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WO2020188704A1 - Cathéter muni d'une pointe orientable - Google Patents

Cathéter muni d'une pointe orientable Download PDF

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Publication number
WO2020188704A1
WO2020188704A1 PCT/JP2019/011217 JP2019011217W WO2020188704A1 WO 2020188704 A1 WO2020188704 A1 WO 2020188704A1 JP 2019011217 W JP2019011217 W JP 2019011217W WO 2020188704 A1 WO2020188704 A1 WO 2020188704A1
Authority
WO
WIPO (PCT)
Prior art keywords
tip
bar spring
catheter
shaft portion
shaft
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2019/011217
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English (en)
Japanese (ja)
Inventor
一樹 中神
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Japan Lifeline Co Ltd
Original Assignee
Japan Lifeline Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Japan Lifeline Co Ltd filed Critical Japan Lifeline Co Ltd
Priority to PCT/JP2019/011217 priority Critical patent/WO2020188704A1/fr
Priority to JP2021506854A priority patent/JP7261290B2/ja
Publication of WO2020188704A1 publication Critical patent/WO2020188704A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0144—Tip steering devices having flexible regions as a result of inner reinforcement means, e.g. struts or rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires

Definitions

  • the present invention relates to a tip-deflecting manipulable catheter. More specifically, by operating an operating portion arranged outside the body, the tip portion of the catheter inserted in the body cavity is flexed to change the direction of the tip. With respect to a tip-deflecting operable catheter.
  • the direction of the tip (distal end) of the catheter inserted into the heart is the posterior end (proximal end or hand) of the catheter placed outside the body. It is necessary to operate the operation unit mounted on the side) to change (deflect) it.
  • Patent Document 1 As a mechanism for operating the tip of the catheter on the hand side to deflect it, the mechanism shown in Patent Document 1 below is known.
  • a leaf spring having a spring force is arranged inside the tip portion of the catheter, and the tip of the operation wire is connected and fixed to one side or both sides of the leaf spring. Then, the leaf spring is bent by pulling the rear end of the operation wire, and the tip portion of the catheter is bent in the direction perpendicular to the plane of the leaf spring to change the direction of the tip of the catheter.
  • the leaf spring By arranging the leaf spring inside the tip portion of the catheter in this way, when the operation wire is pulled, the tip portion is bent in the direction perpendicular to the surface of the leaf spring (to ensure the flatness in the bending direction). ) Can be done.
  • the applicant has placed the catheter shaft, a pair of bar springs arranged opposite to each other across the central axis of the catheter shaft, and both sides of a virtual plane passing through the central axis of the pair of bar springs.
  • a catheter provided with a pair of operating wires slidably inserted into each of the pair of lumens (operating wire insertion passages) (see Patent Document 2 below).
  • the catheter as described in Patent Documents 1 and 2 has a problem that the torque transmission property is inferior because the flatness of the tip portion in the bending direction is too strong. For this reason, if the tip of the catheter (the tip flexible part where the leaf spring or bar spring is arranged) is located at the bent part of the sheath for introducing the catheter to the target site, on the hand side. The applied rotational torque is not transmitted to the tip of the catheter, and as a result, for example, in an ablation catheter, the pressing load of the electrode may be insufficient to sufficiently cauterize.
  • the one bar spring is displaced toward the tip, the tip of the catheter is deformed, or the tip electrode or the like is pushed out by the one bar spring extending from the tip of the catheter shaft. It is possible that it will happen.
  • the tip deflection operable catheter of the present invention extends inside the catheter shaft so as to bend the catheter shaft provided with the tip shaft portion having flexibility and the tip shaft portion in the first direction.
  • the first operating wire capable of pulling the trailing end and the tip shaft portion extend inside the catheter shaft in order to bend in a second direction opposite to the first direction, and then extend. It has a second operation wire whose end can be pulled and operated, and a pair of bar springs extending inside the tip shaft portion and arranged to face each other with the central axis of the catheter shaft interposed therebetween.
  • the catheter shaft has a multi-lumen structure, at least in the tip shaft portion.
  • the first operation wire and the second operation wire are attached to two wire lumens arranged to face each other with the central axis of the catheter shaft interposed therebetween, respectively. It is inserted so that it can slide in the axial direction.
  • Two lumens having their respective central axes on a second virtual plane orthogonal to the first virtual plane including the central axis of each of the wire lumens and arranged to face each other with the central axis of the catheter shaft interposed therebetween.
  • the first bar spring and the second bar spring are slidably inserted into the "bar spring lumen"), respectively, and the base end or the tip end of the first bar spring and the second bar spring, respectively. Is fixed to the base end or the tip end of the tip shaft portion.
  • the tip deflection operable catheter having such a configuration, since the first bar spring and the second bar spring are inserted so as to be slidable in the axial direction with respect to the bar spring lumen, the tip is inserted along the second virtual plane.
  • the first bar spring and the second bar spring slide on opposite sides in the axial direction, so that the resistance of the bar spring to the force that tries to bend the tip shaft part.
  • the force can be absorbed (cancelled), whereby the tip shaft portion can be easily bent (bent).
  • each base end / each tip of the first bar spring and the second bar spring is fixed to the base end / tip of the tip shaft portion, the tip shaft portion that is bent along the second virtual plane is formed. It can be easily restored to a linear shape.
  • each base end / each tip of the first bar spring and the second bar spring is fixed to the base end / tip of the tip shaft portion, even if the tip deflection operation is repeated, the first bar spring and the first bar spring 2 The bar spring does not shift in the tip direction / base end direction.
  • the base ends of the first bar spring and the second bar spring are connected to each other, and the connecting portion is fixed to the base end of the tip shaft portion. Is preferable.
  • the base ends of the first bar spring and the second bar spring can be reliably fixed to the base end of the tip shaft portion. Then, when a force is applied to bend the tip shaft portion along the second virtual plane, one of the bar springs that will be located inside when bent slides toward the tip and when bent. By sliding the other bar spring located on the outside toward the proximal end, it is possible to absorb (cancel) the resistance force of the bar spring against the force to bend the tip shaft portion, whereby the tip can be absorbed.
  • the shaft portion can be easily bent (bent).
  • one bar spring located inside the bend slides toward the proximal end, and the other bar spring located outside the bend slides.
  • the tip shaft portion can be restored to a linear shape.
  • the first bar spring, the second bar spring, and the connecting portion connecting the proximal ends thereof are formed from one high-rigidity member. It is preferably formed.
  • each of the first bar spring and the second bar spring can be easily inserted into the bar spring lumen to be inserted, and the first bar spring and the second bar spring can be inserted. Can be securely fixed to the base end of the tip shaft portion.
  • the tip deflection operable catheter when the tip shaft portion is in a linear state, the tip of the first bar spring and the tip of the second bar spring are respectively. It is preferable that the rod spring lumen is located at a predetermined distance from the tip opening of the inserted bar spring lumen.
  • the tip deflection operable catheter having such a configuration, even when the tip shaft portion is bent along the second virtual plane, the tip portion of any rod spring located inside the bending is a rod. It is possible to prevent the spring lumen from extending from the tip opening.
  • the tips of the first bar spring and the second bar spring may be connected to each other, and the connecting portion may be fixed to the tip of the tip shaft portion. ..
  • the tips of the first bar spring and the second bar spring can be reliably fixed to the tip of the tip shaft portion. Then, when a force is applied to bend the tip shaft portion along the second virtual plane, one of the bar springs that will be located inside when bent slides toward the proximal end and bends. By sliding the other bar spring, which will be located on the outside, toward the tip, the resistance force of the bar spring against the force to bend the tip shaft can be absorbed (cancelled), thereby absorbing (cancelling) the tip.
  • the shaft portion can be easily bent (bent).
  • one bar spring located inside the bend slides toward the tip, and the other bar spring located outside the bend is the base. By sliding in the end direction, the tip shaft portion can be restored to a linear shape.
  • the first bar spring, the second bar spring, and the connecting portion connecting the tips thereof are formed from one high-rigidity member. It is preferable that it is. According to the tip deflection operable catheter having such a configuration, each of the first bar spring and the second bar spring can be easily inserted into the bar spring lumen to be inserted, and the first bar spring and the second bar spring can be inserted. The tip of the tip can be securely fixed to the tip of the tip shaft portion.
  • the base end of the first bar spring and the base end of the second bar spring are It is preferable that each of them is located on the tip side by a predetermined distance from the base end opening of the bar spring lumen through which each is inserted. According to the tip deflection operable catheter having such a configuration, even when the tip shaft portion is bent along the second virtual plane, the base end portion of any bar spring located inside the bending can be formed. It is possible to prevent the bar spring lumen from extending from the base end opening.
  • the tip deflection operable catheter of the present invention is for bending a catheter shaft provided with a flexible tip shaft portion and a non-flexible base end shaft portion and the tip shaft portion in the first direction.
  • the first operation wire extending inside the catheter shaft and the trailing end thereof in a pulling operation and the tip shaft portion in a second direction opposite to the first direction.
  • the above-mentioned A second operating wire that extends inside the catheter shaft and can be pulled at its trailing end, and a pair of bar springs that extend inside the tip shaft and are opposed to each other across the central axis of the catheter shaft.
  • the catheter shaft has a multi-lumen structure, at least in the tip shaft portion.
  • the first operation wire and the second operation wire are attached to two wire lumens arranged to face each other with the central axis of the catheter shaft interposed therebetween, respectively. It is inserted so that it can slide in the axial direction.
  • Two bar spring lumens having their respective central axes on a second virtual plane orthogonal to the first virtual plane including the central axes of each of the wire lumens and arranged to face each other with the central axis of the catheter shaft in between.
  • the first bar spring and the second bar spring are slidably inserted in the axial direction, respectively, and each base end or each tip of the first bar spring and the second bar spring is fixed to the catheter shaft. It is characterized by being.
  • the present invention also includes a case where the tips of the first bar spring and the second bar spring are fixed to the catheter shaft at a portion other than the tip of the tip shaft portion.
  • the tip shaft portion of the catheter shaft can be easily bent along the second virtual plane, and excellent torque transmission can be exhibited. Further, the tip deflection operable catheter of the present invention is also excellent in the stability of the tip shaft portion (restorability from a bent state to a linear state). Further, according to the tip deflection operable catheter of the present invention, even if the tip deflection operation is repeated, the first bar spring and the second bar spring do not shift in the tip direction or the proximal direction.
  • the electrode catheter 100 which is the first embodiment of the tip deflection manipulable catheter of the present invention, is used, for example, for diagnosing or treating arrhythmia in the heart.
  • the electrode catheter 100 of the present embodiment shown in FIGS. 1 to 5 includes a catheter shaft 10 having a flexible tip shaft portion 11, a tip electrode 30 arranged on the tip side of the catheter shaft 10, and a catheter shaft.
  • the catheter shaft 10 In order to bend the ring-shaped electrodes 41 to 43 mounted on the outer peripheral surface of the tip portion of 10 and the tip shaft portion 11 in the first direction, the catheter shaft 10 extends inside the catheter shaft 10 and the rear end can be pulled.
  • the operation wire 51, the second operation wire 52 extending inside the catheter shaft 10 in order to bend the tip shaft portion 11 in the second direction, and the trailing end of which can be pulled, and the tip shaft portion 11.
  • High rigidity formed by connecting the base ends of a pair of bar springs (first bar spring 61 and second bar spring 62) extending inside the tip shaft portion 11 in order to impart flatness in the bending direction.
  • Anchor member 70 arranged between the member 60, the catheter shaft 10 and the tip electrode 30 and fixing the tips of the first operation wire 51 and the second operation wire 52, and attached to the base end of the catheter shaft 10. It is equipped with a catheter 80.
  • the catheter shaft 10 has a multi-lumen structure, and of the 10 lumens formed on the tip shaft portion 11, two wire lumens 111 and 112 arranged opposite to each other with the central axis of the catheter shaft 10 interposed therebetween.
  • the first bar spring 61 and the second bar spring 62 are axially arranged on the two bar spring lumens 113 and 114, which have their respective central axes on P2 and are arranged so as to face each other with the central axis of the catheter shaft 10 interposed therebetween. It is slidably inserted.
  • the base ends of the first bar spring 61 and the second bar spring 62 are connected to each other by a connecting portion 63, and the connecting portion 63 is fixed to the base end of the tip shaft portion 11, whereby the first bar spring 61 and the first bar spring 61 and the second bar spring 61 are connected.
  • Each base end of the 2-bar spring 62 is fixed to the base end of the tip shaft portion 11.
  • the electrode catheter 100 of the present embodiment includes a catheter shaft 10, a tip electrode 30, ring-shaped electrodes 41 to 43, a first operation wire 51, a second operation wire 52, a first bar spring 61, and a first rod spring 61. It includes a high-rigidity member 60 formed by connecting the base ends of two bar springs 62, an anchor member 70, and a handle 80.
  • FIG. 1 12 is a proximal shaft portion of the catheter shaft 10, and 85 is a knob attached to the handle 80 for performing a tip deflection operation of the catheter shaft 10.
  • 30 L is a lead wire of the tip electrode
  • 41 L to 43 L is a lead wire of the ring-shaped electrodes 41 to 43
  • 45 is a thermocouple.
  • the catheter shaft 10 is composed of a tip shaft portion 11, a proximal shaft portion 12 joined to the proximal end side of the distal shaft portion 11, and a tube member 13 joined to the distal end side of the distal shaft portion 11. There is.
  • the tip shaft portion 11 is a flexible tip portion that is flexible and can be bent (bent) by pulling the first operation wire 51 and the second operation wire 52.
  • the tip shaft portion 11 is an insulating tube member having a multi-lumen structure, and as shown in FIG. 3, the tip shaft portion 11 has 10 lumens including wire lumens 111 and 112 and bar spring lumens 113 and 114. (111 to 118, 119A and 119B) are formed.
  • the wire lumen 111 and the wire lumen 112 have their respective central axes on the first virtual plane P1, and are arranged so as to face each other with the central axis of the catheter shaft 10 interposed therebetween.
  • the bar spring lumen 113 and the bar spring lumen 114 have their respective central axes on the second virtual plane P2 orthogonal to the first virtual plane P1, and are arranged so as to face each other with the central axis of the catheter shaft 10 interposed therebetween.
  • 1101 is an inner portion made of resin
  • 1103 is an outer portion made of resin having a hardness higher than that of the inner portion 1101
  • 1102 is a resin blade layer interposed between the inner portion 1101 and the outer portion 1103. .
  • the base end shaft portion 12 has higher rigidity than the tip end shaft portion 11.
  • the base end shaft portion 12 is an insulating tube member having a multi-lumen structure, and as shown in FIG. 4, the base end shaft portion 12 is provided with the lumens (111 to 112, 115 to 118, 119A) of the tip shaft portion 11. And 119B), eight lumens (121-122, 125-128, 129A and 129B) are formed. However, the base end shaft portion 12 is not formed with a lumen that communicates with the bar spring lumen 113 and the bar spring lumen 114 of the tip shaft portion 11.
  • 1201 is an inner portion made of resin
  • 1203 is an outer portion made of resin having a hardness higher than that of inner portion 1201
  • 1202 is a resin blade layer interposed between the inner portion 1201 and the outer portion 1203. .
  • Examples of the constituent material of the catheter shaft 10 include synthetic resins such as polyolefin, polyamide, polyether block polyamide, and polyurethane.
  • the outer diameter of the catheter shaft 10 is usually 2 Fr (0.65 mm) to 8 Fr (2.7 mm), and a suitable example is 6 Fr (2 mm).
  • the length of the tip shaft portion 11 is usually 10 to 150 mm, and a suitable example is 75 mm.
  • the tip electrode 30 is integrally formed of an X-ray opaque metal, and has three spherical surfaces whose centers are on the same straight surface and one reduced diameter connected to these spherical surfaces between adjacent spherical surfaces. It has a curved surface provided with a portion, and the curved surface forms a constriction between adjacent spherical surfaces on the tip electrode 30.
  • the outer diameter of the tip electrode 30 (maximum diameter on the spherical surface) is about the same as the outer diameter of the catheter shaft 10.
  • the X-ray opaque metal constituting the tip electrode 30 is not particularly limited as long as it has good contrast with X-rays, but preferred specific examples include platinum, gold, silver and the like. Examples include alloys that are the main components.
  • Ring-shaped electrodes 41 to 43 made of an X-ray permeable metal are mounted on the outer peripheral surface of the tip portion of the catheter shaft 10. Needless to say, the number of ring-shaped electrodes is not limited to three.
  • the width of the ring-shaped electrodes 41 to 43 (the length of the catheter shaft 10 in the axial direction) is, for example, 1.2 to 5.0 mm.
  • Examples of the X-ray opaque metal constituting the ring-shaped electrodes 41 to 43 include the same metal as that constituting the tip electrode 30.
  • the first operating wire 51 constituting the electrode catheter 100 is axially slidably inserted inside the catheter shaft 10 (lumen 111 of the tip shaft portion 11 and lumen 129A of the proximal shaft portion 12). Further, the second operation wire 52 is slidably inserted inside the catheter shaft 10 (lumen 112 of the tip shaft portion 11 and lumen 129B of the proximal shaft portion 12).
  • the base ends of the first operating wire 51 and the second operating wire 52 are respectively connected to the knob 85 of the handle 80, whereby the pulling operation is possible.
  • the tips of the first operating wire 51 and the second operating wire 52 are fixed to the anchor member 70 so as to face each other with the central axis of the catheter shaft 10 interposed therebetween.
  • the knob 85 of the handle 80 By operating the knob 85 of the handle 80, the first operation wire 51 or the second operation wire 52 is pulled toward the proximal end, the tip shaft portion 11 of the electrode catheter 100 bends, and the distal end of the electrode catheter 100.
  • the ends can be deflected in the direction indicated by the arrow A or B.
  • the knob 85 shown in FIG. 1 in the A1 direction the first operation wire 51 is pulled in the proximal direction, and the tip of the electrode catheter 100 is deflected in the direction indicated by the arrow A.
  • the second operation wire 52 is pulled in the proximal direction, and the tip of the electrode catheter 100 is deflected in the direction indicated by the arrow B.
  • the constituent materials of the first operating wire 51 and the second operating wire 52 are not particularly limited, and all the same constituent materials as the conventionally known operating wires of the tip deflection operable catheter shall be used. Can be done.
  • the diameter of the operating wire 50 is, for example, 0.05 to 0.5 mm, and a suitable example is 0.25 mm.
  • the anchor member 70 is fixed to the tip electrode 30 with its tip portion inserted into the internal space of the tip electrode 30. Further, the anchor member 70 is fixed to the catheter shaft 10 with its base end portion encapsulated in the tube member 13.
  • a clearance C is secured between the tip of the tip shaft portion 11 and the base end of the anchor member 70.
  • the clearance C is, for example, 0.05 to 30 mm, and a suitable example is 0.5 mm.
  • the constituent material of the anchor member 70 is preferably a metal material having good wettability to solder. From this point of view, copper or a copper alloy can be mentioned as a suitable constituent material of the anchor member 70, and brass (brass) having good thermal conductivity is particularly preferable.
  • the lead wire 30L and the thermocouple 45 of the tip electrode 30 extend inside the catheter shaft 10 (lumen 115 of the tip shaft portion 11 and lumen 125 of the proximal shaft portion 12). There is. Further, the lead wires 41L to 43L of the ring electrodes 41 to 43 extend inside the catheter shaft 10 (lumen 116 of the tip shaft portion 11 and lumen 126 of the proximal shaft portion 12).
  • the lead wires 30L and the lead wires 41L to 43L extending inside the catheter shaft 10 are respectively drawn out from the handle 80 through the inside of the handle 80 and connected to, for example, a high frequency generator.
  • FIG. 6 is a side view showing a high-rigidity member 60 constituting the electrode catheter 100 of the present embodiment.
  • the high-rigidity member 60 includes a portion formed by the first bar spring 61, a formed portion of the second bar spring 62, and one end of the first bar spring 61 and the second bar spring 62 (which is a base end in this embodiment). It is composed of a connecting portion 63 that connects the two.
  • the formed portion of the first bar spring 61 and the formed portion of the second bar spring 62 extend in parallel with each other, and one end of each is connected by the connecting portion 63, whereby the high-rigidity member One end side of 60 has a shape folded back in a "U" shape.
  • Examples of the constituent material of the high-rigidity member 60 include metal materials such as stainless steel and Ni—Ti alloy.
  • the diameter of the high-rigidity member 60 is, for example, 0.1 to 1 mm, and a suitable example is 0.2 mm.
  • the length of the formed portion of the first bar spring 61 and the formed portion of the second bar spring 62 is shorter than the length of the tip shaft portion 11, and a suitable example is 72 mm.
  • the first bar spring 61 (the portion formed by the first bar spring in the high-rigidity member 60) is slidably inserted in the bar spring lumen 113 of the tip shaft portion 11 in the axial direction.
  • the second bar spring 62 (the portion formed by the second bar spring in the high-rigidity member 60) is inserted through the bar spring lumen 114 of the tip shaft portion 11 so as to be slidable in the axial direction.
  • the first bar spring 61 is slidably inserted into the bar spring lumen 113 in the axial direction
  • the second bar spring 62 is slidably inserted into the bar spring lumen 114 in the axial direction.
  • the spring 62) slides toward the tip, and the bar spring (second bar spring 62 or first bar spring 61) located on the outside when bent slides toward the proximal end, that is, the first bar spring 61 and The second bar spring 62 slides on opposite sides in the axial direction to cancel the resistance force of the first bar spring 61 and the second bar spring 62 against the force for bending the tip shaft portion 11. This makes it possible to easily bend (bend) the tip shaft portion 11.
  • the bar spring lumen 113 and the bar spring lumen 114 have a diameter slightly larger than the diameter of the high-rigidity member 60 so that the first bar spring 61 and the second bar spring 62 can slide in the axial direction.
  • the diameters of the bar spring lumens 113 and 114 are 0.25 mm.
  • the base end surface of the tip shaft portion 11 and the tip surface of the base end shaft portion 12 are joined (fixed) to each other to join (fix) the connecting portion 63 (first bar spring 61 and the first bar spring 61) of the high rigidity member 60.
  • Each base end of the second bar spring 62) is fixed to the base end of the tip shaft portion 11.
  • the tip end of the first bar spring 61 and the base end of the second bar spring 62 are fixed to the base end of the tip shaft portion 11, the tip end along the second virtual plane P2.
  • the bar spring first bar spring 61 or second bar spring 62 located inside the bend slides toward the proximal end and is located outside the bend.
  • the tip shaft portion 11 can be restored to a linear shape by sliding the current bar spring (first bar spring 62 or first bar spring 61) toward the tip end.
  • the base end of the first bar spring 61 and the base end of the second bar spring 62 are fixed to the base end of the tip shaft portion 11, even if the tip deflection operation is repeated, the first bar spring 61 and the second bar spring 61 are fixed. It is possible to prevent the 2-bar spring 62 from being displaced toward the tip end.
  • the tip 611 of the first bar spring 61 is based on a predetermined distance D from the tip opening (tip of the tip shaft portion 11) of the bar spring lumen 113. It is located on the end side, and the tip 621 of the second bar spring 62 is located on the base end side by the same distance D from the tip opening (tip of the tip shaft portion 11) of the bar spring lumen 114.
  • the bar spring (first bar spring 61 or second bar spring) located inside the bend is located. It is possible to effectively prevent the tip portion of 62) from extending from the tip opening of the bar spring lumen (bar spring lumen 113 or bar spring lumen 114).
  • the distance D is set so that the bar spring located inside the bend does not extend from the tip opening of the bar spring lumen even when the tip shaft portion 11 is bent to the maximum along the second virtual plane P2. It can be adjusted as appropriate, and a suitable example is 3 mm (75 mm-72 mm).
  • FIG. 7 shows the states of the first bar spring 61 and the second bar spring 62 when the tip shaft portion 11 is bent along the second virtual plane.
  • the tip shaft portion 11 is bent to the right as shown in the figure, the second bar spring 62 located inside slides toward the tip when bent, but the tip of the tip shaft portion 11 (the tip opening of the bar spring lumen) ), The tip 621 of the second bar spring 62 does not extend.
  • the tip shaft portion 11 is bent to the left as shown in the figure, the first bar spring 61 located inside slides toward the tip when bent, but the tip of the tip shaft portion 11 (the bar spring lumen)
  • the tip 611 of the first bar spring 61 does not extend from the tip opening).
  • the catheter shaft 10 is formed by inserting the first bar spring 61 and the second bar spring 62 into the two bar spring lumens 113 and 114 so as to be slidable in the axial direction, respectively.
  • the tip shaft portion 11 of the above can be easily bent along the second virtual plane P2, whereby excellent torque transmission can be exhibited.
  • the connecting portion 63 connecting the base ends of the first bar spring 61 and the second bar spring 62 is fixed to the base end of the tip shaft portion 11, the returnability of the tip shaft portion 11 is also excellent. There is. Further, even if the tip deflection operation is repeated, the first bar spring 61 and the second bar spring 62 do not shift in the tip direction.
  • FIG. 8 is a vertical cross-sectional view of the electrode catheter according to this embodiment, and in the same figure, the same reference numerals are used for the same components as the electrode catheter 100 according to the first embodiment. Further, FIGS. 1 to 4 and 6 used in the description of the first embodiment can be used as they are in the present embodiment.
  • the electrode catheter 200 of the present embodiment includes a catheter shaft 10 having a flexible tip shaft portion 11, a tip electrode 30 arranged on the tip side of the catheter shaft 10, and an outer peripheral surface of the tip portion of the catheter shaft 10.
  • the ring-shaped electrodes 41 to 43 mounted on the catheter shaft 10, and the first operation wire 51 that extends inside the catheter shaft 10 and can be pulled at the rear end in order to bend the tip shaft portion 11 in the first direction.
  • a second operation wire 52 extending inside the catheter shaft 10 and capable of pulling the rear end thereof, and a flatness in the bending direction of the tip shaft portion 11 are provided.
  • a high-rigidity member 60 formed by connecting the base ends of a pair of rod springs (first rod spring 61 and second rod spring 62) extending inside the tip shaft portion 11 and a catheter shaft 10
  • An anchor member 70 arranged between the catheter shaft 30 and fixing the tips of the first operating wire 51 and the second operating wire 52, and a handle 80 attached to the base end of the catheter shaft 10 are provided.
  • the catheter shaft 10 has a multi-lumen structure, and of the 10 lumens formed on the tip shaft portion 11, two wire lumens 111 and 112 arranged opposite to each other with the central axis of the catheter shaft 10 interposed therebetween.
  • the first bar spring 61 and the second bar spring 62 are axially arranged on the two bar spring lumens 113 and 114, which have their respective central axes on P2 and are arranged so as to face each other with the central axis of the catheter shaft 10 interposed therebetween. It is slidably inserted.
  • the tips of the first bar spring 61 and the second bar spring 62 are connected to each other by a connecting portion 63, and the connecting portion 63 is fixed to the tip of the tip shaft portion 11, whereby the first bar spring 61 and the second bar Each tip of the spring 62 is fixed to the tip of the tip shaft portion 11.
  • the tips of the first bar spring 61 and the second bar spring 62 are connected to each other by a connecting portion 63, and the connecting portion 63 is fixed to the tip of the tip shaft portion 11. It has the same configuration as the first embodiment.
  • the formed portion of the first bar spring 61 and the formed portion of the second bar spring 62 of the high-rigidity member 60 are respectively from the base end side of the tip shaft portion 11 to the bar spring lumen.
  • the formed portion of the first bar spring 61 and the formed portion of the second bar spring 62 of the high-rigidity member 60 are formed from the tip side of the tip shaft portion 11 and the bar spring lumen 113 and It is inserted into the bar spring lumen 114, and the connecting portion 63 (tips of the first bar spring 61 and the second bar spring 62) of the high-rigidity member 60 is fixed to the tip of the tip shaft portion 11.
  • the first bar spring 61 (the portion formed by the first bar spring in the high-rigidity member 60) is slidably inserted in the bar spring lumen 113 of the tip shaft portion 11 in the axial direction.
  • the second bar spring 62 (the portion formed by the second bar spring in the high-rigidity member 60) is inserted through the bar spring lumen 114 of the tip shaft portion 11 so as to be slidable in the axial direction.
  • the first bar spring 61 is slidably inserted into the bar spring lumen 113 in the axial direction
  • the second bar spring 62 is slidably inserted into the bar spring lumen 114 in the axial direction.
  • the spring 62) slides toward the proximal end, and the bar spring (second bar spring 62 or first bar spring 61) located outside when bent slides toward the tip end, that is, the first bar spring 61 and The second bar spring 62 slides on opposite sides in the axial direction to cancel the resistance force of the first bar spring 61 and the second bar spring 62 against the force for bending the tip shaft portion 11. This makes it possible to easily bend (bend) the tip shaft portion 11.
  • the connecting portion 63 of the high-rigidity member 60 is fixed to the tip of the tip shaft portion 11 by the adhesive 90 filled in the clearance between the tip shaft portion 11 and the anchor member 70. There is.
  • the tip shaft portion 11 is along the second virtual plane P2.
  • the bar spring (1st bar spring 61 or 2nd bar spring 62) located inside the bend slides toward the tip and the bar spring located outside the bend (1st bar spring 61) slides in the bent state.
  • the tip shaft portion 11 can be restored to a linear shape.
  • the tip of the first bar spring 61 and the tip of the second bar spring 62 are fixed to the tip of the tip shaft portion 11, even if the tip deflection operation is repeated, the first bar spring 61 and the second bar spring 62 It is possible to prevent the 62 from being displaced in the proximal direction.
  • the base end 612 of the first bar spring 61 is a predetermined distance from the base end opening (base end of the tip shaft portion 11) of the bar spring lumen 113. Only D is located on the tip side, and the base end 622 of the second bar spring 62 is located on the tip side by the same distance D from the base end opening (base end of the tip shaft portion 11) of the bar spring lumen 114.
  • the bar spring (first bar spring 61 or second bar spring) located inside the bend is located. It is possible to effectively prevent the base end of 62) from coming into contact with the tip end surface of the base end shaft portion 12.
  • the catheter shaft 10 is formed by inserting the first bar spring 61 and the second bar spring 62 into the two bar spring lumens 113 and 114 so as to be slidable in the axial direction, respectively.
  • the tip shaft portion 11 of the above can be easily bent along the second virtual plane P2, whereby excellent torque transmission can be exhibited.
  • the connecting portion 63 connecting the tips of the first bar spring 61 and the second bar spring 62 is fixed to the tip of the tip shaft portion 11, the returnability of the tip shaft portion 11 is also excellent. Further, even if the tip deflection operation is repeated, the first bar spring 61 and the second bar spring 62 do not shift in the proximal direction.
  • Electrode catheter 10 Catheter shaft 11 Tip shaft 111,112 Wire lumen 113,114 Bar spring lumen 115-118 Lumen 119A, 119B Lumen 12 Base shaft 121,122 Lumen 125-128 Lumen 129A, 129B Lumen 30 Tip electrode 41- 43 Ring-shaped electrode 30L, 41L to 43L Lead wire 45 Thermoelectric pair 51 1st operation wire 52 2nd operation wire 61 1st bar spring 611 Tip of 1st bar spring 612 Base end of 1st bar spring 62 2nd bar spring 621 Tip of 2nd bar spring 622 Base end of 2nd bar spring 70 Anchor member 80 Handle 85 Picking 90 Adhesive

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

La présente invention vise à fournir un cathéter à pointe orientable munie d'une section de pointe qui peut être facilement courbée le long d'un plan virtuel comprenant l'axe central d'une paire de ressorts à barre et dotée d'une excellente transmission de couple. Ce cathéter (100) comprend : un arbre (10) présentant une structure à lumières multiples et comprenant une section de pointe de corps de cathéter (11) ; une paire de fils d'actionnement (51, 52) s'étendant à l'intérieur de l'arbre ; et une paire de ressorts à barres (61, 62) s'étendant à l'intérieur de la section de pointe de corps de cathéter. La paire de fils d'actionnement est insérée de manière coulissante à l'intérieur de chacune de deux lumières de fils (111, 112) disposés l'un en face de l'autre sur l'axe central de l'arbre ; chacune des lumières de fil possède un axe central sur un second plan virtuel (P2) orthogonal à un premier plan virtuel (P1) qui comprend chacun des axes centraux des lumières de fil ; la paire de ressorts à barres est insérée de manière coulissante, respectivement, dans chacune de deux lumières de ressorts à barres (113, 114) disposés l'un en face de l'autre sur l'axe central de l'arbre ; et une extrémité de base du ressort à barres est fixée à une extrémité de base de la pointe de corps de cathéter.
PCT/JP2019/011217 2019-03-18 2019-03-18 Cathéter muni d'une pointe orientable Ceased WO2020188704A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/JP2019/011217 WO2020188704A1 (fr) 2019-03-18 2019-03-18 Cathéter muni d'une pointe orientable
JP2021506854A JP7261290B2 (ja) 2019-03-18 2019-03-18 先端偏向操作可能カテーテル

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2019/011217 WO2020188704A1 (fr) 2019-03-18 2019-03-18 Cathéter muni d'une pointe orientable

Publications (1)

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WO2020188704A1 true WO2020188704A1 (fr) 2020-09-24

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PCT/JP2019/011217 Ceased WO2020188704A1 (fr) 2019-03-18 2019-03-18 Cathéter muni d'une pointe orientable

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JP (1) JP7261290B2 (fr)
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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS62265612A (ja) * 1986-03-05 1987-11-18 サ−コン・コ−ポレ−シヨン 耐ねじれ脊柱状組立体
WO2000006242A1 (fr) * 1998-07-31 2000-02-10 Myelotec, Inc. Catheter guidable comportant une pointe segmentee et une gaine d'introduction monobloc
JP2008245766A (ja) * 2007-03-29 2008-10-16 Japan Lifeline Co Ltd 先端偏向操作可能カテーテル
JP2012034971A (ja) * 2010-08-10 2012-02-23 Japan Lifeline Co Ltd カテーテル
US20120296167A1 (en) * 2011-05-18 2012-11-22 Three-In-One Enterprises Co., Ltd. Flexible-Tubed Structure of Endoscope

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5368564A (en) * 1992-12-23 1994-11-29 Angeion Corporation Steerable catheter
JP5697273B2 (ja) * 2013-07-25 2015-04-08 日本ライフライン株式会社 先端偏向操作可能カテーテル

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS62265612A (ja) * 1986-03-05 1987-11-18 サ−コン・コ−ポレ−シヨン 耐ねじれ脊柱状組立体
WO2000006242A1 (fr) * 1998-07-31 2000-02-10 Myelotec, Inc. Catheter guidable comportant une pointe segmentee et une gaine d'introduction monobloc
JP2008245766A (ja) * 2007-03-29 2008-10-16 Japan Lifeline Co Ltd 先端偏向操作可能カテーテル
JP2012034971A (ja) * 2010-08-10 2012-02-23 Japan Lifeline Co Ltd カテーテル
US20120296167A1 (en) * 2011-05-18 2012-11-22 Three-In-One Enterprises Co., Ltd. Flexible-Tubed Structure of Endoscope

Also Published As

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JP7261290B2 (ja) 2023-04-19
JPWO2020188704A1 (ja) 2021-10-21

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