mm.
In particular, in the case of the middle cerebral artery terminal part (M1 portion), which is a frequent site of cerebral infarction, the inner diameter of the blood vessel is about 3 to 4 mm. It is said that many have a diameter of about 3 mm and a length of about 7 mm. Therefore, in the case of the one used at the end portion of the middle cerebral artery (M1 portion), the size of the capturing portion 3 is at least 7 mm in total length in the expanded state (length indicated by L in FIG. 1), preferably Is preferably about 10 to 15 mm and an outer diameter (length indicated by W in FIG. 1) of about 4 to 5 mm in an expanded state.
As described above, the capturing unit 3 can be deformed into a reduced diameter state that can be inserted (inserted) into the lumen (inner lumen) of the catheter 8. In the present invention, since the capturing part 3 has a relatively simple structure as described above, it is advantageous for reducing the diameter of the capturing part 3 in a reduced diameter state.
In particular, in the present invention, the relatively high rigidity (relatively thick) branch wire portions 4a and 4b surely cause the trapping portion 3 to be restored to the expanded state, and the relatively flexible (relatively thin) filament portion. Since 51, 52 and 53 prevent the embolus 200 from falling off and hold it securely, it is possible to achieve both the certainty of capturing the embolus 200 and the reduction in diameter in the reduced diameter state.
In addition, since the capture part 3 can be made as thin as a normal guide wire, the intravascular foreign matter removing wire 1A can be used in combination with an existing microcatheter. You can also.
The value of the ratio W / W ′ of the outer diameter (W) in the expanded state of the capturing part 3 and the outer diameter (width) W ′ in the contracted state is preferably about 1.1 to 20, More preferably, it is about 1.1-10.
In particular, in the case of a device inserted into a microcatheter, the outer diameter W ′ in the reduced diameter state is preferably 0.53 mm (0.021 inch) or less, and 0.46 mm (0.018 inch). It is more preferable that
When the wire body 2 is moved forward relative to the catheter 8 from the state in which the capture part 3 is housed in the catheter 8, and the capture part 3 protrudes (exposes) from the distal end opening 81 of the catheter 8, the capture part 3. Is restored from the reduced diameter state to the expanded diameter state by its own elasticity.
When the wire body 2 is pulled in the proximal direction with respect to the catheter 8 from this state, the proximal ends of the branch wire portions 4a and 4b come into the catheter 8 while abutting the distal end opening 81 (the edge thereof). As a result, the distance between the branch wire portions 4a and 4b is reduced.
When the wire body 2 is further pulled in the proximal direction with respect to the catheter 8, the capturing unit 3 is automatically reduced in diameter and stored again in the catheter 8 while narrowing the interval between the branch wire units 4 a and 4 b. .
As described above, the capture unit 3 can be automatically deformed (displaced) into a diameter-expanded state and a diameter-reduced state as it enters and exits from the distal end opening 81 of the catheter 8.
Further, anti-slip means may be provided on the surface of the capturing unit 3. Thereby, the captured embolus 200 can be more reliably held. As the anti-slip means, an elastic material such as rubber having a relatively high friction coefficient can be coated, or minute irregularities (including a rough surface) can be formed by, for example, sandblasting.
The medical instrument 9 of the present invention has such a blood vessel foreign matter removing wire 1A (1B to 1F) and a catheter 8.
Next, an example of a method of using the intravascular foreign matter removing wire 1A of the present invention will be described in detail.
[1] FIG. 4 shows a state where an embolus 200 such as a thrombus is clogged in the blood vessel 100 and the blood flow is inhibited. The embolus 200 is pressed against the inner wall of the blood vessel 100 by blood pressure and is not easily moved.
A catheter (microcatheter) 8 and a guide wire 10 inserted into the lumen are inserted into the blood vessel 100, and the distal end portion 101 of the guide wire 10 protruding from the distal end opening 81 of the catheter 8 is embolized 200. Insert deeper (peripheral side). In other words, the distal end portion 101 of the guide wire 10 passes through the gap between the embolus 200 and the inner wall of the blood vessel 100 and exceeds the embolus 200. This operation can be performed more easily by using, for example, a micro guide wire having excellent lubricity as the guide wire 10.
[2] When the distal end portion 101 of the guide wire 10 exceeds the embolus 200, the catheter 8 is advanced relative to the guide wire 10, and the distal end portion of the catheter 8 is moved to the embolus 200 and the inner wall of the blood vessel 100 as shown in FIG. 5. Get into the gap. At this time, since the distal end portion of the catheter 8 smoothly enters the gap along the guide wire 10, this operation can be easily performed.
As a conventional treatment, a thrombolytic agent is flowed retrogradely through the catheter 8 in this state to speed up the thrombolysis. Long hours are often experienced by physicians. The present invention is also useful in such a case.
[3] From the state shown in FIG. 5, the guide wire 10 is removed, and the intravascular foreign matter removing wire 1 </ b> A of the present invention is inserted into the lumen of the catheter 8. As shown in FIG. 6, when the capturing part 3 is protruded from the distal end opening 81 of the catheter 8, the capturing part 3 in the catheter 8 in a reduced diameter state is automatically expanded by its own elasticity and expanded in diameter. It becomes a state. When the capturing part 3 is in an expanded state, a foreign matter capturing space 31 for capturing the embolus 200 is formed.
[4] When the catheter 8 is slightly moved in the proximal direction from the state shown in FIG. 6 and the distal end portion of the catheter 8 is pulled back to the front side of the embolus 200, the trapping of the trapping portion 3 as shown in FIG. The embolus 200 is scooped into the space 31 and captured (stored). That is, the embolus 200 enters the foreign substance capturing space 31 from the upper side in FIGS.
[5] When the embolus 200 is accommodated in the capturing part 3, the wire body 2 is pulled in the proximal direction with respect to the catheter 8. As a result, the proximal end portions of the branch wire portions 4a and 4b are brought into contact with the distal end opening portion 81 (the edge portion) to be drawn into the catheter 8 while narrowing each other, and the loop formed by the branch wire portions 4a and 4b. Becomes smaller. Therefore, the embolus 200 is fastened by the branch wire portions 4a and 4b.
With this tightening force, a soft thrombus such as fibrin can be crushed and the blockage of the blood vessel 100 can be eliminated. The embolus 200 that is not crushed is more reliably held by the capture unit 3 by this tightening force, and can be reliably recovered while preventing the detachment (detachment) from the capture unit 3.
[6] The intravascular foreign matter removing wire 1 </ b> A is removed together with the catheter 8 while maintaining the tightened state. As a result, the embolus 200 is recovered (removed) in the parent guiding catheter or sheath introducer (not shown).
If the embolus 200 is stored in the capturing part 3 without performing the tightening operation of [5], the embolus 200 may be removed by removing the intravascular foreign matter removing wire 1A together with the catheter 8 as it is. Good.
FIG. 8 and FIG. 9 are a plan view and a side view, respectively, showing the vicinity of the capturing part in the second embodiment of the intravascular foreign matter removing wire of the present invention. In the following description, the right side in FIGS. 8 and 9 is referred to as “base end”, and the left side is referred to as “tip”.
Hereinafter, the second embodiment of the intravascular foreign matter removing wire of the present invention will be described with reference to these drawings. However, the description will focus on differences from the above-described embodiment, and the description of the same matters will be omitted. To do.
The intravascular foreign matter removing wire 1B of the present embodiment is the same as that of the first embodiment except that the shape of the capturing part 3 is different.
In the capture part 3 of the present embodiment, the branch wire parts 4a and 4b and the filament parts 54 to 59 are formed by the six loop wires 64 to 69 provided in a loop shape (annular) from the tip of the wire body 2. ing.
One base end side portion and the other base end side portion of the loop wires 64 to 69 are aggregated (bundled) to form a branch wire portion 4a and a branch wire portion 4b. That is, the branch wire portions 4a and 4b are formed without twisting the proximal end portions of the loop wires 64 to 69. Note that, unlike the drawing, these portions may be twisted to form the branch wire portions 4a and 4b.
In the side view shown in FIG. 9, the loop wires 64 to 69 are arranged in the order of the loop wires 68, 66, 64, 65, 67, 69 from the upper side. That is, the loop wires 64 and 65 are located in the center among the loop wires 64 to 69.
In the side view shown in FIG. 9, each of the loop wires 64 to 69 is curved toward the outside (upper and lower in FIG. 9). The portions of the loop wires 64 to 69 on the tip side from the curved portion are separated from each other to form filament portions 54 to 59. In addition, the bending angle (degree of outward warping) of the loop wires 64 to 69 is larger as it is on the outer side. With such a configuration, the capturing unit 3 is formed in a bowl shape as a whole.
In the present embodiment, the number of loop wires 64 to 69 is larger than that in the first embodiment, so that the embolus 200 can be captured more reliably, and the embolus 200 once captured is detached. This can be prevented more reliably.
In the present embodiment, the loop wires 66 to 69 are made of a material that does not have radiopacity (radiopacity) and do not have radiographic properties.
On the other hand, the loop wires 64 and 65 located in the center have X-ray contrast properties. Therefore, the filament portions 54 and 55 configured by the tip side portions of the loop wires 64 and 65 and the branch wire portions 4a and 4b including the loop wires 64 and 65 also have X-ray contrast properties. Yes. That is, in the capturing part 3, the filament parts 54 and 55 and the branch wire parts 4a and 4b are contrast parts having X-ray contrast properties, and the filament parts 66 to 69 do not have X-ray contrast properties. .
With this configuration, in the present embodiment, as in the first embodiment, the branch wire portions 4a and 4b and the filament portions 54 and 55, which are contrast portions, are on a plane that passes through the central axis of the wire body 2 ( 9) or in the vicinity thereof. Therefore, in the same manner as described above, the capturing state of the embolus 200 in the capturing unit 3 can be easily confirmed under fluoroscopy such as X-rays.
In the present embodiment, the loop wires 64 and 65 are made of a material that itself (core material) has radiopacity. Thereby, compared with the case where the coil which has radiopacity is wound around the outer periphery of the core material which does not have radiopacity, processing and manufacture are easy and it can manufacture at low cost.
The loop wires 64 and 65 do not have to be radiopaque as a whole, and the contrast portions 642 and 652 positioned near the base end of the foreign matter capturing space 31 and the distal end of the foreign matter capturing space 31 are used. Only the contrast portions 641 and 651 located in the vicinity of the portion may have radiopacity. The contrast portions 641, 642, 651, and 652 are indicated by hatched portions in FIG. In this case, it is preferable that the lengths of the contrast portions 641, 642, 651, and 652 occupy 10 to 40% of the entire length L of the capturing portion 3 so that they can be easily confirmed with a fluoroscopic image. Even in such a configuration, each of the contrast portions 641, 642, 651, 652 extends in the longitudinal direction of the capturing portion 3. The contrast units 642 and 652 and the contrast units 641 and 651 are scattered in the longitudinal direction of the capturing unit 3 so as to be separated from each other. It should be noted that one or two or more contrast portions may be provided between the contrast portions 642 and 652 and the contrast portions 641 and 651 so as to be spaced apart from each other.
Further, even if there is no contrast section 642, 652, and instead a second contrast section (not shown) having radiopaqueness is provided at the tip of the wire body 2 (coil 21). In this case, the same effect can be obtained.
FIG. 10 is a side view showing the vicinity of the capturing part in the fourth embodiment of the intravascular foreign matter removing wire of the present invention.
Hereinafter, the third embodiment of the intravascular foreign matter removing wire of the present invention will be described with reference to the same drawing, but the description will focus on the differences from the above-described embodiment, and the description of the same matters will be omitted. .
The intravascular foreign matter removing wire 1 </ b> C of this embodiment is the same as that of the first embodiment except that the filament parts 52 and 53 have bent parts 521 and 531.
That is, the filament parts 52 and 53 which are inclined with respect to the extension line of the central axis of the wire body 2 in a side view respectively have bent parts 521 and 531 which are bent so that the inclination angle becomes larger in the middle thereof. ing.
In the present embodiment, since the bent portions 521 and 531 are formed, the distal end portions of the filament portions 52 and 53 are greatly spread on both sides and easily adhere to the inner wall of the blood vessel 100, and the embolus 200 is placed in the foreign substance capturing space 31. In the operation of dropping (accommodating) into the container, the shape of the capturing part 3 is more stable, and this operation can be performed more easily and reliably.
FIG. 11 and FIG. 12 are a plan view and a side view, respectively, showing the vicinity of the capturing part in the fourth embodiment of the intravascular foreign matter removing wire of the present invention.
Hereinafter, the fourth embodiment of the intravascular foreign matter removing wire of the present invention will be described with reference to these drawings. However, the difference from the above-described embodiment will be mainly described, and the description of the same matters will be omitted. To do.
The intravascular foreign matter removing wire 1D of the present embodiment has the above-described third embodiment except that it has a net-like body (foreign matter debris catching portion) 11 provided so as to close the gap between the filament portions 51, 52, 53. It is the same.
That is, in the present embodiment, the mesh body 11 is installed so as to block between the filament part 51 and the filament part 52 and between the filament part 51 and the filament part 53.
In the present embodiment, by providing the mesh body 11, it is possible to more reliably prevent the fragments of the captured embolus 200 from escaping (leaking out) from the gaps between the filament parts 51, 52, 53. it can. Therefore, it can prevent more reliably that infarction etc. generate | occur | produce on the peripheral side of the blood vessel 100 with the fragment.
The constituent material of the mesh body 11 is not particularly limited, and various synthetic resin materials and various metal materials can be used. For example, the net-like body 11 is formed by knitting resin fibers such as polyamide (nylon) on the filament parts 51, 52, 53, or assembling bag-like objects made of resin fibers on the filament parts 51, 52, 53. Therefore, it can be installed easily. Further, for example, a metal mesh manufactured by a method such as etching may be used as the mesh body 11, and the metal mesh may be fixed to the filament portions 51, 52, and 53 by brazing, welding, bonding with an adhesive, or the like.
The mesh body 11 may not be fixed to the branch wire portions 4a, 4b and the filament portions 51, 52, 53. For example, the bag-like mesh body 11 is twisted at the tip of the wire body 2 or brazed. The shape may be fixed by the branch wire portions 4 a and 4 b and the filament portions 51, 52 and 53.
Such an intravascular foreign matter removing wire 1D of this embodiment is suitable for capturing an embolus 200 in a relatively large diameter blood vessel (outer diameter of about 5 to 15 mm) such as a carotid artery. The full length L of the capturing part 3 in the expanded state is preferably 10 to 40 mm, and the outer diameter (width) W of the capturing part 3 in the expanded state is preferably 8 to 20 mm.
FIGS. 13 and 14 are a plan view and a side view, respectively, showing the vicinity of the capturing portion in the fifth embodiment of the intravascular foreign matter removing wire of the present invention.
Hereinafter, the fifth embodiment of the intravascular foreign matter removing wire of the present invention will be described with reference to these drawings. However, the description will focus on the differences from the above-described embodiment, and the description of the same matters will be omitted. To do.
The intravascular foreign matter removing wire 1E of the present embodiment is the same as that of the third embodiment except that it has a linear second filament portion 12 laid between the filament portions 51, 52, and 53.
That is, in the present embodiment, the plurality of second filament parts 12 are installed between the filament part 51 and the filament part 52. The plurality of second filament portions 12 are arranged substantially parallel to each other. Similarly, a plurality of second filament parts 12 are installed between the filament part 51 and the filament part 53. The plurality of second filament portions 12 are arranged substantially parallel to each other.
The number of the second filament parts 12 installed between the filament part 51 and the filament part 52 and the number of the second filament parts 12 installed between the filament part 51 and the filament part 53 are shown in the figure. However, the number is not particularly limited and may be one or more, and preferably 2 to 10. Moreover, it is preferable that the space | interval between each 2nd filament part 12 is 0.2 mm or less.
In the present embodiment, by providing the second filament portion 12, it is possible to more reliably prevent the fragments of the captured embolus 200 from escaping (leaking out) from the gaps between the filament portions 51, 52, and 53. be able to. Therefore, it can prevent more reliably that infarction etc. generate | occur | produce on the peripheral side of the blood vessel 100 with the fragment.
The constituent material of the second filament portion 12 is not particularly limited, and examples thereof include the same materials as the filament portions 51, 52, and 53. Moreover, as a fixing method of the 2nd filament part 12, you may twist and fix with respect to branch wire part 4a, 4b, for example, brazing, welding, and adhesive agent with respect to the filament parts 51, 52, 53 It may be fixed by adhesion or the like.
The intravascular foreign matter removing wire 1E according to this embodiment is suitable for capturing an embolus 200 in a relatively large blood vessel (outer diameter of about 5 to 15 mm) such as the carotid artery. The full length L of the capturing part 3 in the expanded state is preferably 10 to 40 mm, and the outer diameter (width) W of the capturing part 3 in the expanded state is preferably 8 to 20 mm.
FIG.As a reference example, capturing part of a wire for removing foreign matter in blood vesselsIt is a top view which shows the vicinity.
Refer to the figure belowWire for removing foreign matter in blood vesselsAlthough the sixth embodiment will be described, the difference from the above-described embodiment will be mainly described, and the description of the same matters will be omitted.
In the present embodiment, the capturing unit 3 includes branch wire portions 4 a and 4 b and filament portions 50 and 50 formed by two loop wires 60 and 60 provided in a loop shape (annular) from the tip of the wire body 2. I have two sets.
One base end side portion and the other base end side portion of one set of loop wires 60, 60 are respectively assembled (bundled) to form branch wire portions 4a and 4b. . In the illustrated configuration, the branch wire portions 4a and 4b are formed without twisting the proximal end portions of the loop wires 60 and 60, but may be twisted together.
And these loop wires 60 and 60 are each curved toward the outside (upper and lower in FIG. 15) on the way. The portions of the loop wires 60, 60 on the tip side from the curved portion are spaced apart from each other to form filament portions 50, 50.
Similarly, the other set of loop wires 60, 60 constitute branch wire portions 4 a, 4 b and filament portions 50, 50.
The two sets of branch wire portions 4a and 4b and the filament portions 50 and 50 are installed so that the angles around the central axis of the wire body 2 are different from each other (the foreign matter capturing spaces 31 are overlapped). In the configuration shown in the drawing, the difference (phase difference) around the central axis of the wire body 2 between the two sets of branch wire portions 4a and 4b and the filament portions 50 and 50 is 90 °. It is not limited.
In the present embodiment, with such a configuration, the two sets of filament portions 50 and 50 intersect each other. Thereby, it can prevent more reliably that the fragment of the embolus 200 escapes (leaks out) from the clearance gap between each filament part 50. FIG.
In the present embodiment, the two sets of loop wires 60 and 60 are both radiopaque, and thus the entire capture unit 3 is radiopaque. Further, one set of loop wires 60, 60 is on or near a plane that passes through the central axis of the wire body 2 and is perpendicular to the paper surface of FIG. 15, and extends in the longitudinal direction of the capturing portion 3. The other set of loop wires 60, 60 is on or near a plane that passes through the central axis of the wire body 2 and is parallel to the paper surface of FIG. 15, and extends in the longitudinal direction of the capturing portion 3. With such a configuration, in the present embodiment, the embolus 200 of the embolus 200 is seen both in the case of performing fluoroscopy such as X-ray in the direction perpendicular to the paper surface of FIG. 15 and in the case of fluoroscopy in the vertical direction in FIG. The capture status can be easily confirmed.
As mentioned above, although the illustrated embodiment of the intravascular foreign matter removing wire and medical instrument of the present invention has been described, the present invention is not limited to this, and each part constituting the intravascular foreign matter removing wire and medical instrument Can be replaced with any structure capable of performing the same function.
For example, the branch wire portion may be provided so as to branch into three or more from the tip of the wire body.
In addition, the intravascular foreign matter removing wire of the present invention may be a combination of any two or more configurations (features) of the above embodiments.
In the present invention, the contrast unit has radiopacity and thus has contrast properties under radioscopy such as X-rays. Such a contrast unit is usually used in CT scan, MRI, and the like. Also has contrast properties. Therefore, the intravascular foreign matter removing wire of the present invention can be used in CT scan, MRI, and the like.
Further, the contrast section is composed of three or more contrast sections, and these contrast sections are provided on or near a plane passing through the central axis of the wire body, and are spaced apart from each other in the longitudinal direction of the capture section. It is good also as the structure made to do.
As described above, according to the present invention, an embolus in a blood vessel can be reliably captured and removed with a simple structure without damaging the blood vessel.
Further, it is advantageous for reducing the diameter in a reduced diameter state, and can be applied to a thin blood vessel.
In addition, when the wire body is pulled in the proximal direction with respect to the catheter, when the branch wire portion comes into contact with the distal end opening of the catheter lumen and the interval between the branch wire portions is narrowed, the embolus is formed by the capturing portion. Thus, the embolus can be crushed or the embolus can be held more securely.
Further, since the capturing part includes a contrast part having radiopaque properties, it is possible to very easily confirm the state of capturing the embolus under radioscopy.
From the above, the present invention is particularly useful as a therapeutic device for cerebral embolism, which can collect in a short time a thrombus that cannot be dissolved by a thrombolytic agent in a short time.
The present invention is also useful for ischemic diseases (venous embolization, arterial embolization) in which a thrombolytic agent does not work. By appropriately selecting the shape and size of the capturing portion, various embolization materials in blood vessels can be obtained. It is effective to remove
FIG. 1 is a plan view showing a first embodiment of an intravascular foreign matter removing wire according to the present invention.
FIG. 2 is a side view showing a first embodiment of the intravascular foreign matter removing wire of the present invention.
3 is a perspective view showing the vicinity of a capturing portion in the intravascular foreign matter removing wire shown in FIGS. 1 and 2. FIG.
FIGS. 4A and 4B are diagrams for explaining step by step how to use the intravascular foreign matter removing wire shown in FIGS. 1 and 2; FIGS.
FIG. 5 is a diagram for explaining step by step how to use the intravascular foreign matter removing wire shown in FIGS. 1 and 2;
6 is a view for explaining step by step how to use the intravascular foreign matter removing wire shown in FIGS. 1 and 2; FIG.
7 is a diagram for explaining step by step how to use the intravascular foreign matter removing wire shown in FIGS. 1 and 2; FIG.
FIG. 8 is a plan view showing the vicinity of a capturing portion in a second embodiment of the intravascular foreign matter removing wire of the present invention.
FIG. 9 is a side view showing the vicinity of a capturing part in a second embodiment of the intravascular foreign matter removing wire of the present invention.
FIG. 10 is a side view showing the vicinity of a capturing part in a third embodiment of an intravascular foreign matter removing wire of the present invention.
FIG. 11 is a plan view showing the vicinity of a capturing part in a fourth embodiment of the intravascular foreign matter removing wire of the present invention.
FIG. 12 is a side view showing the vicinity of a capturing part in a fourth embodiment of the intravascular foreign matter removing wire of the present invention.
FIG. 13 is a plan view showing the vicinity of a capturing part in a fifth embodiment of the intravascular foreign matter removing wire of the present invention.
FIG. 14 is a side view showing the vicinity of a capturing part in a fifth embodiment of the intravascular foreign matter removing wire of the present invention.
FIG. 15As a reference example, capturing part of a wire for removing foreign matter in blood vesselsIt is a top view which shows the vicinity.
1A-1F Wire for removing foreign matter in blood vessels
11 Reticulated body
12 Second filament part
2 Wire body
22 Non-contrast part
3 capture unit
31 Foreign object capture space
4a, 4b Branch wire part
41a, 41b Tip
50, 51, 52, 53, 54, 55, 56, 57, 58, 59 Filament part
521, 531 Bent part
60, 61, 62, 63, 64, 65, 66, 67, 68, 69 Loop wire
641, 642, 651, 652 Contrast unit
8 Catheter
81 Tip opening
9 Medical equipment
100 blood vessels
200 embolus
A long wire body having flexibility;
These loop wires are arranged side by side so that at least the tip side portions are separated from each other and the interval increases in a direction orthogonal to the central axis of the wire body in a side view, The loop wire excluding the loop wire located at the center of the portion is composed of a wire material having no radiopacity, and the center end side portion constitutes the branch wire portion. The loop wire located on the wire body is located on a plane passing through the central axis of the wire main body, wound around at least a part of the outer periphery of the wire having no radiopacity, and having a radiopacity. is composed of a coil with functions as a contrast portion having a radiopaque, the narrowed gap portion between the leading ends of the loop wire, and narrows the spacing portion between the base end Contracted and reduced diameter state, the wire for removing an intravascular foreign body, characterized in that may take the expanded state in which the respective interval is enlarged respectively than said reduced diameter state to be folded.
2. The intravascular portion according to claim 1, wherein, when capturing the foreign matter, the capturing portion is configured to store the foreign matter in the foreign matter capturing space from either side in a direction in which the filament portions are arranged. Foreign matter removal wire.
The intravascular foreign matter removing wire according to claim 1, wherein a second contrast portion having radiopacity is provided at a distal end portion of the wire body.
The intravascular foreign matter removing wire according to any one of claims 1 to 3, wherein the contrast portion is at least near a proximal end portion and a distal end portion of the foreign matter capturing space.
The intravascular foreign matter removing wire according to any one of claims 1 to 4, wherein the contrast section includes a core member made of a radiopaque material.
6. The intravascular foreign matter removing device according to claim 1, wherein the contrast section includes a plurality of contrast sections, and the plurality of contrast sections are scattered in the longitudinal direction of the capturing section. Wire.
The intravascular foreign matter removing wire according to any one of claims 1 to 6, wherein a part on one base end side and a part on the other base end side of the plurality of loop wires are respectively twisted together. .
The intravascular foreign matter removing wire according to any one of claims 1 to 6, wherein one base end side portion and the other base end side portion of the plurality of loop wires are respectively bundled.
The intravascular foreign matter removing wire according to claim 7 or 8, wherein each branch wire portion has higher rigidity than each filament portion.
The blood vessel according to any one of claims 1 to 9 , wherein all or part of the plurality of filament portions are inclined so that a distance from an extension line of a central axis of the wire body increases in a distal direction. Internal foreign matter removal wire.
11. The intravascular foreign matter removing wire according to claim 10 , wherein the inclined filament portion has a bent portion that is bent so that the inclination angle becomes larger in the middle thereof.
The intravascular foreign matter removing wire according to any one of claims 1 to 11 , further comprising a net-like body provided so as to close a gap between the filament portions.
The mesh body has a bag shape and is fixed to the tip of the wire body,
The intravascular foreign matter removing wire according to claim 12 , wherein the branch wire portion and / or the filament portion has a function of maintaining the shape of the mesh body.
The intravascular foreign matter removing wire according to any one of claims 1 to 13 , further comprising at least one second filament portion provided between the filament portions.
15. The intravascular foreign matter removing wire according to claim 14 , wherein a plurality of the second filament parts are arranged in parallel to each other.
The tip vicinity of the wire body, and a contrast portion having a radiopaque, adjacent to the base end side of the contrast shadow, claims 1 and non-contrast portion having no radiopaque are formed The wire for removing a foreign substance in blood vessel according to any one of 15 .
17. The intravascular foreign matter removing wire according to claim 1, wherein at least a part of the branch wire portion and the filament portion is made of an alloy exhibiting superelasticity in a living body.
A medical instrument comprising: the intravascular foreign matter removing wire according to any one of claims 1 to 17 ; and a catheter having a lumen capable of storing the intravascular foreign matter removing wire.
When the wire main body is pulled in the proximal direction from the state in which the wire main body is housed in the lumen and the branch wire portion protrudes from the distal end opening portion of the lumen, the branch wire portion opens to the distal end opening. The medical instrument according to claim 18 , wherein an interval between the branch wire portions is narrowed by contacting the portion.
JP2002179090A 2002-06-19 2002-06-19 Intravascular foreign matter removal wire and medical device Active JP4112911B2 (en)
JP2002179090A JP4112911B2 (en) 2002-06-19 2002-06-19 Intravascular foreign matter removal wire and medical device
JP2004016668A JP2004016668A (en) 2004-01-22
JP4112911B2 true JP4112911B2 (en) 2008-07-02
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JP2002179090A Active JP4112911B2 (en) 2002-06-19 2002-06-19 Intravascular foreign matter removal wire and medical device
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