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WO2024080004A1 - Cathéter - Google Patents

Cathéter Download PDF

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Publication number
WO2024080004A1
WO2024080004A1 PCT/JP2023/030568 JP2023030568W WO2024080004A1 WO 2024080004 A1 WO2024080004 A1 WO 2024080004A1 JP 2023030568 W JP2023030568 W JP 2023030568W WO 2024080004 A1 WO2024080004 A1 WO 2024080004A1
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WO
WIPO (PCT)
Prior art keywords
catheter
lumen
tip
marker
antegrade
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/JP2023/030568
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English (en)
Japanese (ja)
Inventor
伊藤隆史
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.)
Terumo Corp
Original Assignee
Terumo Corp
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 Terumo Corp filed Critical Terumo Corp
Publication of WO2024080004A1 publication Critical patent/WO2024080004A1/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
    • A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers

Definitions

  • the present invention relates to a catheter for insertion into a lumen of a living body.
  • JP 2004-229812 A discloses a sheath introducer that guides a catheter when it is introduced into a blood vessel.
  • the sheath introducer has a tubular sheath tube, and has three contrast regions at the tip of the sheath tube.
  • the three contrast regions are spaced apart from one another in the circumferential direction of the sheath tube, and are in the form of stripes that each extend in the longitudinal direction of the sheath tube.
  • the tip of the sheath tube in JP 2004-229812 A has an outer circumferential surface that tapers toward the tip.
  • medical personnel When checking the tip of the sheath tube under radioscopy, medical personnel will view it from a direction perpendicular to the longitudinal direction of the sheath tube. At this time, the three contrast regions are displayed in an oblique (tapered) shape along the outer circumferential surface of the tip.
  • a first aspect of the present invention is a catheter that can be inserted into a lumen of a living body and advanced along the lumen, the catheter comprising a tubular catheter body having a lumen, and a marker that includes a radiopaque material and is disposed at the tip of the catheter body, the marker having a stripe portion that is parallel to the extension direction of the lumen.
  • the striped portion of the marker and the lumen are arranged in parallel, so that when a guidewire is inserted from the tip of the catheter body into the lumen under radioscopy, the guidewire and the catheter body can be easily aligned coaxially while visually checking the striped portion, and the guidewire can be inserted into the lumen of the catheter body. Because it is easy to align the guidewire and the catheter body, it is possible to reduce the amount of radiation exposure to medical personnel and living organisms when working under radioscopy.
  • the tip of the catheter body may have a bent portion at a position a predetermined distance away from the most distal end of the catheter body in the proximal direction, and the stripe portion may extend at least to the bent portion.
  • the guidewire can be easily aligned and inserted coaxially thanks to the stripe section that is parallel to the lumen.
  • the distance between the most distal end of the marker and the most distal end of the catheter body in the axial direction of the catheter body may be 0.5 mm or less.
  • the axial distance between the most extreme end of the marker placed at the tip of the catheter and the most extreme end of the catheter body is 0.5 mm or less, so that the position of the catheter tip can be confirmed with high accuracy under radioscopy when the catheter is advanced along the lumen of the living body.
  • the marker may have a ring portion that is formed in a ring shape along the circumferential direction of the catheter body and that constitutes the most distal end of the marker.
  • the ring portion can be viewed under radioscopy, making it easier and more accurate to confirm the leading edge of the marker and to accurately confirm the position of the catheter tip.
  • the catheter may be an antegrade catheter that advances along the lumen toward the peripheral side of the living body.
  • the guide wire inserted into the retrograde catheter can be inserted along the striped portion of the marker, thereby improving the insertability of the retrograde catheter.
  • a second aspect of the present invention is a method for treating a lesion in a lumen by using an antegrade catheter that advances along a lumen of a living body toward the peripheral side of the living body, and a retrograde catheter that advances along the lumen toward the central side of the living body, the antegrade catheter comprising a tubular first catheter body having a first lumen, and a marker that includes a radiopaque material and is disposed at the tip of the first catheter body, the marker having a stripe portion parallel to the extension direction of the first lumen, and the retrograde catheter comprising a first
  • the treatment method includes a tubular second catheter body having two lumens, and includes the steps of advancing the antegrade catheter to the peripheral side within the lumen of the living body, advancing the retrograde catheter with a guidewire inserted through the second lumen to the central side, and inserting the tip of the guidewire into the first lumen while checking the position of the stripe portion of the marker and the guidewire under radioscopy, and inserting the tip
  • the striped portion of the marker and the lumen are arranged in parallel in the catheter, so that when a guidewire is inserted from the tip of the catheter body into the lumen under radioscopy, the guidewire and the catheter body can be easily aligned coaxially while visually checking the striped portion, and the guidewire can be inserted into the lumen of the catheter body. Because it is easy to align the guidewire and the catheter body, it is possible to reduce the amount of radiation exposure to the living body when working under radioscopy.
  • FIG. 1 is a plan view showing the overall configuration of a catheter according to an embodiment of the present invention.
  • FIG. 2 is an enlarged plan view of the distal end of the antegrade catheter of FIG.
  • FIG. 3 is a front view of the distal end of the antegrade catheter of FIG. 2 .
  • 4A to 4D are explanatory diagrams showing the manufacturing process when manufacturing a marker.
  • FIG. 5 is an explanatory diagram showing a state in which the tip of the antegrade catheter has been delivered to the upstream end of the lesion and the tip of the retrograde catheter has advanced into the lesion.
  • FIG. 6 is an explanatory diagram showing a state in which a guidewire is inserted into the distal end of an antegrade catheter.
  • FIG. 1 is a plan view showing the overall configuration of a catheter according to an embodiment of the present invention.
  • FIG. 2 is an enlarged plan view of the distal end of the antegrade catheter of FIG.
  • FIG. 3 is a front view of the distal
  • FIG. 7 is an explanatory diagram showing the state in which the tip portion of a retrograde catheter is inserted into the tip portion of an antegrade catheter at a lesion site.
  • FIG. 8 is a plan view showing the overall configuration of a catheter according to a modified example having no bent portion.
  • the catheter 10 is used, for example, to treat a lesion 16 (such as a stenosis or occlusion) that has occurred in a blood vessel 14 of a living body 12.
  • a lesion 16 such as a stenosis or occlusion
  • the catheter 10 is used in lower limb vascular treatment to treat a CTO 16a (chronic total occlusion, lesion 16) that has occurred in a blood vessel 14 of the lower limb of the living body 12 using an antegrade approach.
  • the catheter 10 may also be used to treat a lesion 16 in a lumen other than a blood vessel 14, for example, in a living organ such as a bile duct, trachea, esophagus, urethra, or other organ.
  • the catheter 10 can be inserted into a blood vessel 14 of a living body 12 and advanced along the blood vessel 14.
  • the catheter 10 is used, for example, as an antegrade catheter 18 used in an antegrade approach in lower limb vascular treatment.
  • the catheter 10 is also referred to as an antegrade catheter 18.
  • the tip 36a of a retrograde catheter 20 used in a retrograde approach can be inserted into the tip 24a of the antegrade catheter 18 (see Figure 7).
  • Antegrade catheter 18 is a catheter that advances along blood vessels 14 of living body 12 toward the peripheral side of living body 12 (ankle side, in the direction of arrow A) in lower limb vascular treatment.
  • the antegrade catheter 18 comprises a tubular first catheter body 24 having a first lumen 22 and a marker 26 disposed at the tip 24a of the first catheter body 24.
  • the first catheter body 24 is formed from a resin material having flexibility.
  • the first catheter body 24 is made of a resin material having a certain degree of flexibility, such as polyolefins such as polyethylene, polypropylene, and ethylene-propylene copolymers, polyesters such as polyethylene terephthalate and polybutylene terephthalate, polystyrene, polyvinyl chloride, polyurethane, polyamide, or various elastomers such as polyolefin elastomers, polyester elastomers, polyurethane elastomers, and polyamide elastomers, and may be blended, laminated, or arranged in multiple stages in the axial direction, or a reinforcing member may be arranged.
  • polyolefins such as polyethylene, polypropylene, and ethylene-propylene copolymers
  • polyesters such as polyethylene terephthalate and polybutylene terephthalate
  • polystyrene polyvinyl
  • the first lumen 22 is arranged inside the first catheter body 24.
  • the first lumen 22 extends along the first catheter body 24. Since the antegrade catheter 18 is used to treat the CTO 16a, the tip 24a of the first catheter body 24 is not made of a soft material such as a rubber material (elastomer material), but has a hardness suitable for treating the CTO 16a.
  • the outer peripheral surface of the tip 24a of the first catheter body 24 is tapered, decreasing in diameter toward the tip of the first catheter body 24 (in the direction of arrow A).
  • the tip 24a of the first catheter body 24 has a bent portion 28.
  • the bent portion 28 is positioned at a predetermined distance from the most distal end 24b of the first catheter body 24 in the proximal direction (in the direction of arrow B in FIG. 1).
  • the bent portion 28 causes the tip 24a and the proximal end of the first catheter body 24 to be inclined relative to each other.
  • the marker 26 comprises a cylindrical support 26a and an imaging portion 26b arranged on the support 26a.
  • the marker 26 enables the tip position (leading end 24b) of the antegrade catheter 18 to be visualized under X-ray (radiation) imaging within the living body 12.
  • the marker 26 is arranged on the tip portion 24a of the first catheter body 24.
  • the support 26a is formed into a cylindrical shape from a transparent sheet-like film 44.
  • the support 26a is formed from a resin material that is transmissible to radiation.
  • the support 26a is embedded inside the tip 24a of the first catheter body 24.
  • the support 26a has a predetermined length along the extension direction of the first catheter body 24.
  • the imaging portion 26b includes a radiopaque material (e.g., gold, platinum, tungsten, or a mixture of these, etc.) and is disposed inside the support 26a.
  • the imaging portion 26b is, for example, laminated to the sheet-like support 26a and covered by the support 26a.
  • the contrast section 26b has a stripe section 32a extending in the axial direction of the support 26a and a ring section 32b located at the tip of the stripe section 32a.
  • the stripe portion 32a is made of a wire that extends from the tip to the base of the support 26a.
  • a plurality of stripe portions 32a are provided in the circumferential direction of the support 26a.
  • the stripe portions 32a are equally spaced apart from each other in the circumferential direction of the support 26a. Below, a case where four stripe portions 32a are provided will be described.
  • each of the multiple stripe portions 32a is parallel to the extension direction of the first lumen 22 (direction of arrows A and B).
  • the thickness of the stripe portion 32a in the radial direction of the first catheter body 24 is constant along the stripe portion 32a.
  • the tip of the stripe portion 32a extends to the ring portion 32b.
  • the base end of the stripe portion 32a extends at least to the bent portion 28. In this embodiment, the stripe portion 32a extends to the base end side beyond the bent portion 28.
  • the ring portion 32b is placed at the most distal end 26c of the marker 26.
  • the ring portion 32b constitutes the tip of the marker 26.
  • the ring portion 32b is formed in a ring shape from a wire.
  • the ring portion 32b is placed along the circumferential direction of the support 26a.
  • the ring portion 32b is connected to the tip of each stripe portion 32a.
  • the multiple stripe portions 32a are connected together by the ring portion 32b.
  • the tip of the marker 26 has a leading end 26c that is located in the most distal direction (arrow A direction).
  • the leading end 26c of the marker 26 is the tip of the ring portion 32b.
  • the leading end 26c of the marker 26 is located on the base end side (arrow B direction) of the leading end 24b of the first catheter body 24.
  • the axial distance L between the leading end 26c of the marker 26 and the leading end 24b of the first catheter body 24 is 0.5 mm or less.
  • the leading end 26c of the marker 26 is located within 0.5 mm on the base end side (arrow B direction) of the leading end 24b of the first catheter body 24.
  • the leading end 26c of the marker 26 (ring portion 32b) is not exposed to the outside from the leading end 24b of the first catheter body 24.
  • the base end of the first catheter body 24 includes a first hub 30.
  • the first hub 30 is cylindrical.
  • the base end of the first hub 30 is open.
  • the retrograde catheter 20 used in lower limb vascular treatment.
  • the retrograde catheter 20 advances along the blood vessels 14 of the living body 12 toward the central side of the living body 12 (toward the heart, in the direction of arrow B) during lower limb vascular treatment.
  • the tip 36a of the retrograde catheter 20 can be inserted into the tip 24a of the antegrade catheter 18 (see Figure 7).
  • the retrograde catheter 20 has a tubular second catheter body 36 with a second lumen 34.
  • the second catheter body 36 is formed from a resin material having flexibility.
  • the second catheter body 36 is made of a resin material having a certain degree of flexibility, such as polyolefins such as polyethylene, polypropylene, and ethylene-propylene copolymers, polyesters such as polyethylene terephthalate and polybutylene terephthalate, polystyrene, polyvinyl chloride, polyurethane, polyamide, or various elastomers such as polyolefin elastomers, polyester elastomers, polyurethane elastomers, and polyamide elastomers, and may be blended, laminated, or arranged in multiple stages in the axial direction, or a reinforcing body may be arranged.
  • polyolefins such as polyethylene, polypropylene, and ethylene-propylene copolymers
  • polyesters such as polyethylene terephthalate and polybutylene terephthalate
  • polystyrene polyvinyl
  • the diameter of the second catheter body 36 is smaller than the diameter of the first catheter body 24.
  • the second lumen 34 is arranged inside the second catheter body 36.
  • the second lumen 34 extends along the second catheter body 36.
  • the second lumen 34 is a passage through which the guide wire 38 can be inserted. Because the retrograde catheter 20 is used to treat the CTO 16a, the tip 36a of the second catheter body 36 is not made of a soft material such as rubber (elastomer material) and has a hardness suitable for treating the CTO 16a.
  • the tip 36a of the second catheter body 36 is tapered, the diameter of which decreases in the direction of the tip of the second catheter body 36 (in the direction of arrow B).
  • the tip 36a of the second catheter body 36 is the end that is in the direction of advancement (in the direction of arrow B) when the retrograde catheter 20 is inserted into the blood vessel 14 and advanced.
  • the tip 36a of the second catheter body 36 gradually tapers toward the most distal end 36b (in the direction of the tip, in the direction of arrow B).
  • a contrast marker (not shown) is placed at the tip 36a of the second catheter body 36.
  • the contrast marker contains a radiopaque material and allows the tip position of the retrograde catheter 20 to be visible under X-ray (radiation) imaging within the living body 12.
  • the guidewire 38 is a wire made of a metallic material.
  • the guidewire 38 is movably inserted into the second lumen 34 of the second catheter body 36.
  • the tip 38a of the guidewire 38 can protrude from the most distal end 36b of the second catheter body 36 in the distal direction (central side, arrow B direction).
  • the tip 38a of the guidewire 38 advances through the blood vessel 14 toward the central side (arrow B direction) ahead of the tip 36a of the second catheter body 36.
  • the retrograde catheter 20 is guided through the blood vessel 14 by the guidewire 38.
  • the base end of the second catheter body 36 is provided with a second hub 40.
  • the second hub 40 is cylindrical.
  • the base end of the second hub 40 is open.
  • a guidewire 38 can be inserted into the second lumen 34 through the second hub 40.
  • a plurality of wire materials 42 that constitute the stripe portion 32a and ring portion 32b of the contrast portion 26b are prepared.
  • the wire material 42 is formed into a rod shape from a contrast wire material made of a metal material or a resin material containing a contrast agent.
  • the plurality of wire materials 42 (hereinafter referred to as first wire materials 42a) that will become the stripe portion 32a are arranged at equal intervals in the width direction (direction of arrow C).
  • a lamination process is performed in which all of the first wire materials 42a are sandwiched between a film 44 made of a resin material as shown in FIG. 4B.
  • the film 44 forms the support body 26a in the marker 26.
  • the marker manufacturing sheet 46 is cut to the desired length in the longitudinal direction of the first wire material 42a to form the marker manufacturing sheet 46 into small sheet pieces 48.
  • the wire material 42 that will become the ring portion 32b (hereinafter, the second wire material 42b) is placed at the longitudinal end of the sheet piece 48.
  • the second wire material 42b is placed so as to intersect with and straddle the multiple first wire materials 42a.
  • the second wire material 42b is fixed to the end of the sheet piece 48 by, for example, heat welding.
  • the sheet piece 48 is bent into a ring shape, and the widthwise ends of the sheet piece 48 are fused together by heat welding or the like.
  • the multiple first wire materials 42a form the stripe portion 32a
  • the second wire material 42b forms the ring portion 32b
  • the sheet piece 48 forms the support body 26a.
  • the blood vessel 14 in the lower limb in Figure 1 has a main tube 14a and first and second branch tubes 14b, 14c that are bifurcated downstream of the main tube 14a, and shows a case where a CTO 16a (lesion 16) has occurred in the first branch tube 14b.
  • the first branch tube 14b and the second branch tube 14c are bent in directions that move away from each other downstream.
  • the left side of the CTO 16a in the main tube section 14a and the first branch tube section 14b is the central side (heart side) and the upstream side of the blood flow.
  • the right side of the CTO 16a in the first branch tube section 14b is the peripheral side (ankle side) and the downstream side of the blood flow.
  • the blood vessel 14 (first branch tube section 14b) upstream (left) of the CTO 16a is referred to as the upstream blood vessel section 14d
  • the blood vessel 14 (first branch tube section 14b) downstream (right) of the CTO 16a is referred to as the downstream blood vessel section 14e.
  • the upstream blood vessel section 14d is an artery with a relatively large diameter of the blood vessel 14.
  • the downstream blood vessel section 14e is a peripheral blood vessel with a smaller diameter of the blood vessel 14 than the upstream blood vessel section 14d.
  • an antegrade approach is performed with an antegrade catheter 18 to a blood vessel 14 in the lower limb of a living body 12.
  • a medical professional percutaneously inserts the tip 24a of the antegrade catheter 18 into the main tube 14a of the blood vessel 14.
  • the tip 24a of the antegrade catheter 18 is advanced toward the peripheral side (in the direction of arrow A) toward the CTO 16a along a guide wire (not shown) within the blood vessel 14.
  • the medical professional can visually recognize the marker 26 as a radiographic image via a display or the like under X-ray contrast, thereby performing the procedure while visually recognizing the tip position (leading edge 24b) of the antegrade catheter 18.
  • the ring portion 32b of the marker 26 makes it possible to visually recognize the marker 26 from any circumferential position of the tip 24a of the antegrade catheter 18 (see FIG. 3).
  • a medical professional (not shown) can rotate the antegrade catheter 18 and point the tip 24a toward the first branch pipe section 14b, allowing the tip 24a of the antegrade catheter 18 to be advanced appropriately along the first branch pipe section 14b.
  • a medical professional can rotate the antegrade catheter 18 and point the tip 24a toward the first branch pipe section 14b, allowing the tip 24a of the antegrade catheter 18 to be advanced appropriately along the first branch pipe section 14b.
  • the tip 24a of the antegrade catheter 18 is bent at the bend section 28, it is easy to advance the tip 24a toward the bent first branch pipe section 14b.
  • the tip 24a (leading edge 24b) of the antegrade catheter 18 is delivered to the upstream end of the CTO 16a along the upstream blood vessel 14d.
  • the upstream end of the CTO 16a has a protruding portion 50 that is convex toward the upstream blood vessel 14d (in the direction of arrow B).
  • the leading edge 24b of the antegrade catheter 18 comes into contact with the protruding portion 50.
  • a medical professional (not shown) can use the marker 26 to confirm the position of the tip 24a of the antegrade catheter 18 as a radiological image on a display or the like.
  • a retrograde approach is performed to deliver the tip 36a of the retrograde catheter 20 along the downstream vascular portion 14e to the CTO 16a.
  • the tip 36a of the retrograde catheter 20 is percutaneously inserted into the downstream vascular portion 14e of the blood vessel 14 (see FIG. 1).
  • the guidewire 38 is inserted into the second lumen 34 of the retrograde catheter 20.
  • the tip 36a of the retrograde catheter 20 is advanced toward the central side (arrow B direction) along the guidewire 38 toward the CTO 16a.
  • the direction of advancement of the antegrade catheter 18 first direction, toward the peripheral side
  • the direction of advancement of the retrograde catheter 20 second direction, toward the central side
  • the tip 36a of the retrograde catheter 20 is delivered to the downstream end of the CTO 16a along the downstream blood vessel portion 14e.
  • the downstream end of the CTO 16a has a recessed portion 52 that is recessed toward the upstream blood vessel portion 14d.
  • the leading end 36b of the retrograde catheter 20 is inserted into the recessed portion 52.
  • the tip 36a of the retrograde catheter 20 advances from the recess 52 into the interior of the CTO 16a.
  • the tip 36a (leading edge 36b) of the retrograde catheter 20 excavates the CTO 16a, forming a perforation 54.
  • the perforation 54 is formed from the bottom of the recess 52 toward the protrusion 50. As the retrograde catheter 20 advances, the perforation 54 penetrates all the way to the upstream end (protrusion 50) of the CTO 16a.
  • the tip of the guidewire 38 penetrates the CTO 16a and protrudes from the protrusion 50 in the distal direction.
  • a medical professional (not shown) checks the relative positions of the marker 26 of the antegrade catheter 18 and the tip 38a of the guidewire 38 under X-ray fluoroscopy, and adjusts the direction of the guidewire 38 so that the tip 38a of the guidewire 38 is parallel to the stripe portion 32a of the marker 26. After the guidewire 38 and the stripe portion 32a are made parallel, the tip of the guidewire 38 is advanced toward the center of the ring portion 32b of the marker 26. The tip 38a of the guidewire 38 is inserted into the first lumen 22 of the first catheter body 24.
  • the guidewire 38 can be advanced toward the antegrade catheter 18 along the stripe portion 32a of the marker 26, allowing the guidewire 38 to be easily and reliably inserted into the first lumen 22.
  • the tip 24a (leading edge 24b) of the antegrade catheter 18 advances along the perforation 54 into the interior of the CTO 16a.
  • the tip 36a of the retrograde catheter 20 is inserted into the first lumen 22 of the tip 24a of the antegrade catheter 18.
  • the tip 24a of the antegrade catheter 18 is smoothly inserted into the CTO 16a along the perforation 54.
  • the tip 24a of the antegrade catheter 18 pushes the perforation 54 radially outward.
  • the retrograde catheter 20 is removed.
  • a balloon catheter (not shown) is inserted into the first lumen 22 of the antegrade catheter 18, and the balloon catheter is delivered to the CTO 16a.
  • the CTO 16a is treated with the balloon catheter. Note that after a guidewire (not shown) is inserted into the first lumen 22 of the antegrade catheter 18, the antegrade catheter 18 may be removed to leave the guidewire in place, and the balloon catheter may be delivered to the CTO 16a along the guidewire (not shown).
  • the insertion of the tip 36a of the retrograde catheter 20 into the tip 24a of the antegrade catheter 18 is not limited to being performed inside the CTO 16a.
  • the tip 36a of the retrograde catheter 20 may be inserted into the tip 24a of the antegrade catheter 18 in the upstream vascular section 14d or downstream vascular section 14e near the CTO 16a.
  • the catheter 10 used as the antegrade catheter 18 is not limited to a configuration having a bent portion 28. As shown in FIG. 8, the catheter 10a (antegrade catheter 18a) may have a first catheter body 25 that is linear along the axial direction. The catheter 10a is ideal for use in treating lower limb blood vessels, for example, in unbranched blood vessels 14.
  • the stripe portion 32a of the marker 26 and the first lumen 22 are arranged in parallel, so that when a medical professional inserts the guidewire 38 from the tip portion 24a of the first catheter body 24 into the first lumen 22 under X-ray imaging, the medical professional can easily align the guidewire 38 and the first catheter body 24 coaxially while visually checking the stripe portion 32a, and insert the guidewire 38 into the first lumen 22 of the first catheter body 24.
  • This makes it possible to easily align the guidewire 38 and the first catheter body 24, and reduces the amount of radiation exposure to the medical professional and the living body 12 when the medical professional works under X-ray imaging.
  • the tip 24a of the first catheter body 24 has a bent portion 28 at a position a predetermined distance away from the most distal end 24b of the first catheter body 24 in the proximal direction, and the stripe portion 32a extends at least to the bent portion 28. Therefore, even if the tip 24a of the first catheter body 24 has a bent portion 28, the guidewire 38 can be easily aligned coaxially with the first lumen 22 by the stripe portion 32a arranged parallel to the first lumen 22.
  • the distance between the most distal end 26c of the marker 26 and the most distal end 24b of the first catheter body 24 in the axial direction of the first catheter body 24 is 0.5 mm or less, so when the antegrade catheter 18 is advanced along the blood vessel 14 of the living body 12, the tip position of the antegrade catheter 18 can be confirmed with high accuracy under X-ray imaging.
  • the marker 26 has a ring portion 32b that is formed in a ring shape along the circumferential direction of the first catheter body 24 and constitutes the leading end 26c of the marker 26. Therefore, by visually checking the ring portion 32b under X-ray contrast, medical personnel can more easily and accurately confirm the leading end 26c of the marker 26, and therefore the tip position of the antegrade catheter 18 can be accurately confirmed.
  • the ease of inserting the tip of the retrograde catheter 20 can be improved by inserting the guidewire 38 along the stripe portion 32a of the marker 26 located on the tip portion 24a.
  • the present invention is not limited to the above disclosure, and various configurations may be adopted without departing from the gist of the present invention.
  • the lesion 16 does not have to be a typical CTO 16a, but may be a severely stenosed lesion where a certain degree of blood flow is observed, or may be a mildly stenosed lesion to reduce the burden on the patient.

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  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
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  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
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  • Heart & Thoracic Surgery (AREA)
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  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention concerne un cathéter (10) (cathéter antérograde (18)) apte à avancer le long d'un vaisseau (14) d'un corps vivant (12) et qui comprend un premier corps de cathéter tubulaire (24) ayant une première lumière (22) et un marqueur (26) contenant un matériau radio-opaque et disposé au niveau d'un bout (24a) du premier corps de cathéter (24). Le marqueur (26) a une section de bande (32a) parallèle à la direction d'extension de la première lumière (22).
PCT/JP2023/030568 2022-10-11 2023-08-24 Cathéter Ceased WO2024080004A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2022-163449 2022-10-11
JP2022163449A JP2025176721A (ja) 2022-10-11 2022-10-11 カテーテル

Publications (1)

Publication Number Publication Date
WO2024080004A1 true WO2024080004A1 (fr) 2024-04-18

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PCT/JP2023/030568 Ceased WO2024080004A1 (fr) 2022-10-11 2023-08-24 Cathéter

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JP (1) JP2025176721A (fr)
WO (1) WO2024080004A1 (fr)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS57501165A (fr) * 1980-07-28 1982-07-08
US5921978A (en) * 1997-06-20 1999-07-13 Ep Technologies, Inc. Catheter tip steering plane marker
JP2001104487A (ja) * 1999-10-06 2001-04-17 Kanegafuchi Chem Ind Co Ltd 薬剤注入カテーテル
JP2009268648A (ja) * 2008-05-02 2009-11-19 Nipro Corp 医療用カテーテル
JP2011518615A (ja) * 2008-04-23 2011-06-30 レトロ・ヴァスキュラー・インコーポレーテッド コントロールされた順行性および逆行性トラッキングを使用する閉塞した血管の再疎通
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