Balloon catheter
10342959 ยท 2019-07-09
Assignee
Inventors
- Takahiro Yagi (Otsu, JP)
- Akinori Matsukuma (Otsu, JP)
- Motoki Takaoka (Otsu, JP)
- Chigusa Kamemoto (Otsu, JP)
Cpc classification
International classification
Abstract
A balloon catheter includes an inner cylinder shaft having a small-diameter inner cylinder section in a tip side and a large-diameter inner cylinder section in a base-end side; an outer cylinder shaft with the inner cylinder shaft in its lumen; a balloon whose tip is fixed at a tip of the inner cylinder shaft, and whose base end is fixed at the tip of the outer cylinder shaft, wherein the outer cylinder shaft and the inner cylinder shaft slide over each other and cause a shape change between a normal balloon shape and an extended balloon shape; and a housing communicating with the lumen of the outer cylinder shaft, and having a small-diameter lumen in the tip side and a large-diameter lumen in the base-end side; wherein the housing has an insertion inlet for insertion of the inner cylinder shaft, and a liquid inlet/outlet.
Claims
1. A balloon catheter comprising: an inner cylinder shaft having a small-diameter inner cylinder section in a tip side and a large-diameter inner cylinder section in a base-end side; an outer cylinder shaft in which said inner cylinder shaft is inserted in a lumen of said outer cylinder shaft; a balloon whose tip is fixed at a tip of said inner cylinder shaft, and whose base end is fixed at a tip of said outer cylinder shaft, wherein said outer cylinder shaft and said inner cylinder shaft slide over each other and cause a shape change between a normal balloon shape and an extended balloon shape; and a housing communicating with the lumen of said outer cylinder shaft, and having a small-diameter lumen in a tip side and a large-diameter lumen in a base end side; wherein said housing has an insertion inlet for insertion of said inner cylinder shaft, and a liquid inlet/outlet that allows a liquid to flow into, and to flow out of, said balloon and said outer cylinder shaft, and by inserting said large-diameter inner cylinder section into said small-diameter lumen of said housing when said balloon has said extended balloon shape, inflow of said liquid in said housing is blocked.
2. The balloon catheter according to claim 1, wherein said small-diameter lumen and said large-diameter inner cylinder section have shapes satisfying Formula (1):
(AB)/20.11(1) A: inner diameter (mm) of the small-diameter lumen B: outer diameter (mm) of the large-diameter inner cylinder section.
3. The balloon catheter according to claim 2, wherein a tip of said large-diameter inner cylinder section has an elastic member.
4. The balloon catheter according to claim 2, wherein said large-diameter cylinder section has a projection on an outer periphery of said large-diameter cylinder section, and said small-diameter lumen of said housing has a rail section into which said projection fits on an inner periphery of said small-diameter lumen.
5. The balloon catheter according to claim 2, wherein said housing has a see-through section on a side surface of said housing, for visual observation of an inside of said housing.
6. The balloon catheter according to claim 2, wherein said housing has a valve for said insertion inlet, and a recess(es) and/or a protrusion(s) is/are provided on a side surface of said large-diameter inner cylinder section.
7. The balloon catheter according to claim 1, wherein a tip of said large-diameter inner cylinder section has an elastic member.
8. The balloon catheter according to claim 7, wherein said large-diameter cylinder section has a projection on an outer periphery of said large-diameter cylinder section, and said small-diameter lumen of said housing has a rail section into which said projection fits on an inner periphery of said small-diameter lumen.
9. The balloon catheter according to claim 7, wherein said housing has a see-through section on a side surface of said housing, for visual observation of an inside of said housing.
10. The balloon catheter according to claim 7, wherein said housing has a valve for said insertion inlet, and a recess(es) and/or a protrusion(s) is/are provided on a side surface of said large-diameter inner cylinder section.
11. The balloon catheter according to claim 1, wherein said large-diameter cylinder section has a projection on an outer periphery of said large-diameter cylinder section, and said small-diameter lumen of said housing has a rail section into which said projection fits on an inner periphery of said small-diameter lumen.
12. The balloon catheter according to claim 11, wherein said housing has a see-through section on a side surface of said housing, for visual observation of an inside of said housing.
13. The balloon catheter according to claim 11, wherein said housing has a valve for said insertion inlet, and a recess(es) and/or a protrusion(s) is/are provided on a side surface of said large-diameter inner cylinder section.
14. The balloon catheter according to claim 1, wherein said housing has a see-through section on a side surface of said housing, for visual observation of an inside of said housing.
15. The balloon catheter according to claim 14, wherein said housing has a valve for said insertion inlet, and a recess(es) and/or a protrusion(s) is/are provided on a side surface of said large-diameter inner cylinder section.
16. The balloon catheter according to claim 1, wherein said housing has a valve for said insertion inlet, and a recess(es) and/or a protrusion(s) is/are provided on a side surface of said large-diameter inner cylinder section.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
DESCRIPTION OF SYMBOLS
(9) 1, Balloon catheter; 2, outer cylinder shaft; 3, inner cylinder shaft; 4, housing; 5, balloon; 6, insertion inlet; 7, liquid inlet/outlet; 10, balloon catheter; 11, projection; 12, rail section; 20, balloon catheter; 21, valve; 30, balloon catheter; 31, recess; 40, balloon catheter; 41, see-through section; 50, elastic member.
DETAILED DESCRIPTION
(10) The balloon catheter comprises: an inner cylinder shaft having a small-diameter inner cylinder section in the tip side and a large-diameter inner cylinder section in the base-end side; an outer cylinder shaft in which the inner cylinder shaft is inserted in its lumen; a balloon whose tip is fixed at the tip of the inner cylinder shaft, and whose base end is fixed at the tip of the outer cylinder shaft, wherein the outer cylinder shaft and the inner cylinder shaft slide over each other to cause a shape change between a normal balloon shape and an extended balloon shape; and a housing which communicates with the lumen of the outer cylinder shaft, and has a small-diameter lumen in the tip side and a large-diameter lumen in the base-end side; wherein the housing has an insertion inlet for insertion of the inner cylinder shaft, and a liquid inlet/outlet allowing a liquid to flow into, and to flow out of, the balloon and the outer cylinder shaft, and, by inserting the large-diameter inner cylinder section into the small-diameter lumen of the housing when the balloon has the extended balloon shape, inflow of the liquid into the balloon is blocked.
(11) Preferred examples are described below in detail with reference to drawings, but this disclosure is not limited to these examples. Each identical element is represented using an identical symbol, and redundant explanations are omitted. The ratios used in the drawings are not necessarily the same as those in the description.
(12) A balloon catheter 1 as the first example is shown using
(13) The balloon catheter 1 shown in
(14) The material of the outer cylinder shaft 2 may be any material as long as the material is used for medical catheter shafts. Examples of the material generally include polymer materials having flexibility such as polyamide resins and polyamide elastomers including nylon 11 and nylon 12; polyolefins including polypropylene/polyethylene; polyesters including polyethylene terephthalate; polyurethane; and vinyl chloride. One of these, or a combination of two or more of these may be used.
(15) The inner cylinder shaft 3 is a cylindrical shaft having a small-diameter inner cylinder section in the tip side and a large-diameter inner cylinder section in the base-end side. In the inner cylinder shaft 3, a step is formed between the small-diameter inner cylinder section and the large-diameter lumen section, and the small-diameter inner cylinder section and the large-diameter inner cylinder section are joined to each other along the same axis to form a cylindrical shaft. By insertion of the inner cylinder shaft 3 into the lumen of the outer cylinder shaft 2 and the lumen of the later-mentioned housing 4, a double-cylindrical catheter shaft is constituted.
(16) The small-diameter inner cylinder section is the portion in the inner cylinder shaft where the outer diameter vertical to the longitudinal direction of the cylinder is small, and the large-diameter inner cylinder section is the portion in the inner cylinder shaft where the outer diameter vertical to the longitudinal direction of the cylinder is large.
(17) The material of the inner cylinder shaft 3 may also be any material as long as the material is used for medical catheter shafts. However, the material of the small-diameter inner cylinder section forming the tip side, similarly to the material of the outer cylinder shaft, is preferably a polymer material having flexibility such as a polyamide resin, polyamide elastomer, polyolefin, polyester, polyurethane, or vinyl chloride. From the viewpoint of simplifying operation of the inner cylinder shaft and increasing the performance to block inflow of the liquid into the balloon, the material of the large-diameter inner cylinder section forming the base-end side is preferably a metal, more preferably stainless steel.
(18) The housing 4 is a cylindrical member having a lumen communicating with the lumen of the outer cylinder shaft 2. The lumen in the tip side along the longitudinal direction has a decreased diameter to form a small-diameter lumen, and the lumen in the base-end side along the longitudinal direction has an increased diameter to form a large-diameter lumen. A step is formed between the small-diameter lumen and the large-diameter lumen, and the small-diameter lumen and the large-diameter lumen communicate with each other to form a lumen inside the housing 4. The cross-sectional shape of the lumen of the housing 4 is not limited. The cross-sectional shape is preferably a circular shape from the viewpoint of continuity with the outer cylinder shaft 2.
(19) At the base end of the cylinder of the housing 4, a bottom surface is formed, and this bottom surface has an insertion inlet 6 for insertion of the inner cylinder shaft 3. The inner cylinder shaft 3 is exposed to the outside of the housing 4 through the insertion inlet 6. By operation of sliding this exposed portion in the longitudinal direction, the later-mentioned operation of changing the shape of the balloon 5 can be carried out.
(20) The outer periphery of the cylinder of the housing 4 has a liquid inlet/outlet 7 that allows a liquid to flow into, and to flow out of, the balloon 5 and the outer cylinder shaft 2. By connecting the liquid inlet/outlet 7 to a syringe, pump, or the like, the liquid can be allowed to flow into the lumen of the housing 4, and can then be allowed to flow into, and to flow out of, the inside of the balloon 5 and the outer cylinder shaft 2 through the lumen of the housing 4.
(21) The material of the housing 4 may be any material as long as the material is is used for medical catheters, and has a strength suitable for the operation. The housing 4 may be made of a metal such as iron or aluminum, or a resin such as a polycarbonate or ABS.
(22) The balloon 5 is formed as a film-shaped member, and has a structure in which the tip of the balloon 5 is fixed to the tip of the inner cylinder shaft 3, and the base end of the balloon 5 is fixed to the tip of the outer cylinder shaft 2. By this, the space inside the balloon 5 communicates with the lumen of the housing 4 through the space formed between the outer cylinder shaft 2 and the inner cylinder shaft 3. The shape of the balloon 5 can be changed between a normal balloon shape and an extended balloon shape by sliding the outer cylinder shaft 2 and the inner cylinder shaft 3 over each other concentrically in the longitudinal direction. Further, by allowing a liquid to flow into the balloon having a normal balloon shape, the shape of the balloon is changed from the normal balloon shape to the inflated balloon shape.
(23) The normal balloon shape is a shape of the balloon 5 formed by sliding the inner cylinder shaft 3 toward the base-end side in the longitudinal direction of the outer cylinder shaft 2, wherein inflation of the film forming the balloon 5 is possible by inflow of the liquid. The extended balloon shape is an elongated shape of the balloon 5 formed upon drawing of the film forming the balloon 5 by sliding the inner cylinder shaft 3 toward the tip side in the longitudinal direction of the outer cylinder shaft 2, wherein insertion and passage of the balloon catheter 1 into a protection member or the like are possible. The inflated balloon shape is a shape formed by allowing the liquid to flow into the balloon to make the balloon shape expanded relative to the normal shape.
(24) An appropriate outer diameter of the balloon 5 having the inflated balloon shape varies depending on the affected area to which the surgical technique is applied. For example, when the balloon 5 is used for treatment of arrhythmia, its outer diameter is preferably 20 to 40 mm. The shape of the balloon 5 having the inflated balloon shape is preferably a spherical shape, but may also be in a tapered, conical shape. The shape of the balloon 5 is not limited to these.
(25) The material of the balloon 5 may be any material as long as the material is one which is used for medical catheters. From the viewpoint of increasing adhesiveness to the affected tissue, the material is preferably a flexible material such as a polyurethane or a rubber, for example, a synthetic rubber or a natural rubber. From the viewpoint of increasing adhesiveness to the affected tissue, the wall thickness of the balloon 5 is preferably 20 to 150 m, more preferably 20 to 100 m.
(26) Examples of the liquid with which the balloon 5 may be filled include physiological saline, contrast media for urography/angiography and cisternography/myelography, and contrast media prepared by diluting their stock solutions with physiological saline.
(27) In the housing 4, the lumen in the tip side along the longitudinal direction forms a small-diameter lumen, and the lumen in the base-end side along the longitudinal direction forms a large-diameter lumen. Therefore, when the inner cylinder shaft 3 slides toward the base-end side along the longitudinal direction of the outer cylinder shaft 2 to let the balloon 5 have the normal balloon shape, the tip portion of the large-diameter inner cylinder section of the inner cylinder shaft 3 is positioned in the large-diameter lumen of the housing 4 so that the liquid can be allowed to flow into, and to flow out of, the inside of the balloon 5 and the outer cylinder shaft 2 through the lumen of the housing 4. On the other hand, when the inner cylinder shaft 3 slides toward the tip side along the longitudinal direction of the outer cylinder shaft 2 to let the balloon 5 have the extended balloon shape, the tip of the large-diameter inner cylinder section of the inner cylinder shaft 3 is positioned in the small-diameter lumen of the housing 4 so that the space between the large-diameter lumen and the small-diameter lumen of the housing 4 is narrowed by the large-diameter inner cylinder section of the inner cylinder shaft 3. Therefore, when the liquid is allowed to flow from the liquid inlet/outlet 7 into, or to flow out of, the inside of the housing 4, the liquid passing through the space between the large-diameter lumen and the small-diameter lumen is blocked. This results in a state where the operator who is sliding the inner cylinder shaft 3 can feel resistance on the hand. Thus, the operator can realize that the balloon 5 does not have a normal balloon shape.
(28) Blocking of the liquid means a state where a load is applied to the liquid passing through the space between the large-diameter lumen and the small-diameter lumen of the housing 4 so that the operator who is sliding the inner cylinder shaft 3 can feel resistance on the hand. More specifically, this state means a state where the internal pressure of the housing 4 is not less than 0.100 MPa.
(29) More specifically, to block the flow of the liquid, the shape is preferably one with which the value calculated according to Formula 1 is not more than 0.11. The shape is more preferably one with which the value calculated according to Equation (1) is not more than 0.06.
(AB)/2(1) A: inner diameter (mm) of the small-diameter lumen B: outer diameter (mm) of the large-diameter inner cylinder section
(30) Further, the tip of the large-diameter inner cylinder section of the inner cylinder shaft 3 may have an elastic member 50 as shown in
(31) From the viewpoint of blocking the flow into the balloon 5, examples of the material of the elastic member include, but are not limited to, natural materials such as sponges; and sponges prepared with synthetic resins such as urethane resins and rubbers.
(32) A balloon catheter 10 as the second example is shown using
(33) The balloon catheter 10 shown in
(34) By storing the projection 11 in the rail section 12, rolling of the inner cylinder shaft 3 in the housing 4 can be prevented. This shape prevents twisting of the inner cylinder shaft 3, and prevents breakage of the inner cylinder shaft 3 caused by the twisting.
(35) A balloon catheter 20 as the third example is shown using
(36) The balloon catheter 20 shown in
(37) The material of the valve 21 is not limited as long as the material has elasticity, and examples of the material include natural rubbers and silicone resins.
(38) A balloon catheter 30 as the fourth example is shown using
(39) In the balloon catheter 30 shown in
(40) Upon sliding of the inner cylinder shaft 3 having the recess 31, the recess 31 contacts the valve 21 to allow the operator to feel resistance on the hand. Thus, by preliminarily knowing the shape of the balloon 5 formed upon the contact of the recess 31 with the valve 21, the operator can recognize the shape of the balloon 5 by feeling the resistance even when the balloon 5 is placed in the body. The base end of the inner cylinder shaft 3 may be provided with a scale. Based on the value indicated by the scale, the shape of the balloon 5 can be recognized.
(41) A balloon catheter 40 as the fourth example is shown using
(42) The balloon catheter 40 shown in
EXAMPLES
(43) Specific Examples of our balloon catheters are described below.
Example 1
(44) A balloon catheter according to the example shown in
(45) By a common blow molding method, a polyurethane balloon with an outer diameter of 30 mm and a wall thickness of 20 m, which balloon has a neck portion with an inner diameter of 3.7 mm, an outer diameter of 4.3 mm, and a length of 3 mm at each of both ends, was prepared. A polyurethane outer cylinder shaft having an outer diameter of 4 mm, an inner diameter of 3 mm, and a length of 905 mm, was prepared.
(46) A polyamide small-diameter inner cylinder section for an inner cylinder shaft, having an outer diameter of 1.8 mm, an inner diameter of 1.4 mm, and a total length of 1100 mm, was prepared. In addition, by molding, a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 3 mm and a length of 115 mm, was prepared. The surface of the metallic large-diameter inner cylinder section of the inner cylinder shaft was covered with a polyurethane elastic body. By this, the outer diameter became 3.7 mm. The tip of the large-diameter inner cylinder section of the inner cylinder shaft was arranged at a position of 10 mm from the posterior end of the small-diameter inner cylinder section of the inner cylinder shaft, and an adhesive was injected into the gap for fixation, thereby preparing an inner cylinder shaft.
(47) A polycarbonate housing with a total length of 152 mm having a lumen with an inner diameter of 3.62 mm in the area from the tip to a position 74 mm distant from the tip in the longitudinal direction (small-diameter lumen), and a lumen with an inner diameter of 5.27 mm in the area posterior to the position 74 mm distant from the tip in the longitudinal direction (large-diameter lumen), was prepared. On the side surface of the housing, a liquid inlet with an outer diameter of 5.5 mm and an inner diameter of 4.4 mm was provided, and an insertion inlet with an inner diameter of 3.7 mm having a silicone hemostasis valve in the lumen side of the housing was provided on the bottom surface, which corresponds to the posterior end of the housing. An adhesive was applied to the outer periphery of the tip side of the housing, and the posterior end of the outer cylinder shaft was attached thereto.
(48) The inner cylinder shaft was inserted into the lumen of the housing from the posterior end of the housing. The inner cylinder shaft was then allowed to reach the lumen of the outer cylinder shaft, and the tip of the small-diameter inner cylinder section of the inner cylinder shaft and the tip of the tip-side neck portion of the balloon were joined together, followed by fixing the balloon to the outer periphery of the inner cylinder shaft by thermal welding. The tip of the outer cylinder shaft and the root of the posterior end-side neck portion of the balloon were joined together, and the balloon was fixed to the outer periphery of the outer cylinder shaft by thermal welding, to prepare a balloon catheter.
Example 2
(49) A balloon catheter (hereinafter referred to as Example 2) was prepared in the same manner as in Example 1 except that a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 3.58 mm, was used instead of the metallic large-diameter inner cylinder section for the inner cylinder shaft of Example 1, and that the treatment of covering the surface with the elastic body was not carried out.
Example 3
(50) A balloon catheter (hereinafter referred to as Example 3) was prepared in the same manner as in Example 2 except that a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 3.55 mm, was used instead of the metallic large-diameter inner cylinder section for the inner cylinder shaft of Example 2.
Example 4
(51) A balloon catheter (hereinafter referred to as Example 4) was prepared in the same manner as in Example 2 except that a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 3.50 mm, was used instead of the metallic large-diameter inner cylinder section for the inner cylinder shaft of Example 2.
Example 5
(52) A balloon catheter (hereinafter referred to as Example 5) was prepared in the same manner as in Example 2 except that a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 3.45 mm, was used instead of the metallic large-diameter inner cylinder section for the inner cylinder shaft of Example 2.
Example 6
(53) A balloon catheter (hereinafter referred to as Example 6) was prepared in the same manner as in Example 2 except that a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 3.30 mm, was used instead of the metallic large-diameter inner cylinder section for the inner cylinder shaft of Example 2.
Example 7
(54) A balloon catheter (hereinafter referred to as Example 7) was prepared in the same manner as in Example 2 except that a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 3.30 mm, was used instead of the metallic large-diameter inner cylinder section for the inner cylinder shaft of Example 2.
Comparative Example 1
(55) A balloon catheter (hereinafter referred to as Comparative Example 1) was prepared in the same manner as in Example 2 except that a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 2.50 mm, was used instead of the metallic large-diameter inner cylinder section for the inner cylinder shaft of Example 2.
Comparative Example 2
(56) A handle (hereinafter referred to as Comparative Example 2) was prepared in the same manner as in Example 2 except that a metallic large-diameter inner cylinder section for the inner cylinder shaft, having an outer diameter of 3.58 mm, was used instead of the metallic large-diameter inner cylinder section for the inner cylinder shaft of Example 2, and that the position of the tip of the metallic large-diameter inner cylinder section for the inner cylinder shaft was fixed in the large-diameter lumen of the housing.
(57) Measurement of Pressure during Injection of Liquid
(58) To measure the pressure during injection of the liquid, for each balloon catheter prepared in the Examples and the Comparative Examples, an experiment was carried out using the balloon and the inner cylinder shaft excluding the small-diameter inner cylinder section. As liquids, physiological saline, and a diluted contrast medium prepared by diluting a contrast medium with physiological saline, were provided. The diluted contrast medium was prepared as a 1:1 mixture of Hexabrix 320, a commercially available iodinated contrast medium, and physiological saline. To an automatic injector Mark V ProVis (model number, PPD507), manufactured by MEDRAD, 150 mL of each liquid was fed. To the three-way stopcock of the handle, a pressure gauge and the automatic injector were connected. The maximum pressure value during injection of 100 mL of the liquid at 15 mL/second was recorded.
(59) The results are described in Table 1. Since blocking of the flow of the liquid can be felt at not less than 0.100 MPa during manual injection of the liquid, this value was used as the border. As a result, a clearance of not more than 0.11 was evaluated as a preferred condition based on the results obtained by injection of the diluted contrast medium, which has a higher viscosity than physiological saline, and a clearance of not more than 0.06 was evaluated as a more preferred condition based on the results obtained by injection of physiological saline.
(60) TABLE-US-00001 TABLE 1 Comparative Comparative Example 1 Example 2 Example 3 Example 4 Example 5 Example 6 Example 7 Example 1 Example 2 Inner diameter (mm) 3.62 3.62 3.62 3.62 3.62 3.62 3.62 3.62 3.62 of the small-diameter lumen . . . A Outer diameter (mm) of 3.70 3.58 3.55 3.50 3.45 3.40 3.00 2.50 3.58 the large-diameter inner cylinder section . . . B Clearance 0 (*1) 0.02 0.04 0.06 0.09 0.11 0.31 0.56 1.81 (*2) [(A B)/2] Position of the tip of Small- Small- Small- Small- Small- Small- Small- Small- Large- the large-diameter diameter diameter diameter diameter diameter diameter diameter diameter diameter inner cylinder section lumen lumen lumen lumen lumen lumen lumen lumen lumen in the housing Pressure (MPa) during 0.392 0.379 0.189 0.101 0.094 0.066 0.040 0.040 0.040 injection of physiological saline Pressure (MPa) during 0.483 0.451 0.201 0.196 0.183 0.109 0.080 0.080 0.080 injection of a diluted contrast medium (*1) Since, in Example 1, the small-diameter lumen of the housing and the large-diameter inner cylinder section of the inner cylinder shaft are in close contact with each other because of the elastic member, the clearance in Example 1 was regarded as 0. (*2) Since, in Comparative Example 2, the large-diameter inner cylinder section of the inner cylinder shaft does not reach the small-diameter lumen of the housing, the clearance in Comparative Example 2 was calculated as the inner diameter of the small-diameter lumen of the housing/2.
INDUSTRIAL APPLICABILITY
(61) We provide a balloon catheter that can be easily handled since it prevents rupture of a balloon due to forced feeding of a liquid into the balloon having an extended shape, and also prevents treatment with a balloon having a shape that is not suitable for the treatment.