JP2000083959A - Ultrasonic catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make it possible to recognize the moving quantity of an ultrasonic transducer of an ultrasonic catheter which makes it possible to move the ultrasonic transducer while holding a catheter sheath fixed. SOLUTION: Thus ultrasonic catheter 1 is provided with a catheter sheath connector 7 and is provided with a moving quantity display means for displaying the moving quantity of the longitudinal direction position of the ultrasonic transducer at a drive shaft connector 8 fixed to the base end of a drive shaft 8. This drive shaft connector has a guide tube which is inserted into the catheter sheath connector 7 and covers the prescribed section at the base end of the drive shaft 3.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic catheter system which is inserted into a body cavity such as a blood vessel or a blood vessel and used to display a sectional image of a lumen or to measure a blood flow.

[0002]

2. Description of the Related Art An ultrasonic catheter is mainly used for treatment of a stenosis of a blood vessel, and it is necessary to judge whether the treatment should be performed only by expanding the catheter with a dilatation catheter or by placing a metal tube called a stent. As a help, it is used to observe the condition of the stenosis, and also to observe the condition after treatment.

[0003] Such a conventional ultrasonic catheter is connected to a driving device having a built-in motor, and the motor drives a drive shaft to rotate. An ultrasonic transducer is provided at the tip of the drive shaft to perform a rotational motion. By such a rotational movement, an ultrasonic wave is transmitted from an ultrasonic transducer attached to a distal end portion to be inserted into a body cavity such as a blood vessel, and an echo reflected by a reflector in the subject is received by the same ultrasonic transducer. Wave, amplify
After processing such as detection is performed, the image is displayed on a display such as a CRT.

As described above, an ultrasonic catheter generally obtains an image by rotating and scanning an ultrasonic transducer provided at a distal end portion by a drive shaft. Since the ultrasonic transducer and the drive shaft rotate at a high speed, contact with the blood vessel wall may damage the blood vessel wall or damage the ultrasonic transducer. For this reason, conventionally used ultrasonic catheters are configured such that the ultrasonic transducer and the drive shaft are rotatably housed in the catheter sheath and do not come into contact with the blood vessel wall.

[0005] Here, the ultrasonic catheter obtains a cross-sectional image in a direction perpendicular to the axis of the blood vessel at a position where the ultrasonic transducer is located in the blood vessel. Therefore, the operator operates the ultrasonic catheter so that the distal end where the ultrasonic transducer exists passes through the stenosis in order to observe the state of the vascular stenosis. that time,
In order to repeatedly observe the stenosis in order to know the state of the stenosis in detail, it is necessary to repeat the passage of the ultrasonic catheter through the stenosis every time. However, considerable effort is required to pass the narrowed blood vessel stenosis portion without damaging it, and thus, repetition of such an operation places a heavy burden on the operator.
In order to eliminate such a burden, there has been proposed an ultrasonic catheter having a function of moving only an internal ultrasonic transducer and a drive shaft while a catheter sheath is fixed.

[0006] When the operator brings the ultrasonic catheter to the vascular stenosis, the operator pulls the drive shaft while maintaining the state where the catheter sheath is fixed at the intended position.
Observation is performed by passing through the stenosis while moving the ultrasonic transducer to the front. This eliminates the need for the operator to repeatedly insert the sheath of the ultrasonic catheter through the stenosis. Such movement of the ultrasonic transducer may be performed using a machine or may be performed by a doctor.

According to the above-described method, a 360 ° cross-sectional image of the surrounding tissue body spaced apart in the axial direction in the blood vessel can be obtained by scanning to an arbitrary position. At this time, the position / distance information such as the location of the stenotic part and its length is determined by the catheter sheath displayed by the X-ray angiographic image when the state of the stenosis is confirmed by the blood vessel sectional image displayed on the display. X installed near the upper ultrasonic transducer
Obtained by a line opaque visual marker.

[0008]

However, depending on the shape of the stenotic part, even if the stenotic part can be confirmed in the cross-sectional image of the blood vessel using an ultrasonic catheter, the stenotic part can be identified only by looking at the X-ray angiographic image. It is often difficult to accurately grasp diagnostic information such as the state. Therefore, in cases such as cases where a stenotic part that cannot be confirmed with an X-ray angiographic image exists in a relatively wide area, diagnostic information of the stenotic part obtained from a blood vessel cross-sectional image is obtained from position / distance information obtained from an X-ray angiographic image. The current situation is that feedback is difficult. Therefore, the matching between the diagnosis information of the stenosis and the position / distance information is qualitatively performed based on the experience and intuition of the doctor.

SUMMARY OF THE INVENTION The present invention has been made in view of such a problem, and has a moving amount display means for displaying a moving amount of a longitudinal position of an ultrasonic transducer, so that an X-ray angiographic image can be viewed. The position of the stenosis
Even in cases where distance information cannot be grasped, it is possible to accurately grasp the position and distance information of the stenosis part even when the doctor manually operates the movement of the ultrasonic transducer under the blood vessel cross-sectional imaging. It is an object to provide an ultrasonic catheter.

[0010]

In order to solve the above-mentioned problems, the present invention relates to a catheter sheath inserted into a body cavity or a lumen, and a catheter sheath connector provided at a proximal end of the catheter sheath. A drive shaft inserted into the catheter sheath and transmitting electrical and / or mechanical driving force from a proximal end to a distal end, an ultrasonic transducer fixed to the distal end of the drive shaft, and the drive shaft And a drive shaft connector inserted into the catheter sheath connector, and a movement amount display means for indicating a longitudinal position movement amount of the ultrasonic transducer. An ultrasonic catheter is the solution.

It is preferable that the drive shaft connector has a guide tube inserted into the catheter sheath connector and covering a predetermined portion of a base end of the drive shaft.

Further, the moving amount display means includes a scale portion for quantitatively indicating the moving amount of the ultrasonic transducer within a movable range of the ultrasonic transducer, and a scale portion for moving the ultrasonic transducer in a longitudinal direction. Accordingly, it is desirable to provide an indication marker for indicating the amount of movement of the ultrasonic transducer.

[0013] Further, the moving amount display means may comprise a scale provided on the guide tube.

In this way, even in cases where the position and distance information of the stenosis cannot be grasped only by looking at the X-ray angiographic image, the position and distance information of the stenosis can be obtained under the cross-sectional imaging of the blood vessel. Can be accurately grasped,
Operator discomfort and fatigue can also be reduced.

[0015]

Embodiments of the present invention will be described below with reference to the drawings.

(Embodiment 1) FIG. 1 is a view for explaining an overall image of a system constituting an ultrasonic catheter according to an embodiment of the present invention. In FIG. 1, an ultrasonic catheter 1
Is a catheter, a long part inserted into the body cavity
It has a sheath 2 and a drive shaft and an ultrasonic transducer described later are rotatably accommodated in the sheath 2. A driving device 31 having a built-in motor is detachably provided at a base end of the ultrasonic catheter 1, and an image obtained by the ultrasonic transducer is displayed on an image monitor 32.
The operation panel 33 adjusts an image and controls the driving device 31. The image recording device 34 is a video tape recorder that records the obtained image.

FIG. 2 is a sectional view of the distal end portion of the ultrasonic catheter 1 shown in FIG. 1, and FIG. 3 is a side sectional view showing the structure of the proximal end portion of the ultrasonic catheter 1. In FIG. 2, reference numeral 3 denotes a drive shaft, which is inserted into the sheath 2 and connected to the ultrasonic transducer 4 at a distal end portion of the sheath 2 to transmit a mechanical driving force from a proximal end portion to a distal end portion. A lead wire (not shown) for electrically driving the ultrasonic transducer 4 is provided inside the drive shaft 3.
Is included. A coil 5 for stabilizing rotation is provided at the tip of the ultrasonic transducer 4. A priming hole 6 for injecting an ultrasonic wave propagating substance such as a physiological saline solution into the sheath 2 is provided at the distal end of the sheath 2.

In FIG. 3, reference numeral 7 denotes a sheath connector connected to the base end of the sheath 2, which is formed of a transparent or translucent resin. Reference numeral 8 denotes a drive shaft connector connected to the base end of the drive shaft 3. The sheath connector 7 includes a priming port 9 for discharging gas inside when the priming liquid is injected from the priming hole 6, and the drive shaft connector 8 covers a predetermined portion of the base end of the drive shaft 3. Guide tube 10 slidable inside sheath connector 7
It has.

The sheath connector 7 includes a guide tube 10
A sealing member 11 made of an O-ring for maintaining airtightness between the pressing member 1 and
The sealing member 11 is gripped by the connection between the screw mechanism provided in 3 and the screw portion 12.

The base end of the drive shaft connector 8 is
The rotary terminal 14 is detachable from the driving device 31, and rotates together with the drive shaft 3 when the rotating terminal 14 is engaged with the driving device 31.
The guide tube 10 has a swelling portion 15 at the distal end to prevent the guide tube 10 from dropping off the sheath connector 7. The tip of the bulging portion 15 has a pointing marker 16 that is colored in the transparent or translucent sheath connector 7 so that the position can be seen from the outside.

FIG. 4 is an enlarged side view of a portion indicated by a dotted line in FIG. 3, and is partially shown for easy understanding. The guide tube 10 is inserted inside the transparent or translucent sheath connector 7, and the indication marker 16 provided at the tip of the guide tube 10 can be seen. A scale 17 is provided on the surface of the sheath connector 7, and a relative movement amount of the drive shaft connector 8 with respect to the sheath connector 7 from an initial position (a state where the drive shaft connector 8 is inserted into the sheath connector 7 as far as possible). Can be checked. In the first embodiment, the indication marker 16 and the scale 17 constitute a moving amount display unit that indicates the moving amount of the ultrasonic transducer 4 from the initial position.

Next, according to the ultrasonic catheter of the present invention,
The operation method and operation of the movement amount display means will be described.

Referring to FIG. 3, the drive shaft connector 8 is slid from right to left in the drawing to bring the drive shaft connector 8 into contact with the rear end surface of the sheath connector 7 which is the initial position. At this time, it is confirmed that the instruction marker 16 is located at the origin of the scale 17 (scale 0).

After inserting the distal end of the ultrasonic catheter 1 into an arbitrary position in a body cavity or a lumen, the sheath connector 7 is fixed to a patient, and the drive device 31 is turned on to rotate the drive shaft 3 and the drive shaft 3. And start the ultrasound scan. Next, the drive shaft connector 8
Can be moved manually to any position in the longitudinal direction or automatically by a linear motion device (not shown) to produce a 360 ° cross-section of an axially spaced surrounding tissue in a body cavity or lumen. An image can be obtained by scanning to an arbitrary position. FIG. 5 shows that an ultrasonic catheter is inserted into a stenosis of a blood vessel, and an ultrasonic transducer 4 is inserted.
FIG. 5 is a diagram showing a state in which is pulled to the near side.

At this time, the indwelling position of the distal end portion of the ultrasonic catheter 1 is set to a highly visible part such as a branch point in the body cavity or the lumen, and the body cavity or the lumen is determined from the cross-sectional image obtained in the scanning range. If stenosis is observed in
By confirming the scanning position at the time of appearance and disappearance of the stenosis in the cross-sectional image by the movement amount display means, the distance from the fixed position of the sheath 2 to the stenosis, the axial length of the stenosis, and the like can be accurately known. Can be. Therefore, even in a case where the position / distance information of the stenosis cannot be grasped only by looking at the X-ray angiographic image, the position / distance information of the stenosis can be accurately grasped under the cross-sectional imaging of the blood vessel. Therefore, discomfort and fatigue of the operator can be reduced.

(Embodiment 2) In Embodiment 1 described above, the indication marker inside is confirmed using a transparent or translucent sheath connector.
By providing a scale on the guide tube 10, the material of the sheath connector, the presence or absence of the indicating marker, and the like do not matter. Note that the structures of the distal end portion and the proximal end portion of the ultrasonic catheter are common to those of the first embodiment, and thus description thereof is omitted.

FIG. 6 is a partial side view of the sheath connector 7 and the drive shaft connector 8 of the ultrasonic catheter according to the second embodiment of the present invention. In FIG. 6, a scale 18 is provided on the surface of the guide tube 10 of the drive shaft connector 8. The scale 18 is not visible at the initial position when the two connectors are in close contact with each other, and this point is set to 0. Thereafter, when the drive shaft connector 8 is pulled toward the user, the scale 18 gradually appears, and the position of the base end surface of the sheath connector 7 (the base end surface of the pusher 13) of the scale 18 indicates a position exceeding the initial position. The moving amount of the acoustic wave transducer 4 can be grasped.

The embodiments described above have been described for the purpose of facilitating the understanding of the present invention, but are not intended to limit the present invention. Therefore, each element disclosed in the above embodiment is intended to include all design changes and equivalents belonging to the technical scope of the present invention.

[0029]

According to the ultrasonic catheter of the present invention, since the drive shaft connector and the catheter sheath connector are provided with the movement amount display means, the movement amount of the ultrasonic transducer in the longitudinal direction can be accurately grasped.

Even in a case where the position / distance information of the stenosis cannot be grasped only by looking at the X-ray angiographic image, the position / distance information of the stenosis can be accurately grasped under the cross-sectional imaging of the blood vessel. Therefore, discomfort and fatigue of the operator can be reduced.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram for explaining the overall configuration of an ultrasonic catheter system according to the present invention.

FIG. 2 is a side sectional view showing an embodiment of a base portion of an ultrasonic catheter according to the present invention.

FIG. 3 is a cross-sectional view of a distal end portion of the ultrasonic catheter according to the embodiment shown in FIG.

FIG. 4 is an enlarged partial cross-sectional view of a movement amount display means for displaying a position movement amount of the ultrasonic transducer according to the present invention.

FIG. 5 shows a state in which the ultrasonic catheter according to the present invention is inserted through a stenotic part of a blood vessel.

FIG. 6 is an enlarged partial side view of a movement amount display unit according to the second embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic catheter 2 ... Catheter sheath 3 ... Drive shaft 4 ... Ultrasonic transducer 5 ... Coil 6 ... Priming hole 7 ... Sheath connector 8 ... Drive shaft connector 9 ... Priming port 10 ... Guide tube 11 ... Sealing material 12 ... Screw Part 13 ... Presser 14 ... Rotating terminal 15 ... Swelling part 16 ... Indicator marker 17 ... Scale 18 ... Scale 31 ... Driver 32 ... Image monitor 33 ... Operation panel 34 ... Video tape recorder

Claims (4)

[Claims] 1. A catheter sheath inserted into a body cavity or a lumen, a catheter sheath connector provided at a proximal end of the catheter sheath, and an electrical and electrical device inserted into the catheter sheath from a proximal end to a distal end. A drive shaft for transmitting a mechanical driving force, an ultrasonic transducer fixed to the distal end side of the drive shaft, and a drive inserted into the catheter sheath connector for moving the drive shaft in a longitudinal direction. An ultrasonic catheter comprising: a shaft connector; and a moving amount display means for indicating a moving amount of the ultrasonic transducer in a longitudinal direction. 2. The ultrasonic catheter according to claim 1, wherein the drive shaft connector has a guide tube inserted into the catheter sheath connector and covering a predetermined portion at a base end of the drive shaft. 3. The moving amount display means includes: a scale portion that quantitatively represents a moving amount of the ultrasonic transducer within a movable range of the ultrasonic transducer; Accompanying
The ultrasonic catheter according to claim 1, further comprising: an indicating marker that indicates an amount of movement of the ultrasonic transducer. 4. The ultrasonic catheter according to claim 2, wherein said moving amount display means comprises a scale provided on said guide tube.