Catheter for removing foreign body in blood vessel
11426192 · 2022-08-30
Assignee
Inventors
Cpc classification
A61B2017/320775
HUMAN NECESSITIES
A61B17/221
HUMAN NECESSITIES
A61B17/320758
HUMAN NECESSITIES
A61B17/320725
HUMAN NECESSITIES
A61B2017/22078
HUMAN NECESSITIES
A61B2017/22072
HUMAN NECESSITIES
A61B2017/320733
HUMAN NECESSITIES
A61B2017/320716
HUMAN NECESSITIES
A61B17/32075
HUMAN NECESSITIES
International classification
A61B17/3207
HUMAN NECESSITIES
Abstract
A capturing unit provided on a distal end of a second tube can be deformed into a contracted state and an expanded state, in which the capturing unit is deployed to form a capturing chamber. The capturing chamber has an opening area decreased as it goes from a distal end opening of the capturing chamber toward a proximal end opening of the capturing chamber. A third tube rotatable relative to the second tube and a cutting unit provided on a distal end of the third tube for cutting a foreign substance are arranged in a second lumen. In the expanded state of the capturing unit, the cutting unit is arranged more toward the proximal end opening of the capturing chamber than the distal end opening.
Claims
1. A catheter for removing a foreign substance in a blood vessel, the catheter comprising: a tube configured to be inserted in the blood vessel; and a capturing unit provided on a distal end of the tube and configured to be radially expandable and to be guided into the blood vessel through the tube to capture the foreign substance in the blood vessel; and a guide unit configured to guide a foreign substance between the guide unit and the capturing unit toward the capturing unit, the guide unit comprising wire members, each of the wire members being convex toward a wall of the blood vessel when the guide unit is placed inside the blood vessel, wherein the capturing unit includes a plurality of frame portions and a plurality of sheet portions, wherein the capturing unit forms a capturing chamber, an opening area of which is decreased as it goes from a distal end opening of the capturing chamber toward a proximal end opening of the capturing chamber in an expanded state of the capturing chamber, wherein each of the plurality of frame portions has a same shape, and the plurality of frame portions are arranged circumferentially at a constant regularity, wherein each of the plurality of frame portions includes a protrusion provided only on an inner side of the capturing unit, wherein the plurality of frame portions and the plurality of sheet portions are alternatively arranged around an axis centered on a tube axis of the catheter, wherein, in a contracted state, the capturing unit is configured so that a distal end sides of the plurality of frame portions are gathered in a circumference shape and the sheet portions are folded on only an outer side of the capturing unit, wherein each of the plurality of protrusions extends in the axial direction from a proximal end to a distal end of the capturing unit, and wherein, in the expanded state, each of the plurality of sheet portions cover between adjacent frame portions of the plurality of frame portions in a membrane shape.
2. The catheter according to claim 1, wherein the capturing unit is configured such that an outer side of the capturing unit touches the wall of the blood vessel when the capturing unit is expanded.
3. The catheter according to claim 1, wherein the capturing unit and the guide unit are sized such that the foreign substance guided toward the capturing unit is nodulized between the plurality of frame portions of the capturing unit and the wire members of the guide unit.
4. The catheter according to claim 1, wherein the capturing unit comprises a portion configured to expand in a bowl shape extending from an end of the tube when the capturing unit is in the expanded state.
5. The catheter according to claim 1, wherein the plurality of sheet portions are configured to cover gaps between the plurality of frame portions.
6. The catheter according to claim 1, wherein each of the plurality of frame members is column shaped.
7. The catheter according to claim 6, wherein each of the plurality of frame members is a triangular column shape.
8. The catheter according to claim 1, wherein the guide unit comprises a balloon.
Description
BRIEF DESCRIPTION OF DRAWINGS
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
DESCRIPTION OF EMBODIMENTS
(9) Each of embodiments of a catheter for removing foreign body in blood vessel according to the present invention will be now described in detail on the basis of the drawings.
First Embodiment
(10)
(11) The sheath 11 includes a first tube 21 having a first lumen 22 and a second tube 23 having a second lumen 24 and has a double lumen structure in which the second tube 23 is inserted through the first lumen 22 of the first tube 21 and thus is adapted to be movable in first lumen 22 in an axial direction of the first tube 21.
(12) The first and second tubes 21 and 23 are molded of an elastically deformable material, such as polyethylene, polyethylene terephthalate, polypropylene, polyurethane, polyamide elastomer, polyimide, polyimide elastomer, copolymers thereof, silicone rubber, or natural rubber, and have a substantially uniform outer diameter over a longitudinal direction thereof. Also, the first and second lumens 22 and 24 are likewise formed to have a substantially uniform inner diameter over a longitudinal direction thereof.
(13) An operation unit 30 is provided on a proximal end side of the second tube 23. The operation unit 30 is provided with a first port 25 and a second port 26. The first port 25 is communicated with the second lumen 24 and provided on an axis of the sheath 11 (second tube 23), and also has an opening fluid-tightly occluded by a valve body, not shown, formed of silicone rubber or the like. A third tube 41 as described below is inserted in the first port 25 to extend through the valve body and then to be inserted through the second lumen 24.
(14) The second port 26 is communicated with the second lumen 24 and formed to extend from the second tube 23 in a direction intersecting the axis of the sheath 11. Other devices (not shown), such as a syringe, is connected to the second port 26 to impart a suction force to the second lumen 24, so that a foreign substance 2, such as thrombus formed within a blood vessel 1, are sucked and removed through the second port 26 to the outside of a body.
(15) Referring to
(16) The capturing unit 12 has a plurality of generally triangle column-shaped frame portions 31 (16 pieces in the embodiment shown in the drawings) made of a shape memory alloy (for example, Ni—Ti alloy), in which the expanded state is shape-memorized, and a plurality of sheet portions 32 (16 pieces in the embodiment shown in the drawings) formed in a membrane shape for connecting the adjacent frame portions 31 to each other and being deployable in an umbrella shape in accordance with expansion of the frame portions 31.
(17) The frame portions 31 are arranged at substantially equal intervals in a circumferential direction and extend in an axial direction in a state where proximal end sides 31a of the frame portions 31 are fixed on an outer periphery of a tip of the second tube 23 and distal end sides 31b of the frame portions 31 are opened. In the contracted state, in which frame portions are received in the first lumen 22, each frame portion 31 is pushed and contracted against the restoring force, by which the shape memory alloy is to be expanded, because an outer peripheral surface of each frame portion 31 is abutted to and constrained by an inner peripheral surface (first lumen 22) of the first tube 21. Namely, the capturing unit 12 in the contracted state forms a generally cylinder because the distal end sides 31b of the plurality of frame portions 31 are aligned on a circumference. The frame portions 31 in the contracted state are arranged so that one ridge 31c of three ridges, which extend along an axial direction of the second tube 23, protrudes toward an inner surface of the cylinder. Therefore, on an inner surface of the capturing unit 12, unevenness along a circumferential direction thereof is formed. Also, the frame portions 31 in a natural state, in which constraint by the first lumen 22 is released, are deployed by the self-restoring force to become the expanded state.
(18) The sheet portions 32, which have a foldable flexibility, extend in the axial direction of the second tube 23 and also are fixed on lateral surfaces of the adjacent frame portions 31. In addition, proximal end sides of the sheet portions 32 are fixed on the outer periphery of the tip of the second tube 23. The folded sheet portions 32 are deployed in an umbrella shape when the frame portions 31 become the expanded state, and thus cover between the adjacent frame portions 31 in a membrane shape.
(19) Thus, in the contracted state (see
(20) Meanwhile, it is not necessary for the frame portions 31 to be made of a shape memory alloy, in which the expanded state is shape-memorized, and accordingly, the sheet portions 32 may be formed by a balloon. In this case, in a state, where a fluid has not been introduced into the balloon, the balloon is folded and also the frame portions 31 are also contracted so that the capturing unit 12 exhibits the contracted state, whereas in a state, where the fluid has been introduced into the balloon, the balloon is inflated and thus the frame portions 31 are also deployed in accordance with expansion of the balloon, as a result which the capturing unit 12 forms the capturing chamber 12A.
(21) As shown in
(22) The cutting unit 13 is intended to nodulize the foreign substance 2, which has been flowed into the capturing chamber 12A, by cutting, crushing or grinding, and is provided on a distal end of the third tube 41 as shown in
(23) The third tube 41, which has a third lumen 42, is inserted into the second lumen 24 through the valve body (not shown) of the first port 25 and rotatable relative to the second tube 23, and also is arranged to be axially movable by a predetermined distance only toward a distal end side thereof. The third tube 41 is provided on a proximal end side thereof with a spinning rod 43 for operating the cutting unit 13 (see
(24) The cutting unit 13 according to the present embodiment has a plurality of blades 44 (8 pieces in the embodiment shown in the drawings), which have one ends 44a on proximal end sides thereof fixed on a distal end of the third tube 41 and the other ends 44b on distal end sides thereof being opened, and are arranged at substantially equal intervals in a circumferential direction to take a propeller shape, and also extend in an axial direction.
(25) Each blade 44 has an arc-shaped cross-section shape, which is swelled outward, i.e., toward an inner peripheral surface of the capturing chamber 12A, and is formed of a shape memory alloy (for example, Ni—Ti alloy), in which an expanded state thereof is shape-memorized. The blades 44 in a natural state are urged by a restoring force of the shape memory alloy, so that the other ends 44b on the distal end sides of the blades 44 are flared in a direction spaced away from each other, i.e., each blade 44 is radially flared. Further, when being received in the capturing unit 12, an outer peripheral surface of each blade 44 is abutted to and constrained by the frame portions 31, and thus becomes a contracted state (see
(26) Namely, the blades 44 become a contracted state when having been received in the contracted capturing unit 12, and the plurality of blades 44 are aligned in a cylinder shape (see
(27) As shown in
(28) The balloon 52 is formed of a general material, such as polyamide elastomer. The balloon 52 has an outer surface covered with a wire material 53, which is a protection member for protecting the balloon 52 from the blades 44 and the like. Preferably, the wire material 53 is formed of Ni—Ti alloy or the like having an X-ray contrast property to allow a location thereof in vivo to be checked from the outside of a body under X-ray illumination, and serves as a radiographic marker. However, the wire material 53 is not necessary to be made of a metal, and accordingly may be made of a resin.
(29) In addition, the blades 44 are likewise preferably formed of alloy, such as Ni—Ti alloy, having an X-ray contrast property to serve as a radiographic marker. Therefore, locations of the balloon 52 and the blades 44 can be checked from the outside of the body, and thus when the foreign substance 2, such as thrombus is nodulized by the blades 44 while being condensed in the capturing chamber 12A by the balloon 52 as described below, interference between the balloon 52 and the blades 44 can be prevented.
(30) Meanwhile, the radiographic markers are not limited to the balloon 52 or the blades 44, and accordingly, rings (not shown) or the like formed of a material having an X-ray contrast property may be arranged at suitable locations.
(31) Alternatively, Ni—Ti alloy may be substituted with a superelastic alloy, such as Au—Cd alloy, Cu—Al—Ni alloy, Ni—Ti—Co alloy, or Ni—Ti—Cu alloy, which all have an X-ray contrast property.
(32) In addition, the guide unit provided on the tip end of the guide wire 50 is not limited to the balloon 52, and for example, a thrombus capturing instrument made of a wire material formed in a coil shape (see JP 2010-188068 A) or the like may be employed.
(33) Next, a method of using the catheter for removing foreign body in blood vessel 10 will be described.
(34) First, as shown in
(35) Subsequently, in a state where the contracted capturing unit 12 is received in the first lumen 22, and also the contracted cutting unit 13 is received in the capturing unit 12, the first, second and third tubes 21, 23 and 41 are inserted in the blood vessel 1 along the guide wire 50, and then, distal ends of the first, second and third tubes 21, 23 and 41, i.e., the capturing unit 12 and the cutting unit 13, which all are received in the first lumen 22 to be in the contracted state, are positioned in front of the foreign substance 2.
(36) When the capturing unit 12 and the cutting unit 13 are pushed out from the distal end of the first tube 21 by operating the operation unit 30 of the second tube 23 and the spinning rod 43 of the third tube 41, as shown
(37) Then, after a fluid is supplied from the lumen 51 of the guide wire 50 to inflate the balloon 52, the guide wire 50 is retracted so that the foreign substance 2, such as thrombus, is guided into the capturing chamber 12A by the balloon 52. Because the capturing chamber 12A has an opening area gradually decreased as it goes from the distal end opening 33 of the capturing chamber 12A toward the proximal end opening 34 of the capturing chamber 12A, the foreign substance 2 is effectively condensed in the proximal end opening 34 side of the capturing chamber 12A, i.e., in the vicinity of the blades 44.
(38) At this time, when the spinning rod 43 is rotated, the foreign substance 2 is cut by the rotating blades 44 and also ground between the frame portions 31 of the capturing chamber 12A and the blades 44 to be nodulized. Because unevenness is formed on the inner surface of the capturing chamber 12A by the ridges 31c of the triangle column-shaped frame portions 31, a resistance is applied to the foreign substance 2 by the unevenness so that the foreign substance 2 can be reliably nodulized without rotating together with the blades 44. Meanwhile, the spinning rod 43 may be manually rotated, but may be rotated by a power, such as a motor.
(39) After the foreign substance 2 has been nodulized by the blades 44, other devices, such as a syringe, connected to the second port 26, are activated to build a negative pressure inside the second lumen 24, so that the nodulized foreign substance 2 is sucked and removed from the second port 26 to the outside of the body. At this time, by operating the spinning rod 43 to move the blades 44 in a direction toward a distal end thereof and thus to widen a gap between a distal end-side opening of the second lumen 24 and the blades 44, a relatively large foreign substance 2 can be also effectively sucked and removed.
(40) In addition, as an alternative method, the blades 44 may be moved to a base of the second tube 23 (the vicinity of the first port 25) and then the foreign substance may be sucked and removed from the second port 26. In this case, the third tube 41 has to be provided to be axially movable toward a proximal end side of the second tube 23 as well.
(41) After suction and removal of the foreign substance 2 is ended, the capturing unit 12 (capturing chamber 12A) and the cutting unit 13, which are in the expanded state, are retracted into the first lumen 22 of the first tube 21 to become the contracted state against the restoring force of each thereof, and then the first, second and third tubes 21, 23 and 41 are withdrawn from the blood vessel 1 and also after flatting the balloon 52, the guide wire 50 together with the balloon 52 is withdrawn from the blood vessel 1.
(42) Meanwhile, although the foreign substance 2, such as thrombus, is guided into the capturing chamber 12A by the balloon 52 in the foregoing description, the balloon 52 is not used, but the foreign substance 2 may be guided into the capturing chamber 12A by only suction from the second port 26. In this case, the balloon 52 is not required and also the guide wire 50 can be omitted.
(43) As described above, according to the catheter for removing foreign body in blood vessel 10 of the present embodiment, the capturing unit 12 is provided on the distal end of the second tube 23 and the capturing unit 12 can be deformed into a contracted state and an expanded state in which the capturing chamber 12A having an opening area decreased as it goes from the distal end opening 33 toward the proximal end opening 34, is formed. Because the third tube 41, which is rotatable relative to the second tube 23, and the cutting unit 13, which is provided on the distal end of the third tube 41 and arranged on the proximal end opening 34 side of the capturing chamber 12A to cut the foreign substance 2 captured in the capturing chamber 12A, are disposed in the second lumen 24, the foreign substance 2, such as thrombus, can be guided from the distal end opening 33 having a large opening area toward the proximal end opening 34 having a small opening area, and thus can be effectively condensed in the proximal end opening 34. Also, by cutting or grinding the foreign substance 2, which has been condensed in the proximal end opening 34 of the capturing chamber 12A, by the cutting unit 13, the foreign substance 2 can be effectively nodulized. Therefore, a large foreign substance 2, which would not be previously sucked into a catheter, can be also effectively sucked and removed. In addition, because the cutting unit 13 is arranged more toward the proximal end opening 34 of the capturing chamber 12A than the distal end opening 33 of the capturing chamber 12A, the cutting unit 13 is not exposed in the blood vessel 1 upon cutting, thereby ensuring safety.
(44) Also, because the power transmitting members is the third tube 41 having the third lumen 42 through which the guide wire 50 can be inserted, the catheter for removing foreign body in blood vessel 10 can be directed by the guide wire 50 to be reliably guided to a site, where the foreign substance is generated.
(45) In addition, because the balloon 52 for guiding the foreign substance 2 into the capturing chamber 12A can be inserted through the third tube 41, the foreign substance 2 can be effectively guided and condensed into the capturing chamber 12A by the balloon 52. Meanwhile, the balloon 52 may be provided on the guide wire 50 as described above, and also, after other guide wires not having a balloon are used instead of the guide wire 50, a typical balloon catheter may be used.
(46) Further, because as the radiographic makers, which allows a distance between the balloon 52 and the cutting unit 13 to be seen by eyes, the wire material 53 and the blades 44 are formed of materials having an X-ray contrast property, the balloon 52 and the blades 44 can be operated while checking locations thereof from the outside of the body, thereby preventing contact between the cutting unit 13 and the balloon 52 and thus avoiding damage of the balloon 52 by the cutting unit 13.
(47) Further, because the cutting unit 13 is the plurality of foldable blades 44, even a large foreign substance 2 can be reliably sucked and removed by cutting and nodulizing the foreign substance 2 by the blades 44.
(48) Further, because unevenness along a circumferential direction is formed on the inner surface of the capturing chamber 12A by the triangle column-shaped frame portions 31, the foreign substance 2 can be ground and crushed by the unevenness formed on the inner surface of the capturing chamber 12A and the blades 44, thereby effectively nodulizing the foreign substance 2.
(49) In addition, because the third tube 41 can be moved relative to the second tube 23 only toward the distal end side thereof, the third tube 41 is moved relative to the second tube 23 toward the distal end side thereof after nodulizing the foreign substance 2, so that the nodulized foreign substance 2 can be effectively sucked from the proximal end opening 34 of the capturing chamber 12A. Also, during insertion into the blood vessel 1, movement of the third tube 41 relative to the second tube 23 toward the proximal end side thereof is restricted, so that when inserting the second tube 23 into the blood vessel 1, a location of the third tube 41 is restricted, thereby allowing an easy insertion of the second tube. Meanwhile, the third tube 41 may be configured to be movable relative to the second tube 23 toward the distal end side and the proximal end side.
Second Embodiment
(50) Next, a second embodiment of a catheter for removing foreign body in blood vessel will be described with reference to
(51)
(52) As shown in
(53) The propellers 62 are formed of a shape memory alloy, in which an expanded state, where the propellers extend radially outward from the cylindrical base portion 61, is shape-memorized, and are deformable into a contracted state, in which, as shown in
(54) As shown in
(55) Then, by operating a spinning rod 43 to rotate the propellers 62, a foreign substance 2, such as thrombus, condensed in the capturing chamber 12A is cut and nodulized and then sucked and removed from a second port 26 to the outside of the body.
(56) As described above, according to the catheter for removing foreign body in blood vessel 10 of the present embodiment, because the cutting unit 13 is the foldable propellers 62, even a large foreign substance 2 can be reliably sucked and removed by reliably cutting and nodulizing the foreign substance 2 by the propellers 62.
Third Embodiment
(57) Next, a third embodiment of a catheter for removing foreign body in blood vessel according to the present invention will be described with reference to
(58) As shown in
(59) The wire materials 66 are formed of a shape memory alloy, which is shape-memorized to have a generally elliptical shape in a natural state, and are deformable into an contracted state, in which, as shown in
(60) When a capturing unit 12 is pushed out from a distal end opening 22a of the first lumen 22, the plurality of wire materials 66 constituting the meshed member 65 are released from constraint by the first lumen 22, and thus the middle part thereof is swelled radially outward by the self-restoring thereof to be deformed into a generally elliptical shape, thereby forming a capturing chamber 12A.
(61) Then, by operating a spinning rod 43 to rotate the meshed member 65, a foreign substance 2, such as thrombus, condensed in the capturing chamber 12A is cut and nodulized by the meshed member 65 and then sucked and removed from a second port 26 to the outside of the body.
(62) As described above, according to the catheter for removing foreign body in blood vessel 10 of the present embodiment, because the cutting unit 13 is the expandable meshed member 65, even a large foreign substance 2 can be reliably sucked and removed by reliably cutting and nodulizing the foreign substance 2 by the meshed member 65.
(63) Meanwhile, the present invention is not limited to each of the foregoing embodiments, and accordingly, appropriate changes, modifications or the like thereof can be made.
(64) For examples, a vibration generating member may be provided on the capturing unit 12, the cutting unit 13, the balloon 52 and the like, so that the vibration generating member can generate a vibration by operation of a user. In this case, due to the vibration of the vibration generating member, a vibration can be applied to the foreign substance flowed into the capturing chamber 12A, so that the foreign substance becomes smaller pieces to easily flow.
(65) In addition, the sheath 11 is not necessary to include the first tube 21 having the first lumen 22 and the second tube 23 having the second lumen 24, but may be constituted of only the second tube 23 having the second lumen 24, and thus, a member corresponding to the first tube 21 having the first lumen 22 may be separately prepared during surgery and also may be employed as a guiding catheter used in other treatments. Therefore, for example, when a stent or the like is indwelled after removing a foreign substance, an operation can be performed with the guiding catheter remained.
(66) More specifically, if the guiding catheter is used instead of the first tube 21 of the sheath 11, when the sheath 11 is withdrawn, the second and third tubes 23 and 41 are withdrawn with the guiding catheter remained as it is. In this state, an indwelling catheter for indwelling a stent or the like is inserted into a blood vessel and reaches an indwelling site through the inside of the guiding catheter, and then the stent or the like is indwelled.
REFERENCE NUMERALS LIST
(67) 2 Foreign substance 10 Catheter for removing foreign body in blood vessel 11 Sheath 12 Capturing unit 12A Capturing chamber 13 Cutting unit 21 First tube 22 First lumen 22a Opening 23 Second tube (Tube) 24 Second lumen 33 Distal end opening 34 Proximal end opening 41 Third tube (Power transmitting member) 42 Third lumen 44 Blade (Cutting unit, Propeller-shaped member) 50 Guide wire 53 Balloon (Guide unit) 53 Wire material (Protection member) 62 Propeller (Cutting unit, Propeller-shaped member) 65 Meshed member (Cutting unit)