JPH11164890A - Double balloon-type catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable expansion and fibrinolysis therapy of a lesion part, where a blood vessel is stenosed or blocked, in a short time and by administration of a small dosage of chemicals, and to prevent occurrence of a peripheral embolus due to liberation of thrombus. SOLUTION: At the front end 2a of a catheter body 2 having a plurality of lumens 3-6, a balloon 7 for blood vessel expansion with low expansion- contractibility and a balloon 8 for blood vessel blockage with greater expansion- contractibility than the blood vessel expansion balloon 7 are disposed from the front end of the catheter body toward yourself. An outlet 9 for discharging drug on the outer peripheral surface of the catheter body is provided between the blood vessel expansion balloon 7 and the blood vessel blockage balloon 8, and both balloons 7, 8 as well as the outlet 9 are respectively communicated with different one of the lumens 3, 4 and 5.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a double-balloon catheter, and more particularly, to a method in which a blood vessel is narrowed.
The present invention relates to a double-balloon catheter capable of treating an occluded lesion with a short period of time and administering a small amount of a drug solution, and preventing the occurrence of peripheral emboli due to thrombus release.

[0002]

2. Description of the Related Art Percutaneous angioplasty (PTA) for stenotic lesions is performed in cerebral blood vessels, peripheral blood vessels, dialysis shunts and the like. In this angioplasty, a balloon of a balloon-type catheter is introduced into a stenotic lesion in a blood vessel, where the balloon is inflated to expand a stenotic blood vessel.

[0003] However, when the stenotic lesion is pushed and expanded with a balloon in this way, when the balloon is deflated, a thrombus near the stenotic lesion is released, and the thrombus rides on the blood flow to reach a peripheral blood vessel and becomes peripheral. There is a problem that an embolus may be caused, and a peripheral obstruction may cause a complication. Further, for example, in the case of treatment of a stenotic portion generated in a shunt portion of hemodialysis, two types of catheters, a balloon type catheter and a drug solution administration catheter, are often used in combination.
In this treatment, the operation of dilating a vascular stenosis portion using a balloon-type catheter and administering a drug solution for suppressing thrombus formation or dissolving a thrombus in the vicinity of a stenotic lesion using a drug solution administration catheter is repeated two or three times.

However, in this operation, since it is necessary to repeatedly introduce and remove both catheters, there is a problem that the treatment is complicated and the treatment time is long. In addition, there is a problem in that it is necessary to administer a considerably large amount of drug solution since the drug solution administered to the lesion is flushed by the bloodstream without stagnation.

[0005]

SUMMARY OF THE INVENTION It is an object of the present invention to enable dilatation and fibrinolysis of a stenotic or occluded lesion in a blood vessel in a short period of time and administration of a small amount of a drug solution, and peripheral emboli due to thrombus release. An object of the present invention is to provide a double-balloon catheter that can prevent the occurrence of inflammation.

[0006]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention provides a catheter body having a plurality of lumens,
Along with a vascular dilatation balloon having a low inflation / contraction property and a vaso-occlusive balloon having a high inflation / contraction property larger than the vasodilation balloon in order from the tip to the near side, the vascular dilation balloon and the vascular occlusion balloon are An opening for discharging a drug solution is provided on the outer peripheral surface of the catheter body between the two, and the two balloons and the opening are respectively connected to different ones of the lumens.

As described above, a vascular dilatation balloon having low inflation and contraction is disposed at the distal end of the catheter body, and a vaso-occlusive balloon having high inflation and contraction is disposed at the front side, and a drug solution is discharged between the two balloons. Because there is an opening for
By inflating the vascular dilatation balloon to expand and expand the occlusive or stenotic lesion, the vaso-occlusive balloon is inflated to close the blood vessel, and the drug solution is discharged from the opening. In addition, thrombus released from a lesion can be dissolved while being retained. As a result, the released thrombus is prevented from flowing into peripheral blood vessels by the vaso-occlusive balloon, and the thrombus can be dissolved by a high-concentration drug solution, so that it can be prevented from flowing into peripheral blood vessels and causing peripheral embolus. .

In the case of treatment of a stenosis in a shunt portion of hemodialysis, the treatment from the treatment to the administration of a drug solution can be performed with a single catheter, and the drug solution stays in the lesion portion. Since the treatment can be performed, treatment can be effectively performed with a small amount.

[0009]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The configuration of the present invention will be described below in detail with reference to the accompanying drawings. FIG. 1 shows an example of the double balloon type catheter of the present invention. The catheter 1 includes a flexible catheter main body 2, and the catheter main body 2 is provided inside the catheter main body 2 along its longitudinal direction as shown in FIG.
(Four in the figure) are extended independently from each other. The distal end portion 2a of the catheter body 2 has a vascular dilatation balloon 7 at the distal end thereof in series in the longitudinal direction thereof, and a vascular occlusion balloon 8 at the front side thereof.
Is arranged.

The distal-side vascular dilatation balloon 7 communicates with a lumen 3 having a circular cross section in the catheter body 2, and is inflated by supplying and discharging a diluted liquid such as a contrast medium into the balloon 7 from the lumen 3. I try to shrink. The vasodilation balloon 7 is made of a low-elongation material having a lower inflation / contraction property than the vaso-occlusive balloon 8, and is formed in a slender shape whose longitudinal length is larger than that of the vaso-occlusive balloon 8. It performs the role of extension.

A lumen 4 having a substantially fan-shaped cross section in the catheter body 2 communicates with the vascular occlusion balloon 8 on the near side, and a fluid such as carbon dioxide or a diluted contrast agent is supplied into the balloon 8 from the lumen 4. It is made to expand and contract by discharging. The vascular occlusion balloon 8 is made of a highly extensible material having a higher inflation / contraction property than the vasodilation balloon 7,
It becomes spherical when inflated and adheres to the inner wall of the blood vessel, acting as a plug.

An opening 9 for discharging a chemical is formed in the outer peripheral surface 2b of the catheter body 2 between the balloons 7, 8. The number of the openings 9 may be two or more.
Communicates with the inner cavity 5 having a substantially fan-shaped cross section. The distal end 2c of the catheter body 2 is provided with an opening through which a lumen 6 having a large diameter and a circular cross section communicates. The lumen 6 is used for inserting a guide wire when introducing a catheter into a lesion in a blood vessel.

An X-ray opaque marker 11 is provided at two positions before and after the surface of the catheter body 2 in the vascular dilatation balloon 7 so that X-rays can be seen during treatment. Also,
An X-ray opaque marker 10 is also provided on the surface of the central portion of the catheter body 2 in the vascular occlusion balloon 8. The distal end of the catheter body 2 is formed in a tapered shape with a tapered end to facilitate introduction of the catheter 1 into a blood vessel.

The rear end of the catheter body 2 is connected to a connector 12 made of hard plastic or the like, and an extension tube 13 communicating with the lumen 6 is connected to the rear end of the connector 12. In addition, lumens 3, 4, 5, and 5 are provided in each of the branch portions 12a, 12b, and 12c protruding from the outer peripheral surface of the connector 12.
Are connected to extension tubes 14, 15, and 16, respectively. Connection ports 17 to 20 are attached to the rear ends of the tubes 13 to 16, respectively.

The case of treating vascular stenosis using the catheter 1 of the present invention will be described as an example. First, as shown in FIG. 3A, the downstream of the blood flowing as shown by the arrow, using a guide wire (not shown). The vascular dilatation balloon 7 in a contracted state is introduced into the stenosis lesion 22 of the blood vessel 21 from the side. Then, by supplying a diluted liquid such as a contrast medium from the connection port 18, the liquid is filled into the vascular dilatation balloon 7 through the extension tube 14 and the lumen 3, and the vascular dilation balloon 7 is inflated (FIG. 3 (b)). As a result, the stenotic lesion 22 is pressed and expanded by the vascular dilatation balloon 7.

After the expansion, a fluid such as carbon dioxide gas or a diluted contrast agent is supplied from the connection port 19 to extend the extension tube 1.
5. The fluid is filled into the vascular occlusion balloon 8 through the lumen 4, and the vascular occlusion balloon 8 is inflated so as to close the blood vessel 21 (FIG. 3C). After the filled liquid is discharged in this state and the vascular dilatation balloon 7 is contracted, a thrombus-dissolving drug such as urokinase is discharged from the opening 9 through the connection port 20 through the extension tube 16 and the lumen 5 ( FIG. 3D). When the vascular dilatation balloon 7 is deflated, the thrombus formed on the surface of the stenotic lesion 21 is released, but this thrombus is inflated by the inflated vasoocclusive balloon 8 blocking the downstream side of the blood vessel 21. , Stay in the vicinity of the lesion, and dissolve and disappear with the drug solution. Therefore, even if the thrombus is released, peripheral embolism does not occur.

After the drug solution is administered to dissolve and eliminate the thrombus,
The filled fluid is extracted, and the vascular occlusion balloon 8 is contracted. The operations shown in FIGS.
By repeating the procedure twice, the stenotic lesion 22 is expanded without causing peripheral emboli due to thrombus release. In the case of treating a stenotic lesion in the shunt of hemodialysis, the same operation is used to dilate the lesion with the same catheter, administer the drug solution, and retain the drug solution in the lesion. Therefore, the treatment can be efficiently performed in a short time with a small amount of the drug solution.

In the present invention, as the flexible material forming the catheter body 2, for example, polyethylene or nylon can be preferably used. As a material constituting the vascular dilatation balloon 7, for example, polyurethane,
Plastics such as polyester, polyethylene and nylon can be mentioned. When the vascular dilatation balloon 7 is formed by combining these materials and thicknesses, it is preferable that the balloon 7 has a property of withstanding 2 atm. Preferably, it is made non-extensible with little stretching or deformation when pressure is applied.

As a material constituting the vascular occlusion balloon 8, latex, silicone, or the like, which easily expands and deforms when pressure is applied, can be preferably used.
When the vascular occlusion balloon 8 is constructed by combining these materials and thicknesses, it is preferable that the balloon 8 has characteristics such that the balloon 8 is broken at less than 2 atmospheres, and has high extensibility that cannot expand a lesion. Preferably, it has a property of breaking at 1.2 atm or less.

It is preferable that the outer peripheral surface of the catheter body 2 and the inner peripheral surfaces of the lumens 5 and 6 and the outer surfaces of the balloons 7 and 8 are coated with a biocompatible substance, particularly an antithrombotic substance. As this antithrombotic substance, for example, heparin, urokinase and the like are suitable. The above lumens 3,4
5 has a substantially fan-shaped or circular cross-sectional shape in the above-described embodiment, but is not limited thereto.

Although the present invention has been described with reference to an example of vascular stenosis in the above embodiment, the present invention can be suitably used for vascular occlusion. In this case, a hole penetrating the closed portion is formed by a guide wire, and the portion of the vascular dilatation balloon 7 of the catheter is inserted into the hole, and the procedure can be performed in the same manner as described above. Further, the location of the lesion may be a vein or an artery.

[0022]

As described above, according to the present invention, a vascular dilatation balloon and a vaso-occlusive balloon are arranged at the distal end of a catheter body having a plurality of lumens in this order from the distal end to the near side. An opening for discharging a drug solution was provided on the outer peripheral surface of the catheter body between the balloon for balloon and the balloon for vascular occlusion, and both the balloon and the opening were respectively connected to different ones of the lumens. After dilating the lesion with a balloon, the vaso-occlusive balloon is expanded and the blood vessel is closed, and by discharging the drug solution from the opening, the thrombus released from the vicinity of the lesion can be dissolved and lost while being retained. Therefore, the occurrence of peripheral emboli due to thrombus release in dilation therapy can be prevented.
In addition, even in the case of treatment of a stenotic part generated in a shunt part of hemodialysis, the treatment from the treatment to the administration of the drug solution can be performed with only a single catheter, and further, the drug solution is retained in the lesion part. Therefore, dilation of the lesion and fibrinolysis can be performed in a short time and by administering a small amount of a drug solution.

[Brief description of the drawings]

FIG. 1 is a front view showing an example of a double balloon type catheter of the present invention with a part thereof omitted.

FIG. 2 is an enlarged sectional view taken along the line AA of FIG.

FIGS. 3A to 3D are explanatory views showing the operation of the double balloon catheter of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 Double balloon type catheter 2 Catheter main body 2a Tip part 2b Outer peripheral surface 3, 4, 5, 6 Lumen 7 Vascular dilatation balloon 8 Vascular occlusion balloon 9 Opening 21 Blood vessel 22 Stenosis lesion

Claims (2)

[Claims] 1. A vascular dilatation balloon having a lower inflation / contraction property and a vaso-occlusive vessel having a higher inflation / contraction property than the vascular dilation balloon in order from the front end to the front side of the catheter body having a plurality of lumens. Place the balloon and
A double balloon in which an opening for discharging a drug solution is provided on the outer peripheral surface of the catheter body between the vascular dilatation balloon and the vaso-occlusive balloon, and the balloon and the opening are respectively connected to different ones of the lumens. Type catheter. 2. The method according to claim 1, wherein the material of the vascular dilatation balloon is at least one selected from plastics such as polyester, polyethylene, nylon and polyurethane, and the material of the vaso-occlusive balloon is latex or silicone. The double balloon type catheter according to the above.