WO2018110561A1 - Medical device - Google Patents
Medical device Download PDFInfo
- Publication number
- WO2018110561A1 WO2018110561A1 PCT/JP2017/044608 JP2017044608W WO2018110561A1 WO 2018110561 A1 WO2018110561 A1 WO 2018110561A1 JP 2017044608 W JP2017044608 W JP 2017044608W WO 2018110561 A1 WO2018110561 A1 WO 2018110561A1
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- WO
- WIPO (PCT)
- Prior art keywords
- connecting member
- linear member
- medical device
- linear
- opening
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
Definitions
- the present invention relates to a medical device for indwelling an indwelling member such as a coil at an aneurysm occurrence site or the like.
- a vascular embolization method in which an indwelling member such as a coil is placed at a site where the aneurysm occurs is known.
- the indwelling member is connected to the distal end portion of a guide member such as a tube via a connecting member.
- the guide member is passed through a catheter disposed in the living body.
- the indwelling member is guided to a desired position in the living body.
- the connecting member disengages the indwelling member from the guide member.
- the indwelling member is placed at a desired position in the living body.
- Patent Document 1 discloses a microcoil assembly having a microcoil part, a coil pusher part, a suture thread, and a tension wire.
- the tension wire is inserted through the through hole of the coil pusher portion.
- the microcoil portion is tied to the loop at the distal end portion of the pulling wire by a suture thread.
- the microcoil part is inserted into the cerebral aneurysm generation site of the patient by operating the coil pusher part. Thereafter, the pulling wire is pulled toward the proximal end side.
- the pull wire brings the suture thread tied to the loop at the tip portion into contact with the edge portion provided at the tip portion of the coil pusher portion. As a result, the suture thread is cut, and the microcoil portion is placed in the cerebral aneurysm generation site.
- the suture is cut by pulling the pull wire toward the proximal end. For this reason, force may be applied to the distal end portion of the coil pusher portion by reaction when the suture is cut. Due to this force, there is a possibility that a force directed from the distal end portion of the coil pusher portion toward the distal end side acts on the microcoil portion. In this case, force may be applied to the site where the cerebral aneurysm is generated. Further, there is a possibility that a force acts on the placed microcoil portion and moves.
- An object of the present invention is to provide a medical device capable of appropriately removing an indwelling member from a guiding member after the indwelling member is guided to a desired position in a living body by the guiding member.
- the medical device includes a cylindrical guide member extending in the extending direction between the proximal end and the distal end, and a linear member inserted into the guide member so as to be movable along the extending direction. And a connecting member provided on the distal end side of the guide member, the through hole through which a part of the linear member is inserted, and a first opening from which the distal end side of the linear member protrudes.
- a support part that removably supports the first through hole and the end part on the distal end side of the linear member, wherein the linear member moves in accordance with the movement of the linear member to the proximal end side.
- a connecting member having a support portion that can be switched from a support state in which the end portion on the tip side of the member is supported to a detached state in which the end portion on the tip side of the linear member is detached; and
- An indwelling member having an annular portion through which the protruding portion protruding from the first opening is inserted.
- the indwelling member wherein connected to the coupling member in a supported state, characterized in that desorbed from the connecting member in the desorption state.
- an indwelling member is guided to a desired position (for example, an aneurysm generation site) in a living body by a guiding member in a state where the indwelling member is coupled to a coupling member provided at an end portion on the distal end side of the guiding member. .
- a desired position for example, an aneurysm generation site
- the indwelling member is disposed at a desired position, when the linear member moves to the proximal end side, the end portion on the distal end side of the linear member is detached from the support portion.
- the indwelling member is detached from the connecting member and placed in a desired position in the living body.
- the indwelling member is connected to the connecting member by inserting a linear member through the annular portion.
- the medical device can appropriately remove the indwelling member from the connecting member after the indwelling member is guided to a desired position in the living body.
- the support portion may include a clamping portion that clamps the end portion on the distal end side of the linear member.
- the medical device can easily form a support portion on the connecting member that can be switched from the support state to the detachment state in accordance with the movement of the linear member toward the proximal end.
- the connecting member has a first concave portion that is recessed toward the base end side at an end portion on the distal end side, and the first concave portion is a bottom surface that is a surface intersecting the extending direction;
- the first opening is provided on the bottom surface of the first recess, and the support portion is provided on the side surface of the first recess.
- the protruding portion of the linear member can be easily inclined with respect to the extending direction.
- stretching direction of the force which acts on an indwelling member becomes small according to having moved the linear member to the base end side. Therefore, the medical device can further suppress the movement of the indwelling member according to the movement of the linear member.
- the first opening and the support portion may be arranged side by side in the extending direction.
- the medical device can suppress the linear member from being bent in the vicinity of the first opening. Therefore, the medical device can smoothly move the linear member to the proximal end side and switch from the support state to the detached state.
- the said connection member has the 2nd recessed part dented in the direction which cross
- It has a certain side,
- the 1st opening and the support part may be provided in the side of the 2nd crevice.
- a portion of the linear member through which the annular portion of the indwelling member is inserted can be disposed in the second recess. Therefore, the medical device can stabilize the state in which the linear member is inserted into the annular portion, and thus the linear member can be prevented from being detached from the annular portion when the indwelling member is guided by the guiding member.
- the connecting member further has a second through-hole penetrating between the end portion on the distal end side and the side surface of the second recess, and through which the annular portion of the indwelling member is inserted.
- the medical device can suppress the annular portion of the indwelling member from being disposed outside the outer peripheral surface of the connecting member. Therefore, the medical device can prevent the guide of the indwelling member by the guide member from being hindered by the annular portion. Further, the medical device can more effectively suppress the linear member from being detached from the annular portion when the indwelling member is guided by the guiding member.
- the said linear member is provided with the obstruction
- occlusion member is the said linear member in the said 2nd opening. May be switched between a state in which the linear member is held and a state in which the linear member is not held in the second opening.
- the blocking member can suppress the linear member from moving to the proximal end side when the indwelling member is guided by the guiding member while the linear member is held in the second opening.
- the blocking member is separated from the connecting member by keeping the linear member from being held in the second opening.
- the indwelling member can be detached.
- the hardness of the first portion supported by at least the support portion of the linear member may be harder than the hardness of the second portion excluding the first portion.
- the medical device can easily support the linear member in a detachable manner by the support portion.
- the protruding portion of the linear member may extend along the extending direction.
- the medical device can suppress bending of the linear member. Therefore, the medical device can smoothly move the linear member to the proximal end side and switch from the support state to the detached state.
- the connecting member includes a first connecting member and a second connecting member that can be brought into contact with and separated from each other, and the support portion is the linear shape at a portion where the first connecting member and the second connecting member are in contact with each other.
- the medical device can strongly support the linear member by the support portion by increasing the force with which the first connecting member and the second connecting member are pressed against each other. Therefore, the medical device can suppress the linear member from being detached from the support portion when the indwelling member is guided by the guiding member.
- the medical device can easily switch from the support state to the detached state according to the movement of the linear member by weakening the force with which the first connection member and the second connection member are pressed against each other.
- the second connecting member has a third recessed portion that is recessed toward the proximal end at an end portion on the distal end side, and the third recessed portion is a surface that intersects the extending direction.
- the first opening may be provided on the bottom surface or the side surface of the third recess.
- the bottom surface may be a surface parallel to the extending direction.
- the protruding portion of the linear member can be easily crossed with respect to the extending direction.
- stretching direction of the force which acts on an indwelling member becomes small, so that the angle in case a protrusion part cross
- the medical device can maintain the state where the first connecting member and the second connecting member are strongly pressed against each other by the holding unit. Further, the medical device can easily weaken the force of the first connecting member and the second connecting member pressed against each other when the linear member moves to the proximal end side. Therefore, the medical device can be easily switched from the support state to the detached state according to the movement of the linear member to the proximal end side.
- one of the first connecting member and the second connecting member may have a fitting portion into which the other of the first connecting member and the second connecting member fits.
- the medical device can maintain the state where the first connecting member and the second connecting member are strongly pressed against each other by the fitting portion.
- the protruding portion of the linear member may extend along a direction orthogonal to the extending direction.
- the protruding portion of the linear member can be disposed along the direction orthogonal to the extending direction.
- the medical device can further suppress the movement of the indwelling member according to the movement of the linear member.
- the maximum outer diameter of the connecting member may be larger than the inner diameter of the guiding member. In this case, since it can suppress that a connection member moves according to the movement to the base end side of a linear member, a medical device can be appropriately switched from a support state to a desorption state.
- the medical apparatus 1A is used for vascular embolization.
- the medical device 1 ⁇ / b> A includes a guide member 2, a linear member 3, a connecting member 4, and an indwelling member 9.
- a catheter for guiding the medical device 1A is placed at a predetermined position in the living body.
- the guide member 2 moves in a catheter arranged in the living body, and guides an indwelling member 9 described later to a desired position in the living body.
- the guide member 2 is cylindrical and has flexibility.
- the guide member 2 can be bent along the catheter.
- the inner diameter of the guide member 2 is substantially the same over the entire area in the extending direction.
- the guide member 2 has a space surrounded by an inner surface 21 that is an inner surface of the peripheral wall (hereinafter referred to as “lumen 21A”).
- the inner diameter of the guiding member 2 is denoted as L11, and the outer diameter of the guiding member 2 is denoted as L12.
- the direction of the medical device 1 ⁇ / b> A is defined based on the shape of the guide member 2 in order to help understand the description of the drawing.
- the direction in which the guide member 2 extends is referred to as “stretching direction”, and the direction orthogonal to the stretching direction is referred to as “orthogonal direction”.
- One end in the stretching direction is referred to as “tip”, and the other end is referred to as “base end”.
- the guide member 2 extends between the distal end and the proximal end along the extending direction.
- the side close to the cross-sectional center of the guide member 2 is referred to as “inside” and is separated from the cross-sectional center of the guide member 2.
- the side is called “outside”.
- the above definition of the direction is also applied to medical devices 1B, 1C, and 1D in second to fourth embodiments described later.
- the material of the guide member 2 is not particularly limited, and various materials having flexibility can be used.
- derivation member 2, and the connection member 4 mentioned later contacts the inner surface 21 may be formed with a different material from another part. At this time, the hardness of a part of the leading end side of the guide member 2 may be larger than the hardness of other parts.
- the connecting member 4 is provided at the distal end portion of the guiding member 2.
- the connecting member 4 is made of resin and closes the lumen 21A at the distal end portion of the guide member 2.
- the connecting member 4 has a main body 41 and a protrusion 43.
- the shape of the main body 41 is a cylindrical shape.
- the center of the main body 41 extends along the extending direction.
- the main body 41 fits into the lumen 21 ⁇ / b> A at the distal end of the guide member 2.
- the outer diameter of the main body 41 is denoted as L13.
- the outer diameter L13 is substantially the same as the inner diameter L11 of the guide member 2.
- the main body 41 has a main body side surface 41A and main body bottom surfaces 41B and 41C.
- the main body side surface 41A corresponds to the side surface of the main body portion 41 and extends in parallel with the extending direction.
- the main body side surface 41 ⁇ / b> A is in close contact with the inner surface 21 of the distal end portion of the guide member 2.
- the main body bottom surface 41 ⁇ / b> B corresponds to the bottom surface of the end portion on the front end side of the main body portion 41.
- the main body bottom surface 41 ⁇ / b> C corresponds to the bottom surface of the end portion on the proximal end side of the main body portion 41.
- the main body bottom surfaces 41B and 41C are orthogonal to the extending direction.
- a first recess 42 that is recessed toward the base end side is formed on the main body bottom surface 41B.
- the cross-sectional shape of the first recess 42 is circular.
- the first recess 42 has a recess side surface 42A and a recess bottom surface 42B.
- the recess side surface 42A corresponds to the side surface of the first recess 42 and extends parallel to the extending direction.
- the recess bottom surface 42B corresponds to the bottom surface of the first recess 42 and is orthogonal to the extending direction.
- the main body 41 has a first through hole 41E.
- the first through hole 41E extends in a direction inclined with respect to the extending direction across the recess bottom surface 42B and the main body bottom surface 41C.
- the opening formed in the recess bottom surface 42B by the first through hole 41E is referred to as a “first opening 411”.
- the first opening 411 is formed at a position shifted outward with respect to the center of the recess bottom surface 42B.
- An opening formed in the main body bottom surface 41 ⁇ / b> C by the first through hole 41 ⁇ / b> E is formed at the center of the main body bottom surface 41 ⁇ / b> C as a “second opening 412”.
- the main body 41 has a clamping part 41F.
- the sandwiching portion 41F is a bottomed hole provided on the concave side surface 42A of the first concave portion 42.
- the clamping part 41F extends in a direction inclined outward from the proximal end side toward the distal end side.
- the sandwiching portion 41F is disposed along an imaginary straight line extending toward the distal end side along the first through hole 41E.
- the inner diameter of the sandwiching portion 41F is smaller than the inner diameter of the first through hole 41E.
- the protrusion 43 protrudes outward from the end of the main body side surface 41A of the main body 41 on the front end side.
- the outer diameter of the protrusion 43 is denoted as L14.
- the outer diameter L14 is substantially the same as the outer diameter L12 of the guide member 2, and is larger than the inner diameter L11 of the guide member 2.
- the end portion on the distal end side of the protrusion 43 is inclined toward the proximal end side from the inside toward the outside.
- the linear member 3 is an elongated metal wire.
- the linear member 3 is inserted into the lumen 21 ⁇ / b> A of the guide member 2.
- the linear member 3 extends along the extending direction and is movable along the extending direction.
- the linear member 3 has a first portion 31 and a second portion 32. A part on the proximal end side of the linear member 3 corresponds to the second part 32, and the other part corresponds to the first part 31.
- the outer diameter of the first portion 31 is smaller than the inner diameter of the first through hole 41E of the connecting member 4, and is substantially the same as the inner diameter of the clamping part 41F.
- the first portion 31 and the second portion 32 have different hardnesses.
- the hardness of the first portion 31 is harder than the hardness of the second portion 32.
- a closing member 36 is provided at a boundary portion between the first portion 31 and the second portion 32 of the linear member 3.
- the closing member 36 has a truncated cone shape.
- the linear member 3 passes through the center of the closing member 36.
- the diameter of the bottom surface of the closing member 36 on the first portion 31 side is smaller than the diameter of the bottom surface on the second portion 32 side.
- the linear member 3 is soldered to the bottom surface of the closing member 36 on the second portion 32 side. As a result, the closing member 36 is fixed to the linear member 3.
- the first portion 31 of the linear member 3 can be inserted into the first through hole 41E of the connecting member 4.
- the end portion on the distal end side of the first portion 31 is inserted into the clamping portion 41F.
- the outer diameter of the first portion 31 and the inner diameter of the sandwiching portion 41F are substantially the same. For this reason, the edge part of the front end side of the 1st part 31 is clamped by the inner wall of the clamping part 41F.
- the state of the medical device 1A when the end portion on the distal end side of the first portion 31 is sandwiched by the sandwiching portion 41F is referred to as a “supported state”.
- a part of the linear member 3 that protrudes from the first opening 411 and is disposed in the first recess 42 is referred to as a “projecting part 3A”.
- the protruding portion 3A extends along the extending direction. More specifically, the protruding portion 3A extends in a direction slightly inclined with respect to the extending direction.
- the inclination angle of the protruding portion 3A with respect to the extending direction is not particularly limited, but the inclination angle is any angle from 0 degrees to 45 degrees, for example.
- the closing member 36 fits into the second opening 412 from the proximal end side and closes the second opening 412.
- the linear member 3 is held in the second opening 412 and cannot move relative to the connecting member 4.
- the end portion on the distal end side of the first portion 31 of the linear member 3 is detached from the clamping portion 41F, and the closing member 36 is detached from the second opening 412.
- the state of the medical device 1 ⁇ / b> A when the end portion on the distal end side of the first portion 31 is detached from the sandwiching portion 41 ⁇ / b> F is referred to as “detached state”.
- the linear member 3 is not held in the second opening 412 and can be moved relative to the connecting member 4.
- the clamping unit 41F can switch the medical device 1A between the support state and the detachment state by detachably supporting the end portion on the distal end side of the linear member 3. it can.
- the indwelling member 9 is disposed on the distal end side with respect to the guide member 2.
- the indwelling member 9 has a cored bar 91, a wire 92, and an annular part 93.
- the cored bar 91 has a rod shape and extends along the extending direction.
- the core 91 can be bent.
- the shape of both ends of the cored bar 91 is hemispherical.
- the wire 92 is wound in a coil shape around a portion excluding both ends of the cored bar 91.
- As the material of the wire 92 any one of platinum, tungsten, gold, tantalum, iridium, and alloys thereof having a small influence on the living body is used.
- the annular portion 93 is formed in an annular shape by connecting both ends of the string-like member to the proximal end of the cored bar 91.
- the annular portion 93 has flexibility.
- the closed region inside the annular portion 93 is referred to as a “closed region 93A”.
- the shape of the closed region 93 ⁇ / b> A of the annular portion 93 is deformed in response to an external force acting.
- the protruding portion 3A of the linear member 3 is inserted into the closed region 93A of the annular portion 93.
- the edge part by the side of the front end of the linear member 3 is clamped by the clamping part 41F.
- the annular portion 93 is not detached from the protruding portion 3A.
- the indwelling member 9 is connected to the connecting member 4 in the support state.
- the medical device 1A changes from the support state to the detached state
- the end portion on the distal end side of the linear member 3 is detached from the clamping portion 41F.
- the annular portion 93 can be detached from the protruding portion 3A.
- the indwelling member 9 can be detached from the connecting member 4.
- the user operates the guide member 2 and sequentially feeds it into the catheter (arrow Y11).
- Indwelling member 9 receives a force in the direction toward the distal end side from guiding member 2 (arrow Y12).
- the medical device 1A moves in the catheter toward the distal end side.
- the user guides the indwelling member 9 to a desired position in the living body by adjusting the feed amount of the guide member 2.
- FIG. 2B when the indwelling member 9 reaches the desired position, the user stops the feeding operation of the guide member 2.
- the indwelling member 9 is disposed at a desired position.
- the user operates the linear member 3 while holding the guide member 2 to apply a force in the direction toward the proximal end to the linear member 3.
- the movement of the connecting member 4 toward the proximal end side is regulated by the protrusion 43 coming into contact with the end portion on the distal end side of the guiding member 2.
- the edge part by the side of the front end of the linear member 3 detach
- the blocking member 36 is detached from the second opening 412.
- the linear member 3 moves to the proximal end side (arrow Y13).
- the protruding portion 3 ⁇ / b> A of the linear member 3 is disengaged from the closed region 93 ⁇ / b> A of the annular portion 93 of the indwelling member 9.
- the indwelling member 9 becomes detachable from the connecting member 4.
- the user moves the linear member 3 further to the proximal side (arrow Y14).
- the first portion 31 of the linear member 3 is detached from the first through hole 41E.
- the user applies a force in a direction toward the proximal end side to the guide member 2.
- the guide member 2 and the connecting member 4 move to the proximal end side. (Arrow Y15). Since the indwelling member 9 is detached from the connecting member 4, the indwelling member 9 is indwelled at a desired position.
- the guide member 2, the linear member 3, and the connecting member 4 are taken out of the catheter.
- the indwelling member 9 of the medical device 1A is guided to a desired position in the living body (for example, an aneurysm generation site) by the guide member 2 in a state of being connected to the connecting member 4 (arrows Y11, Y12, FIG. 2 ( a)).
- a desired position for example, an aneurysm generation site
- the guide member 2 in a state of being connected to the connecting member 4 (arrows Y11, Y12, FIG. 2 ( a)).
- the indwelling member 9 is disposed at a desired position (see FIG. 2B)
- the linear member 3 moves to the proximal end side (see arrow Y13, FIG. 2C)
- the distal end of the linear member 3 The end on the side is detached from the clamping part 41F.
- the indwelling member 9 is detached from the connecting member 4 and placed in a desired position in the living body.
- the indwelling member 9 is connected to the connecting member 4 by inserting the linear member 3 through the annular portion 93. Therefore, even if the linear member 3 moves to the proximal end side in the above process, it is difficult for force to act on the indwelling member 9 from the linear member 3. Therefore, when the indwelling member 9 is detached from the connecting member 4, the possibility that a force acts on the site where the cerebral aneurysm is generated is reduced, and the indwelling member is caused by the reaction of the force according to the movement of the linear member 3. 9 is suppressed from moving from the desired position. Accordingly, the medical device 1A can appropriately remove the indwelling member 9 from the connecting member 4 after the indwelling member 9 is guided to a desired position in the living body.
- the sandwiching portion 41F is a bottomed hole having a smaller diameter than the first portion 31 of the linear member 3.
- the clamping part 41F can suppress the linear member 3 from being detached by clamping the end of the linear member 3 on the distal end side with the inner wall.
- the sandwiching portion 41F can detach the linear member 3 in response to the force in the direction toward the proximal end acting on the linear member 3.
- the medical device 1A can easily realize a mechanism capable of switching from the support state to the detached state by the sandwiching portion 41F.
- the connecting member 4 has a first recess 42.
- the first opening 411 of the first through hole 41E is provided at the center of the recess bottom surface 42B.
- the clamping portion 41F is provided on the concave side surface 42A.
- a closing member 36 is provided on the linear member 3.
- the closing member 36 holds the linear member 3 in the second opening 412 in a state of being fitted in the second opening 412, and makes the linear member 3 relatively unmovable with respect to the connecting member 4. For this reason, the closing member 36 can suppress the linear member 3 from moving to the proximal end side when the indwelling member 9 is guided by the guide member 2. Further, the closing member 36 does not hold the linear member 3 in the second opening 412 in a state of being detached from the second opening 412, and enables the linear member 3 to move relative to the connecting member 4.
- the closing member 36 can easily detach the end portion on the distal end side of the linear member 3 from the clamping portion 41 ⁇ / b> F when the indwelling member 9 is detached from the connecting member 4.
- the hardness of the first portion 31 of the linear member 3 is harder than the hardness of the second portion 32.
- the clamping part 41F is easy to stably clamp the first portion 31 of the linear member 3. Accordingly, the medical device 1A can easily hold the linear member 3 in a detachable manner by the holding portion 41F.
- the outer diameter of the protrusion 43 of the connecting member 4 is substantially the same as the outer diameter L12 of the guide member 2, and is larger than the inner diameter L11 of the guide member 2. For this reason, the connecting member 4 can be easily positioned with respect to the guide member 2 by bringing the protrusion 43 into contact with the guide member 2. Further, when the linear member 3 is operated to detach the indwelling member 9 from the connecting member 4, the connecting member 4 cannot move to the proximal end side with respect to the guide member 2. That is, the movement of the connecting member 4 to the proximal end side is suppressed by the protrusion 43. Therefore, the medical device 1A suppresses the movement of the connecting member 4 to the proximal side in response to the movement of the linear member 3 to the proximal side, and can appropriately switch from the support state to the detached state. it can.
- the clamping part 41F is not limited to a bottomed hole.
- the clamping part 41F may be a slit-like cut provided on the concave side surface 42A.
- the cut may be formed by two opposing wall portions.
- the sandwiching portion 41F may sandwich the end portion on the distal end side of the linear member 3 between the two wall portions.
- the edge part of the front end side of the linear member 3 may be adhere
- the linear member 3 may be peeled from the concave side surface 42A.
- the recess bottom surface 42B of the first recess 42 may be inclined with respect to the direction orthogonal to the extending direction.
- the sandwiching portion 41F may be provided on the recess bottom surface 42B.
- the protruding portion 3A of the linear member 3 extends from the first opening 411 to the distal end side, bends to the proximal end side and extends to the proximal end side, and the distal end end portion is sandwiched by the sandwiching portion 41F.
- the first opening 411 may be provided on the concave side surface 42A.
- the first through hole 41E may extend in the extending direction.
- the first opening 411 may be formed at the center of the recess bottom surface 42B of the first recess 42.
- the first portion 31 of the linear member 3 may extend in the extending direction along the first through hole 41E and bend at the first opening 411.
- the protruding portion 3A of the linear member 3 may extend in a direction inclined with respect to the extending direction.
- the closing member 36 may not be provided on the linear member 3.
- the linear member 3 may always be movable with respect to the connecting member 4.
- the hardness of the portion clamped by the clamping portion 41F may be different from the hardness of the other portion.
- the hardness of the part clamped by the clamping part 41F among the linear members 3 may be harder than the hardness of other parts.
- the linear member 3 may have a uniform hardness over the entire area.
- the connecting member 4 has only the main body 41 and may not have the protrusion 43.
- the outer diameter of the connecting member 4 may be L13 over the entire area.
- the connecting member 4 may include a protruding portion that is orthogonal to the extending direction and protrudes outward.
- the guide member 2 may be formed with a hole that can be fitted to the protruding portion of the connecting member 4. By connecting the protrusion and the hole, the connecting member 4 and the guiding member 2 are more firmly connected.
- the hole formed in the guide member 2 may be a bottomed hole or a through hole. A plurality of protrusions and holes may be provided.
- FIGS. 1B A medical device 1B according to the second embodiment will be described with reference to FIGS.
- a connecting member 5 is used instead of the connecting member 4 in the first embodiment. Since the guide member 2, the linear member 3, and the indwelling member 9 are the same as those in the first embodiment, description thereof is omitted.
- the connecting member 5 has a main body 51 and a protrusion 53.
- the main body 51 and the protrusion 53 correspond to the main body 41 and the protrusion 43 in the connecting member 4 (see FIG. 1) of the first embodiment, respectively.
- the main body side surface 51A and the main body bottom surfaces 51B and 51C of the main body portion 51 correspond to the main body side surface 41A and the main body bottom surfaces 41B and 41C of the main body portion 41 of the connecting member 4, respectively.
- a second recess 52 that is recessed in the orthogonal direction is formed on the main body side surface 51A.
- the cross-sectional shape of the second recess 52 is circular.
- the second recess 52 has a recess side surface 52A and a recess bottom surface 52B.
- the recess side surface 52A corresponds to the side surface of the second recess 52 and is orthogonal to the extending direction.
- the recess bottom surface 52B corresponds to the bottom surface of the second recess 52 and extends
- the main body 51 has a first through hole 51E.
- the first through hole 51E extends between the base end side portion of the recess side surface 52A and the main body bottom surface 51C.
- the opening formed in the recess side surface 52A by the first through hole 51E is referred to as a “first opening 511”.
- the opening formed in the main body bottom surface 51C by the first through hole 51E is referred to as a “second opening 512”.
- the second opening 512 is provided at the center of the main body bottom surface 51C.
- the first through hole 51E extends in the extending direction from the second opening 512 toward the first opening 511.
- the main body 51 has a clamping part 51F.
- the sandwiching portion 51F is a through hole extending between the tip side portion of the recess side surface 52A and the main body bottom surface 51B.
- the inner diameter of the sandwiching portion 51F is smaller than the inner diameter of the first through hole 51E and is substantially the same as the outer diameter of the first portion 31 of the linear member 3.
- the clamping part 51F extends in the extending direction.
- the opening formed in the recess side surface 52A by the sandwiching part 51F is referred to as an “opening 513”.
- An opening formed in the bottom surface 51B of the main body by the sandwiching portion 51F is referred to as an “opening 514”.
- the opening 514 is provided at the center of the main body bottom surface 51B.
- the sandwiching portion 51F extends in the extending direction from the opening 514 toward the opening 513.
- the first through holes 51E and the sandwiching portions 51F are arranged in a straight line in the extending direction. For this reason, the first opening 511 of the first through hole 51E and the opening 513 of the sandwiching portion 51F are arranged side by side in the extending direction with the second recess 52 interposed therebetween.
- the first portion 31 of the linear member 3 can be inserted into the first through hole 51E and the clamping portion 51F.
- the first portion 31 crosses the second recess 52 in the extending direction.
- a portion on the distal end side of the first portion 31 is inserted into the holding portion 51F.
- the end portion on the distal end side of the first portion 31 slightly protrudes toward the distal end side from the opening 514 of the main body bottom surface 51B.
- the outer diameter of the first portion 31 and the inner diameter of the sandwiching portion 51F are substantially the same. For this reason, the part of the front end side of the 1st part 31 is clamped by the inner wall of the clamping part 51F.
- the state of the medical device 1B when the distal end portion of the first portion 31 is sandwiched by the sandwiching portion 51F corresponds to the “supported state”.
- a part of the linear member 3 that protrudes from the first opening 511 and is disposed in the second recess 52 corresponds to the “protrusion 3 ⁇ / b> A”.
- the protruding portion 3A extends along the extending direction. More specifically, the protrusion 3A extends in parallel with the extending direction.
- the closing member 36 fits into the second opening 512 from the proximal end side and closes the second opening 512.
- the linear member 3 is held in the second opening 512 in a state where the closing member 36 is fitted in the second opening 512.
- the main body 51 has a second through hole 51G.
- the second through hole 51G extends between the tip side portion of the concave side surface 52A and the main body bottom surface 51B.
- the inner diameter of the second through hole 51G is larger than the inner diameter of the first through hole 51E.
- An opening formed in the recess side surface 52A by the second through hole 51G is referred to as an “opening 515”.
- An opening communicating with the bottom surface 51B of the main body through the second through hole 51G is referred to as an “opening 516”.
- the opening 516 is provided at a position shifted outward from the center of the main body bottom surface 51B.
- the second through hole 51G extends in the extending direction from the opening 516 toward the opening 515.
- the annular portion 93 of the indwelling member 9 is inserted through the opening 516 into the second through hole 51G. A portion on the proximal end side of the annular portion 93 protrudes from the opening 515 into the second recess 52.
- the protruding portion 3 ⁇ / b> A of the linear member 3 is inserted into the closed region 93 ⁇ / b> A of the annular portion 93.
- the part of the front end side of the linear member 3 is clamped by the clamping part 51F.
- the annular portion 93 is not detached from the protruding portion 3A. For this reason, the indwelling member 9 is connected to the connecting member 5 in the support state.
- the distal end side portion of the linear member 3 is detached from the clamping portion 51F.
- the annular portion 93 can be detached from the protruding portion 3A. Therefore, the indwelling member 9 can be detached from the connecting member 4 in the detached state.
- a user operates the guide member 2 of the medical device 1B, and sends out sequentially in a catheter (arrow Y21).
- Indwelling member 9 receives a force in the direction toward the distal end side from guiding member 2 (arrow Y22).
- the indwelling member 9 reaches a desired position.
- the user operates the linear member 3 while holding the guide member 2, and applies a force in a direction toward the proximal end side to the linear member 3.
- the end portion on the distal end side of the linear member 3 is detached from the clamping portion 51F.
- the linear member 3 moves to the proximal end side (arrow Y23).
- the protruding portion 3 ⁇ / b> A of the linear member 3 comes off from the closed region 93 ⁇ / b> A of the annular portion 93 of the indwelling member 9.
- the indwelling member 9 becomes detachable from the connecting member 4.
- the user moves the linear member 3 further to the proximal end side (arrow Y24).
- the user applies a force in a direction toward the proximal end side to the guide member 2.
- the guide member 2 and the connecting member 4 move to the proximal end side (arrow Y25).
- the indwelling member 9 is indwelled at a desired position.
- the guide member 2, the linear member 3, and the connecting member 5 are taken out of the catheter.
- the first through holes 51E and the sandwiching portions 51F are arranged in a straight line in the extending direction.
- the protruding portion 3A of the linear member 3 extends in parallel with the extending direction. Therefore, since medical device 1B can control that linear member 3 bends near the 1st opening 511, it can move linear member 3 to the base end side smoothly. Therefore, the user can easily switch from the state in which the end portion on the front end side of the linear member 3 is sandwiched by the sandwiching portion 51F to the state in which the end portion on the front end side of the linear member 3 is detached from the sandwiching portion 51F. Can do.
- the second recess 52 is provided on the main body side surface 51A of the connecting member 5.
- the second recess 52 is recessed in the orthogonal direction.
- the protruding portion 3 ⁇ / b> A of the linear member 3 is inserted into the closed region 93 ⁇ / b> A of the annular portion 93. For this reason, when guiding the indwelling member 9, it is difficult for an external object to come into contact with the protruding portion 3 ⁇ / b> A and the annular portion 93 of the linear member 3 from the front in the traveling direction.
- the medical device 1B can stabilize the state where the annular portion 93 is inserted into the linear member 3, so that the linear member 3 is detached from the annular portion 93 when the indwelling member 9 is guided by the guiding member 2. Can be suppressed.
- the sandwiching portion 51F and the second through hole 51G extend between the tip side portion of the recess side surface 52A of the second recess 52 and the main body bottom surface 51B.
- the annular portion 93 of the indwelling member 9 is inserted through the second through hole 51G.
- the medical device 1B can stabilize the state where the annular portion 93 is inserted into the linear member 3, so that the linear member 3 is detached from the annular portion 93 when the indwelling member 9 is guided by the guiding member 2. Can be suppressed. Further, the guide of the indwelling member 9 by the guide member 2 can be executed smoothly.
- the first opening 511 of the first through hole 51E and the opening 513 of the holding part 51F may be arranged at positions shifted in the radial direction.
- the extending direction of the first through hole 51E may be inclined with respect to the extending direction.
- the clamping part 51F may be arranged along an imaginary straight line extending to the tip side along the first through hole 51E.
- the protruding portion 3A may extend in a direction inclined with respect to the extending direction.
- the clamping part 51F may be provided on the recess bottom surface 52B.
- a portion of the main body 51 of the connecting member 5 that is on the tip side of the second recess 52 that is, a portion of the main body 51 that is provided with the second through hole 51 ⁇ / b> G in FIG. 3.
- the peripheral part of may be cut out.
- a gap is formed between the inner surface 21 of the guiding member 2 and the portion of the main body 51 on the tip side of the second recess 52.
- the annular portion 93 of the indwelling member 9 may extend to the inside of the second recess 52 through this gap.
- a medical device 1C according to the third embodiment will be described with reference to FIGS.
- a connecting member 6 is used instead of the connecting member 4 in the first embodiment. Since the guide member 2, the linear member 3, and the indwelling member 9 are the same as those in the first embodiment, description thereof is omitted.
- the connecting member 6 includes a first connecting member 6A and a second connecting member 6B.
- the shape of the first connecting member 6A is a columnar shape.
- the center of the first connecting member 6A extends along the extending direction.
- the outer diameter of the first connecting member 6A is the outer diameter of the main body 41 (see FIG. 1) of the connecting member 4 in the first embodiment and the main body 51 (see FIG. 3) of the connecting member 5 in the second embodiment. Is equal to L13 and is substantially the same as the inner diameter L11 of the guide member 2.
- the first connecting member 6A has a connecting side surface 60A and connecting bottom surfaces 60B and 60C.
- the connection side surface 60A corresponds to the side surface of the first connection member 6A.
- connection bottom surface 60B corresponds to the bottom surface on the tip side of the first connection member 6A.
- connection bottom surface 60C corresponds to the bottom surface on the base end side of the first connection member 6A.
- the first connecting member 6A has a through hole 60E.
- the through hole 60E passes through the center of the first connecting member 6A and extends in the extending direction between the connecting bottom surfaces 60B and 60C.
- the opening formed in the connection bottom surface 60B by the through hole 60E is referred to as “opening 601”, and the opening formed in the connection bottom surface 60C is referred to as “second opening 602”.
- the second connecting member 6 ⁇ / b> B has a main body 61 and a protrusion 63.
- the main body 61 and the protrusion 63 correspond to the main body 41 and the protrusion 43 in the connecting member 4 (see FIG. 1) of the first embodiment, respectively.
- the main body side surface 61A and the main body bottom surfaces 61B and 61C of the main body portion 61 correspond to the main body side surface 41A and the main body bottom surfaces 41B and 41C of the main body portion 41 of the connecting member 4 in the first embodiment, respectively.
- a third recess 62 that is recessed toward the base end side is formed on the main body bottom surface 61B.
- the third recess 62 has a recess side surface 62A and a recess bottom surface 62B.
- the concave side surface 62A and the concave bottom surface 62B respectively correspond to the concave side surface 42A and the concave bottom surface 42B of the first concave portion 42 in the first embodiment.
- the second connecting member 6B is disposed on the distal end side of the first connecting member 6A.
- the main body bottom surface 61C of the second connecting member 6B and the connecting bottom surface 60B of the first connecting member 6A can be separated from each other.
- the main body 61 has a first through hole 61E and a through hole 61G.
- the first through hole 61E extends in the orthogonal direction between the concave side surface 62A and the main body side surface 61A.
- the opening formed in the recess side surface 62A by the first through hole 61E is referred to as a “first opening 611”.
- An opening formed in the main body side surface 61A by the first through hole 61E is referred to as an “opening 612”.
- the through hole 61G extends in the orthogonal direction across the portion of the recess side surface 62A that faces the first opening 611 and the main body side surface 61A.
- An opening formed in the recess side surface 62A by the through hole 60E is referred to as an “opening 613”.
- An opening formed in the main body side surface 61A by the through hole 60E is referred to as an “opening 614”.
- the first through hole 61E and the through hole 60E are arranged in a straight line in the orthogonal direction.
- Grooves 66 and 67 are formed in the main body side surface 61A.
- the groove 66 extends in the extending direction from the opening 612 toward the base end side.
- the groove 67 extends in the extending direction from the opening 614 toward the base end side.
- the depths of the grooves 66 and 67 are slightly larger than the diameter of the first portion 31 of the linear member 3.
- the first portion 31 of the linear member 3 includes a through hole 60E of the first connecting member 6A, a connecting bottom surface 60B of the first connecting member 6A, and a main body bottom surface 61C of the second connecting member 6B, a groove 66, and a first through hole. It passes through the hole 61E, the third recess 62, the through hole 61G, and the groove 67 in order.
- the front end portion of the first portion 31 is disposed between the connection bottom surface 60B of the first connection member 6A and the main body bottom surface 61C of the second connection member 6B.
- the tip side portion of the first portion 31 is sandwiched between the connecting bottom surface 60B and the main body bottom surface 61C.
- a portion of each of the connection bottom surface 60B and the main body bottom surface 61C that sandwich the portion on the distal end side of the first portion 31 is referred to as a “nip portion 61F”.
- the state of the medical device 1C when the distal end portion of the first portion 31 of the linear member 3 is sandwiched by the sandwiching portion 61F corresponds to the “supported state”.
- a part of the linear member 3 that protrudes from the first opening 611 and is disposed in the third recess 62 corresponds to the “protrusion 3 ⁇ / b> A”.
- the protrusion 3A extends in the orthogonal direction.
- the holding portion 37 is a boundary portion between the first portion 31 and the second portion 32 of the linear member 3, that is, a portion of the linear member 3 on the base end side with respect to the protruding portion 3 ⁇ / b> A of the first connecting member 6 ⁇ / b> A.
- the second opening 602 formed in the connection bottom surface 60C is held immovably.
- the holding part 37 moves the first connecting member 6 ⁇ / b> A to the proximal end side according to the movement of the linear member 3. In this case, a gap is generated between the connection bottom surface 60B and the main body bottom surface 61C. A portion on the distal end side of the first portion 31 of the linear member 3 is detached from the clamping portion 61F.
- the state of the medical device 1 ⁇ / b> C when the distal portion of the first portion 31 is detached from the clamping unit 61 ⁇ / b> F corresponds to the “detached state”.
- the protruding portion 3A of the linear member 3 is inserted into the closed region 93A of the annular portion 93.
- the part of the front end side of the linear member 3 is clamped by the clamping part 61F.
- the annular portion 93 is not detached from the protruding portion 3A.
- the indwelling member 9 is connected to the connecting member 6 in the support state.
- the medical device 1C is changed from the support state to the detached state
- the distal end portion of the linear member 3 is detached from the clamping portion 61F.
- the annular portion 93 can be detached from the protruding portion 3A.
- the indwelling member 9 can be detached from the connecting member 6 in the detached state.
- the usage method of the medical device 1C is the same as the usage method of the medical device 1A.
- a brief description will be given below.
- the user operates the guide member 2 of the medical device 1C to sequentially send it out into the catheter (arrow Y31).
- Indwelling member 9 receives a force in the direction toward the distal end side from guiding member 2 (arrow Y32).
- FIG. 7B the indwelling member 9 reaches a desired position.
- the user operates the linear member 3 while holding the guide member 2, and applies a force in a direction toward the proximal end side to the linear member 3.
- the first connecting member 6A of the connecting member 6 moves to the proximal end side.
- a gap is generated between the first connecting member 6A and the second connecting member 6B.
- the part of the front end side of the linear member 3 detach
- the linear member 3 and the first connecting member 6A move to the proximal end side (arrow Y33).
- the protruding portion 3 ⁇ / b> A of the linear member 3 comes off from the closed region 93 ⁇ / b> A of the annular portion 93 of the indwelling member 9.
- the indwelling member 9 becomes detachable from the connecting member 6.
- the user moves the linear member 3 further to the proximal end side (arrow Y34).
- the user applies a force in a direction toward the proximal end side to the guide member 2.
- the guide member 2 and the connecting member 6 move to the proximal end side. (Arrow Y35).
- the indwelling member 9 is indwelled at a desired position.
- the guide member 2, the linear member 3, and the connecting member 6 are taken out of the catheter.
- the connecting member 6 includes a first connecting member 6A and a second connecting member 6B.
- the tip side portion of the linear member 3 is clamped by a clamping portion 61F formed at the contact portion of the first connecting member 6A and the second connecting member 6B.
- the medical device 1C can strongly hold the linear member 3 by the holding portion 61F by increasing the force with which the first connecting member 6A and the second connecting member 6B are pressed against each other.
- the medical device 1 ⁇ / b> C can appropriately suppress the linear member 3 from being detached from the holding portion 61 ⁇ / b> F when the indwelling member 9 is guided by the guide member 2.
- the medical device 1C can easily weaken the force with which the first connecting member 6A and the second connecting member 6B are pressed against each other. Therefore, the medical device 1 ⁇ / b> C can be easily switched from the support state to the detached state by the movement of the linear member 3.
- the main body 61 of the second connecting member 6B has a third recess 62.
- the first opening 611 of the first through hole 61E and the opening 613 of the through hole 61G face each other in the orthogonal direction.
- the protruding portion 3A of the linear member 3 is orthogonal to the extending direction.
- the component in the extending direction of the force acting on the indwelling member 9 in accordance with the movement of the linear member 3 toward the proximal end as the angle when the protruding portion 3A intersects the extending direction approaches a right angle. Becomes smaller.
- the medical device 1 ⁇ / b> C can further effectively suppress the indwelling member 9 from moving from the desired position due to the reaction of the force according to the movement of the linear member 3.
- the holding part 37 holds the first connecting member 6 ⁇ / b> A so as not to move with respect to the linear member 3.
- the medical device 1 ⁇ / b> C can maintain the state where the first connecting member 6 ⁇ / b> A and the second connecting member 6 ⁇ / b> B are strongly pressed against each other by the holding unit 37.
- the first connecting member 6A held by the linear member 3 can be moved in accordance with the movement of the linear member 3 toward the proximal end side, the first connecting member 6A and the second connecting member are pressed against each other. Can easily weaken the force. Therefore, the medical device 1C can be easily switched from the support state to the detached state in accordance with the movement of the linear member 3 to the proximal end side.
- the first through hole 61E may extend in the extending direction from the center of the main body bottom surface 61C toward the recess bottom surface 62B of the third recess 62.
- the first opening 611 may be provided at the center of the recess bottom surface 62B.
- the first portion 31 of the linear member 3 may extend in the extending direction through the first through hole 61E.
- the protruding portion 3A of the linear member 3 may extend from the first opening 611 toward the opening 613 provided on the recess side surface 62A in a direction inclined with respect to the extending direction.
- the first through hole 61 ⁇ / b> E may be formed inside the main body 61.
- the first through hole 61E may extend inside the main body 61 from the center of the main body bottom surface 61C to the first opening 611 of the concave side surface 62A.
- a medical device 1D according to the fourth embodiment will be described with reference to FIGS.
- a connecting member 7 is used instead of the connecting member 4 in the first embodiment. Since the guide member 2, the linear member 3, and the indwelling member 9 are the same as those in the first embodiment, description thereof is omitted.
- the connecting member 7 includes a first connecting member 7A and a second connecting member 7B.
- the shape of the second connecting member 7B is substantially the same as the second connecting member 6B (see FIG. 6) in the third embodiment.
- the main body 71 and the protrusion 73 of the second connecting member 7B correspond to the main body 61 and the protrusion 63 (see FIG. 6), respectively.
- the main body side surface 71A and the main body bottom surfaces 71B and 71C of the main body portion 71 correspond to the main body side surface 61A and the main body bottom surfaces 61B and 61C (see FIG. 6), respectively.
- the third recess 72 corresponds to the third recess 62 (see FIG. 6).
- the concave side surface 72A and the concave bottom surface 72B of the third concave portion 72 correspond to the concave side surface 62A and the concave bottom surface 62B (see FIG. 6) of the third concave portion 62, respectively.
- the first through hole 71E and the through hole 71G of the main body 71 correspond to the first through hole 61E and the through hole 61G (see FIG. 6), respectively.
- the first opening 711 and the opening 712 of the first through hole 71E and the openings 713 and 714 of the through hole 71G correspond to the first opening 611, the openings 612, 613, and 614 (see FIG. 6), respectively.
- the grooves 76 and 77 of the main body 71 correspond to the grooves 66 and 67 (see FIG. 6) of the main body 61, respectively.
- the second connecting member 7B is different from the second connecting member 6B in that a fitting portion 75 that is recessed toward the distal end side is provided at the center of the main body bottom surface 71C.
- the fitting part 75 has a fitting side surface 75A and a fitting bottom surface 75B.
- the fitting side surface 75 ⁇ / b> A corresponds to the side surface of the fitting portion 75
- the fitting bottom surface 75 ⁇ / b> B corresponds to the bottom surface of the fitting portion 75.
- the inner diameter of the fitting portion 75 becomes smaller toward the fitting bottom surface 75B.
- the inner diameter of the fitting portion 75 is smaller than the inner diameter of the third recess 72.
- the shape of the first connecting member 7A is a truncated cone.
- the center of the first connecting member 7A extends along the extending direction.
- the first connecting member 7A has a connecting side surface 70A and connecting bottom surfaces 70B and 70C.
- the connecting side surface 70A corresponds to the side surface of the first connecting member 7A.
- the connection bottom surface 70B corresponds to the bottom surface on the distal end side of the first connection member 7A.
- the connection bottom surface 70C corresponds to the bottom surface on the base end side of the first connection member 7A.
- the diameter of the connecting bottom surface 70B is smaller than the diameter of the connecting bottom surface 70C.
- the first connecting member 7A can be fitted to the fitting portion 75 of the second connecting member 7B.
- the first connecting member 7A has a through hole 70E.
- the through hole 70E extends in the extending direction from the center of the connection bottom surface 70C toward the distal end, bends outward inside the first connection member 7A, and extends in the orthogonal direction to the connection side surface 70A.
- the opening formed in the connection side surface 70A by the through hole 70E is referred to as “opening 701”, and the opening formed in the connection bottom surface 70C is referred to as “second opening 702”.
- the holding portion 37 holds the boundary portion between the first portion 31 and the second portion 32 of the linear member 3 in the second opening 702 formed on the connection bottom surface 70C of the first connection member 7A so as not to move.
- the first portion 31 of the linear member 3 includes a through hole 70E of the first connecting member 7A, a base end side of the bottom surface 71C of the main body of the second connecting member 7B, a groove 76, a first through hole 71E, the third recess 72,
- the through hole 71G, the groove 77, and the base end side of the main body bottom surface 71C of the second connecting member 7B pass in order.
- the front end portion of the first portion 31 is disposed between the connecting side surface 70A of the first connecting member 7A and the fitting side surface 75A of the second connecting member 7B.
- the tip side portion of the first portion 31 is sandwiched between the connecting side surface 70A and the fitting side surface 75A.
- the portion of the connecting side surface 70A and the fitting side surface 75A that sandwiches the tip side portion of the first portion 31 is referred to as a “nip portion 71F”.
- the state of the medical device 1D when the end portion on the distal end side of the first portion 31 is sandwiched by the sandwiching portion 71F corresponds to the “supported state”.
- a part of the linear member 3 that protrudes from the first opening 711 and is disposed in the third recess 72 corresponds to the “projecting part 3A”.
- the protrusion 3A extends in the orthogonal direction.
- the holding part 37 moves the first connecting member 7 ⁇ / b> A to the proximal end side according to the movement of the linear member 3.
- a gap is generated between the connecting side surface 70A and the fitting side surface 75A.
- a portion on the tip end side of the first portion 31 of the linear member 3 is detached from the clamping portion 71F.
- the state of the medical device 1D when the end portion on the distal end side of the first portion 31 is detached from the sandwiching portion 71F corresponds to the “detached state”.
- the protruding portion 3A of the linear member 3 is inserted into the closed region 93A of the annular portion 93.
- the part of the front end side of the linear member 3 is clamped by the clamping part 71F.
- the annular portion 93 is not detached from the protruding portion 3A.
- the indwelling member 9 is connected to the connecting member 7 in the support state.
- the medical device 1D is changed from the support state to the detached state
- the portion on the distal end side of the protruding portion 3A is detached from the sandwiching portion 71F.
- the annular portion 93 can be detached from the protruding portion 3A.
- the indwelling member 9 can be detached from the connecting member 7 in the detached state.
- the usage method of the medical device 1D is the same as the usage method of the medical device 1C.
- a brief description will be given below.
- the user sequentially sends out the proximal end side of the guide member 2 of the medical device 1D into the catheter (arrows Y41 and Y42).
- the indwelling member 9 reaches a desired position.
- the user applies a force in a direction toward the proximal end side to the linear member 3.
- a gap is generated between the first connecting member 7A and the second connecting member 7B.
- a portion on the tip side of the linear member 3 is detached from the sandwiching portion 71F.
- the linear member 3 and the first connecting member 7A move to the proximal end side (arrow Y43).
- the protruding portion 3 ⁇ / b> A of the linear member 3 comes off from the closed region 93 ⁇ / b> A of the annular portion 93 of the indwelling member 9.
- the user further moves the linear member 3 to the proximal end side (arrow Y44).
- the user applies a force in a direction toward the proximal end side to the guide member 2.
- the guide member 2 and the connecting member 7 move to the proximal end side (arrow Y45).
- the indwelling member 9 is indwelled at a desired position.
- the medical device 1D includes a first connecting member 7A and a second connecting member 7B.
- the first connecting member 7A is fitted into the fitting portion 75 of the second connecting member 7B.
- the tip-side portion of the linear member 3 is sandwiched by a sandwiching portion 71F formed by the first connecting member 7A and the fitting portion 75.
- the medical device 1D can maintain the state where the first connecting member 7A and the second connecting member 7B are strongly pressed to each other by the fitting portion 75. Therefore, the medical device 1D can appropriately sandwich the distal end portion of the first portion 31 of the linear member 3 by the sandwiching portion 71F.
- the first through hole 71E may extend in the extending direction from the center of the fitting bottom surface 75B of the fitting portion 75 toward the recess bottom surface 72B of the third recess 72.
- the first opening 711 may be provided at the center of the recess bottom surface 72B.
- the first portion 31 of the linear member 3 may extend in the extending direction through the first through hole 71E.
- the protrusion 3A of the linear member 3 may extend from the first opening 711 toward the opening 713 provided on the recess side surface 72A in a direction inclined with respect to the extending direction. For example, as shown in FIG.
- the first through hole 71E may be formed inside the main body 71 from the center of the fitting bottom surface 75B to the first opening 711 of the concave side surface 72A.
- the first through hole 71E may extend inside the main body 71 from the center of the fitting bottom surface 75B to the first opening 711 of the concave side surface 72A.
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Abstract
Description
本発明は、動脈瘤の発生部位等にコイル等の留置部材を留置させるための医療装置に関する。 The present invention relates to a medical device for indwelling an indwelling member such as a coil at an aneurysm occurrence site or the like.
動脈瘤等の治療法として、動脈瘤の発生部位にコイル等の留置部材を留置する血管塞栓術が知られている。この方法では、チューブ等の誘導部材の先端部に、連結部材を介して留置部材が連結される。誘導部材は、生体内に配置されたカテーテルに通される。誘導部材がX線透視下で操作されることによって、留置部材が生体内の所望位置に誘導される。留置部材が所望位置に到達した場合、連結部材は、誘導部材から留置部材を離脱させる。これによって、生体内の所望位置に留置部材が留置される。 As a method for treating an aneurysm or the like, a vascular embolization method in which an indwelling member such as a coil is placed at a site where the aneurysm occurs is known. In this method, the indwelling member is connected to the distal end portion of a guide member such as a tube via a connecting member. The guide member is passed through a catheter disposed in the living body. By operating the guide member under fluoroscopy, the indwelling member is guided to a desired position in the living body. When the indwelling member reaches the desired position, the connecting member disengages the indwelling member from the guide member. Thus, the indwelling member is placed at a desired position in the living body.
特許文献1は、マイクロコイル部、コイルプッシャー部、縫合糸、及び、引張ワイヤを有するマイクロコイルアセンブリーを開示する。引張ワイヤは、コイルプッシャー部の貫通孔に挿通される。引張ワイヤの先端部のループに、マイクロコイル部が縫合糸によって結ばれる。マイクロコイルアセンブリーでは、コイルプッシャー部が操作されることによって、患者の脳動脈瘤発生部位にマイクロコイル部が挿入される。その後、引張ワイヤが基端側に引っ張られる。引張ワイヤは、先端部のループに結ばれた縫合糸を、コイルプッシャー部の先端部に設けられたエッジ部に接触させる。これによって縫合糸は切断され、脳動脈瘤発生部位にマイクロコイル部が留置される。
上記の装置では、引張ワイヤが基端側に引っ張られることによって縫合糸が切断される。このため、縫合糸が切断されたときの反動で、コイルプッシャー部の先端部に力が加わる場合がある。この力により、コイルプッシャー部の先端部からマイクロコイル部に対して先端側に向かう力が作用する可能性がある。この場合、脳動脈瘤の発生部位にも力が加わり得る。又、留置されたマイクロコイル部に力が作用して移動する可能性がある。 In the above device, the suture is cut by pulling the pull wire toward the proximal end. For this reason, force may be applied to the distal end portion of the coil pusher portion by reaction when the suture is cut. Due to this force, there is a possibility that a force directed from the distal end portion of the coil pusher portion toward the distal end side acts on the microcoil portion. In this case, force may be applied to the site where the cerebral aneurysm is generated. Further, there is a possibility that a force acts on the placed microcoil portion and moves.
本発明の目的は、生体内の所望位置に誘導部材によって留置部材が誘導された後、誘導部材から留置部材を適切に脱離させることが可能な医療装置を提供することである。 An object of the present invention is to provide a medical device capable of appropriately removing an indwelling member from a guiding member after the indwelling member is guided to a desired position in a living body by the guiding member.
本発明の医療装置は、基端と先端との間に亘って延伸方向に延びる筒状の誘導部材と、前記誘導部材の内部に、前記延伸方向に沿って移動可能に挿通される線状部材と、前記誘導部材の前記先端側に設けられた連結部材であって、前記線状部材の一部が挿通する貫通孔であって、前記線状部材の前記先端側が突出する第1開口を有する第1貫通孔、及び、前記線状部材の前記先端側の端部を脱離可能に支持する支持部であって、前記線状部材が前記基端側に移動することに応じ、前記線状部材の前記先端側の端部を支持した支持状態から、前記線状部材の前記先端側の端部が脱離した脱離状態に切り換え可能な支持部を有する連結部材と、前記線状部材のうち前記第1開口から突出する突出部が挿通される環状部を有する留置部材とを備え、前記留置部材は、前記支持状態で前記連結部材に連結し、前記脱離状態で前記連結部材から脱離することを特徴とする。 The medical device according to the present invention includes a cylindrical guide member extending in the extending direction between the proximal end and the distal end, and a linear member inserted into the guide member so as to be movable along the extending direction. And a connecting member provided on the distal end side of the guide member, the through hole through which a part of the linear member is inserted, and a first opening from which the distal end side of the linear member protrudes. A support part that removably supports the first through hole and the end part on the distal end side of the linear member, wherein the linear member moves in accordance with the movement of the linear member to the proximal end side. A connecting member having a support portion that can be switched from a support state in which the end portion on the tip side of the member is supported to a detached state in which the end portion on the tip side of the linear member is detached; and An indwelling member having an annular portion through which the protruding portion protruding from the first opening is inserted. The indwelling member, wherein connected to the coupling member in a supported state, characterized in that desorbed from the connecting member in the desorption state.
医療装置において、留置部材は、誘導部材の先端側の端部に設けられた連結部材に連結された状態で、誘導部材によって生体内の所望位置(例えば、動脈瘤の発生部位)まで誘導される。所望位置に留置部材が配置された後、線状部材が基端側に移動した場合、線状部材の先端側の端部は支持部から脱離する。これによって、留置部材は連結部材から脱離し、生体内の所望位置に留置される。留置部材は、環状部に線状部材が挿通されることによって連結部材に連結されている。従って、線状部材が基端側に移動しても、線状部材から留置部材に対して力が作用し難い。このため、連結部材から留置部材が脱離される場合において、脳動脈瘤の発生部位に力が作用する可能性が軽減され、且つ、線状部材の移動に応じた留置部材の移動は抑制される。従って、医療装置は、生体内の所望位置に留置部材が誘導された後、連結部材から留置部材を適切に脱離させることができる。 In a medical device, an indwelling member is guided to a desired position (for example, an aneurysm generation site) in a living body by a guiding member in a state where the indwelling member is coupled to a coupling member provided at an end portion on the distal end side of the guiding member. . After the indwelling member is disposed at a desired position, when the linear member moves to the proximal end side, the end portion on the distal end side of the linear member is detached from the support portion. As a result, the indwelling member is detached from the connecting member and placed in a desired position in the living body. The indwelling member is connected to the connecting member by inserting a linear member through the annular portion. Therefore, even if the linear member moves to the proximal end side, it is difficult for force to act on the indwelling member from the linear member. For this reason, when the indwelling member is detached from the connecting member, the possibility that a force acts on the site where the cerebral aneurysm is generated is reduced, and the movement of the indwelling member according to the movement of the linear member is suppressed. . Therefore, the medical device can appropriately remove the indwelling member from the connecting member after the indwelling member is guided to a desired position in the living body.
本発明において、前記支持部は、前記線状部材の前記先端側の端部を挟持する挟持部を有してもよい。この場合、医療装置は、線状部材の基端側への移動に応じて支持状態から脱離状態に切り換え可能な支持部を、連結部材に容易に形成できる。 In the present invention, the support portion may include a clamping portion that clamps the end portion on the distal end side of the linear member. In this case, the medical device can easily form a support portion on the connecting member that can be switched from the support state to the detachment state in accordance with the movement of the linear member toward the proximal end.
本発明において、前記連結部材は、前記先端側の端部に、前記基端側に向けて凹んだ第1凹部を有し、前記第1凹部は、前記延伸方向と交差する面である底面と、前記延伸方向と平行な面である側面とを有し、前記第1開口は、前記第1凹部の前記底面に設けられ、前記支持部は、前記第1凹部の前記側面に設けられてもよい。この場合、線状部材の突出部を延伸方向に対して傾斜させることが容易に可能となる。なお、突出部が延伸方向に対して傾斜する場合、線状部材を基端側に移動させたことに応じて留置部材に作用する力の延伸方向の成分は小さくなる。従って、医療装置は、線状部材の移動に応じた留置部材の移動を更に抑制できる。 In the present invention, the connecting member has a first concave portion that is recessed toward the base end side at an end portion on the distal end side, and the first concave portion is a bottom surface that is a surface intersecting the extending direction; The first opening is provided on the bottom surface of the first recess, and the support portion is provided on the side surface of the first recess. Good. In this case, the protruding portion of the linear member can be easily inclined with respect to the extending direction. In addition, when a protrusion part inclines with respect to an extending | stretching direction, the component of the extending | stretching direction of the force which acts on an indwelling member becomes small according to having moved the linear member to the base end side. Therefore, the medical device can further suppress the movement of the indwelling member according to the movement of the linear member.
本発明において、前記第1開口と前記支持部とは、前記延伸方向に並んで配置されてもよい。この場合、医療装置は、線状部材が第1開口近傍で屈曲することを抑制できる。従って、医療装置は、線状部材を基端側にスムーズに移動させ、支持状態から脱離状態に切り換えることができる。 In the present invention, the first opening and the support portion may be arranged side by side in the extending direction. In this case, the medical device can suppress the linear member from being bent in the vicinity of the first opening. Therefore, the medical device can smoothly move the linear member to the proximal end side and switch from the support state to the detached state.
本発明において、前記連結部材は、前記延伸方向に沿って延びる面に、前記延伸方向と交差する方向に凹んだ第2凹部を有し、前記第2凹部は、前記延伸方向と交差する面である側面を有し、前記第1開口、及び、前記支持部は、前記第2凹部の前記側面に設けられてもよい。この場合、線状部材のうち留置部材の環状部が挿通される部分を、第2凹部内に配置させることができる。従って医療装置は、環状部に線状部材が挿通された状態を安定化できるので、誘導部材による留置部材の誘導時に線状部材が環状部から脱離することを抑制できる。 In this invention, the said connection member has the 2nd recessed part dented in the direction which cross | intersects the said extending direction in the surface extended along the said extending | stretching direction, and the said 2nd recessed part is a surface which cross | intersects the said extending direction. It has a certain side, The 1st opening and the support part may be provided in the side of the 2nd crevice. In this case, a portion of the linear member through which the annular portion of the indwelling member is inserted can be disposed in the second recess. Therefore, the medical device can stabilize the state in which the linear member is inserted into the annular portion, and thus the linear member can be prevented from being detached from the annular portion when the indwelling member is guided by the guiding member.
本発明において、前記連結部材は、前記先端側の端部と前記第2凹部の前記側面との間に亘って貫通し、前記留置部材の前記環状部が挿通する第2貫通孔を更に有してもよい。この場合、医療装置は、連結部材の外周面よりも外側に留置部材の環状部が配置されることを抑制できる。従って、医療装置は、誘導部材による留置部材の誘導が、環状部によって妨げられることを防止できる。又、医療装置は、誘導部材による留置部材の誘導時に線状部材が環状部から脱離することを更に効果的に抑制できる。 In the present invention, the connecting member further has a second through-hole penetrating between the end portion on the distal end side and the side surface of the second recess, and through which the annular portion of the indwelling member is inserted. May be. In this case, the medical device can suppress the annular portion of the indwelling member from being disposed outside the outer peripheral surface of the connecting member. Therefore, the medical device can prevent the guide of the indwelling member by the guide member from being hindered by the annular portion. Further, the medical device can more effectively suppress the linear member from being detached from the annular portion when the indwelling member is guided by the guiding member.
本発明において、前記線状部材は、前記第1貫通孔のうち前記第1開口と反対側の第2開口を閉塞する閉塞部材を備え、前記閉塞部材は、前記第2開口に前記線状部材が保持された状態と、前記第2開口に前記線状部材が保持されない状態とに切り換え可能であってもよい。閉塞部材は、線状部材を第2開口に保持した状態で、誘導部材による留置部材の誘導時に線状部材が基端側に移動することを抑制できる。又、閉塞部材は、医療装置を支持状態から脱離状態に切り換えるために線状部材が基端側に移動した場合、線状部材が第2開口に保持されない状態とすることによって、連結部材から留置部材を脱離させることができる。 In this invention, the said linear member is provided with the obstruction | occlusion member which obstruct | occludes the 2nd opening on the opposite side to the said 1st opening among the said 1st through-holes, The said obstruction | occlusion member is the said linear member in the said 2nd opening. May be switched between a state in which the linear member is held and a state in which the linear member is not held in the second opening. The blocking member can suppress the linear member from moving to the proximal end side when the indwelling member is guided by the guiding member while the linear member is held in the second opening. In addition, when the linear member moves to the proximal end side in order to switch the medical device from the support state to the detachment state, the blocking member is separated from the connecting member by keeping the linear member from being held in the second opening. The indwelling member can be detached.
本発明において、前記線状部材の少なくとも前記支持部によって支持される第1部分の硬さが、前記第1部分を除く第2部分の硬さよりも硬くてもよい。この場合、医療装置は、線状部材を支持部によって脱離可能に支持することが容易に可能となる。 In the present invention, the hardness of the first portion supported by at least the support portion of the linear member may be harder than the hardness of the second portion excluding the first portion. In this case, the medical device can easily support the linear member in a detachable manner by the support portion.
本発明において、前記線状部材の前記突出部は、前記延伸方向に沿って延びてもよい。この場合、医療装置は、線状部材が屈曲することを抑制できる。従って、医療装置は、線状部材を基端側にスムーズに移動させ、支持状態から脱離状態に切り換えることができる。 In the present invention, the protruding portion of the linear member may extend along the extending direction. In this case, the medical device can suppress bending of the linear member. Therefore, the medical device can smoothly move the linear member to the proximal end side and switch from the support state to the detached state.
本発明において、前記連結部材は、互いに接離可能な第1連結部材及び第2連結部材を備え、前記支持部は、前記第1連結部材及び前記第2連結部材が接触する部分で前記線状部材の前記先端側の端部を挟持してもよい。この場合、医療装置は、第1連結部材及び第2連結部材が互いに押し付けられる力を強めることによって、支持部によって線状部材を強く支持できる。従って、医療装置は、誘導部材による留置部材の誘導時に線状部材が支持部から外れることを抑制できる。一方、医療装置は、第1連結部材及び第2連結部材が互いに押し付けられる力を弱めることによって、線状部材の移動に応じて支持状態から脱離状態に容易に切り換えることができる。 In the present invention, the connecting member includes a first connecting member and a second connecting member that can be brought into contact with and separated from each other, and the support portion is the linear shape at a portion where the first connecting member and the second connecting member are in contact with each other. You may clamp the edge part of the said front end side of a member. In this case, the medical device can strongly support the linear member by the support portion by increasing the force with which the first connecting member and the second connecting member are pressed against each other. Therefore, the medical device can suppress the linear member from being detached from the support portion when the indwelling member is guided by the guiding member. On the other hand, the medical device can easily switch from the support state to the detached state according to the movement of the linear member by weakening the force with which the first connection member and the second connection member are pressed against each other.
本発明において、前記第2連結部材は、前記先端側の端部に、前記基端側に向けて凹んだ第3凹部を有し、前記第3凹部は、前記延伸方向と交差する面である底面と、前記延伸方向と平行な面である側面とを有し、前記第1開口は、前記第3凹部の前記底面又は前記側面に設けられてもよい。この場合、線状部材の突出部を延伸方向に対して交差させることが容易に可能となる。なお、突出部が延伸方向に対して交差する場合の角度が直角に近づく程、線状部材を基端側に移動させたことに応じて留置部材に作用する力の延伸方向の成分は小さくなる。従って、医療装置は、線状部材の移動に応じた留置部材の移動を更に抑制できる。 In the present invention, the second connecting member has a third recessed portion that is recessed toward the proximal end at an end portion on the distal end side, and the third recessed portion is a surface that intersects the extending direction. The first opening may be provided on the bottom surface or the side surface of the third recess. The bottom surface may be a surface parallel to the extending direction. In this case, the protruding portion of the linear member can be easily crossed with respect to the extending direction. In addition, the component in the extending | stretching direction of the force which acts on an indwelling member becomes small, so that the angle in case a protrusion part cross | intersects with an extending | stretching direction approaches a right angle, according to having moved the linear member to the base end side. . Therefore, the medical device can further suppress the movement of the indwelling member according to the movement of the linear member.
本発明において、前記線状部材のうち前記突出部よりも基端側の部分を前記第1連結部材に移動不能に保持する保持部を備えてもよい。この場合、医療装置は、第1連結部材及び第2連結部材が互いに強く押し付けられた状態を、保持部によって維持できる。又、医療装置は、線状部材が基端側に移動した場合に、第1連結部材及び第2連結部材の互いに押し付けられる力を容易に弱めることができる。従って、医療装置は、線状部材が基端側に移動したことに応じて支持状態から脱離状態に容易に切り換えることができる。 In this invention, you may provide the holding | maintenance part which hold | maintains the part of a base end side rather than the said protrusion part to the said 1st connection member among the said linear members so that a movement is impossible. In this case, the medical device can maintain the state where the first connecting member and the second connecting member are strongly pressed against each other by the holding unit. Further, the medical device can easily weaken the force of the first connecting member and the second connecting member pressed against each other when the linear member moves to the proximal end side. Therefore, the medical device can be easily switched from the support state to the detached state according to the movement of the linear member to the proximal end side.
本発明において、前記第1連結部材及び前記第2連結部材の一方は、前記第1連結部材及び前記第2連結部材の他方が嵌る嵌合部を有してもよい。この場合、医療装置は、第1連結部材及び第2連結部材が互いに強く押し付けられた状態を、嵌合部によって維持できる。 In the present invention, one of the first connecting member and the second connecting member may have a fitting portion into which the other of the first connecting member and the second connecting member fits. In this case, the medical device can maintain the state where the first connecting member and the second connecting member are strongly pressed against each other by the fitting portion.
本発明において、前記線状部材の前記突出部は、前記延伸方向と直交する方向に沿って延びてもよい。この場合、延伸方向に対して直交する方向に沿って線状部材の突出部を配置させることが可能となる。なお、突出部が延伸方向に対して直交する方向に延びる場合、線状部材を基端側に移動させた場合に環状部を介して留置部材に作用する力の延伸方向の成分は最も小さくなる。従って、医療装置は、線状部材の移動に応じた留置部材の移動を更に抑制できる。 In the present invention, the protruding portion of the linear member may extend along a direction orthogonal to the extending direction. In this case, the protruding portion of the linear member can be disposed along the direction orthogonal to the extending direction. In addition, when a protrusion part is extended in the direction orthogonal to an extending | stretching direction, when a linear member is moved to a base end side, the component of the extending | stretching direction of the force which acts on an indwelling member via an annular part becomes the smallest . Therefore, the medical device can further suppress the movement of the indwelling member according to the movement of the linear member.
本発明において、前記連結部材の最大外径は、前記誘導部材の内径よりも大きくてもよい。この場合、線状部材の基端側への移動に応じて連結部材が移動することを抑制できるので、医療装置を支持状態から脱離状態に適切に切り換えることができる。 In the present invention, the maximum outer diameter of the connecting member may be larger than the inner diameter of the guiding member. In this case, since it can suppress that a connection member moves according to the movement to the base end side of a linear member, a medical device can be appropriately switched from a support state to a desorption state.
<第1実施形態>
図1及び図2を参照し、第1実施形態に係る医療装置1Aについて説明する。医療装置1Aは、血管塞栓術に使用される。医療装置1Aは、誘導部材2、線状部材3、連結部材4、及び、留置部材9を備える。
<First Embodiment>
A
<誘導部材2>
血管塞栓術では、医療装置1Aを案内する為のカテーテルが生体内の所定の位置に配置される。図1に示すように、誘導部材2は、生体内に配置されたカテーテル内を移動し、後述する留置部材9を生体内の所望位置に誘導する。誘導部材2は筒状であり、可撓性を有する。誘導部材2は、カテーテルに沿って曲折可能である。誘導部材2の内径は、延伸方向の全域に亘って略同一である。誘導部材2は、周壁の内側の面である内面21で囲まれた空間(以下、「内腔21A」という。)を有する。誘導部材2の内径をL11と表記し、誘導部材2の外径をL12と表記する。
<
In vascular embolization, a catheter for guiding the
以下、図の説明の理解を助けるため、誘導部材2の形状に基づいて医療装置1Aの方向を定義する。誘導部材2の延びる方向を、「延伸方向」といい、延伸方向に対して直交する方向を、「直交方向」という。延伸方向の一方側の端を「先端」といい、他端側の端を「基端」という。誘導部材2は、延伸方向に沿って先端と基端との間に亘って延びる。延伸方向と直交する平面上において、誘導部材2の断面中心を基準とする半径方向のうち、誘導部材2の断面中心に近接する側を「内側」といい、誘導部材2の断面中心から離隔する側を「外側」という。なお、上記の方向の定義は、後述する第2~第4実施形態における医療装置1B、1C、1Dにも適用される。
Hereinafter, the direction of the
誘導部材2の材料は特段限定されず、可撓性を有する種々の材料を用いることが可能である。なお、誘導部材2の先端側の一部分であって後述する連結部材4が内面21に接触する部分は、他部分と異なる材料により形成されてもよい。このとき、誘導部材2の先端側の一部分の硬度を、他部分の硬度よりも大きくしてもよい。
The material of the
<連結部材4>
連結部材4は、誘導部材2の先端部に設けられる。連結部材4は樹脂製であり、誘導部材2の先端部の内腔21Aを閉塞する。連結部材4は、本体部41及び突起部43を有する。
<Connecting
The connecting
本体部41の形状は円柱状である。本体部41の中心は、延伸方向に沿って延びる。本体部41は、誘導部材2の先端部の内腔21Aに嵌る。本体部41の外径をL13と表記する。外径L13は、誘導部材2の内径L11と略同一である。本体部41は、本体側面41A及び本体底面41B、41Cを有する。本体側面41Aは本体部41の側面に対応し、延伸方向と平行に延びる。本体側面41Aは、誘導部材2の先端部の内面21に密着する。本体底面41Bは、本体部41の先端側の端部の底面に対応する。本体底面41Cは、本体部41の基端側の端部の底面に対応する。本体底面41B、41Cは、それぞれ、延伸方向と直交する。
The shape of the
本体底面41Bには、基端側に向けて凹む第1凹部42が形成される。第1凹部42の断面形状は円形である。第1凹部42は、凹部側面42A及び凹部底面42Bを有する。凹部側面42Aは、第1凹部42の側面に対応し、延伸方向と平行に延びる。凹部底面42Bは、第1凹部42の底面に対応し、延伸方向と直交する。
A
本体部41は第1貫通孔41Eを有する。第1貫通孔41Eは、凹部底面42Bと本体底面41Cとの間に亘って、延伸方向に対して傾斜する方向に延びる。第1貫通孔41Eによって凹部底面42Bに形成される開口を、「第1開口411」という。第1開口411は、凹部底面42Bの中心に対して外側にずれた位置に形成される。第1貫通孔41Eによって本体底面41Cに形成される開口を、「第2開口412」という第2開口412は、本体底面41Cの中心に形成される。
The
本体部41は挟持部41Fを有する。挟持部41Fは、第1凹部42の凹部側面42Aに設けられた有底状の孔である。挟持部41Fは、基端側から先端側に向けて外側に傾斜する方向に延びる。挟持部41Fは、第1貫通孔41Eに沿って先端側に延びる仮想直線上に沿って配置される。挟持部41Fの内径は、第1貫通孔41Eの内径よりも小さい。
The
突起部43は、本体部41の本体側面41Aの先端側の端部から、外側に突出する。突起部43の外径を、L14と表記する。外径L14は、誘導部材2の外径L12と略同一であり、誘導部材2の内径L11よりも大きい。突起部43の先端側の端部は、内側から外側に向けて基端側に傾斜する。医療装置1Aの製造過程で誘導部材2の内腔21Aに本体部41が先端側から進入したとき、誘導部材2の先端側の端部に、突起部43の基端側の端部が接触する。これによって、連結部材4は誘導部材2に対して位置決めされる。
The
<線状部材3>
線状部材3は、金属製の細長いワイヤである。線状部材3は、誘導部材2の内腔21Aに挿通される。線状部材3は、延伸方向に沿って延び、且つ、延伸方向に沿って移動可能である。線状部材3は、第1部分31及び第2部分32を有する。線状部材3の基端側の一部分が第2部分32に対応し、他部分が第1部分31に対応する。第1部分31の外径は、連結部材4の第1貫通孔41Eの内径よりも小さく、挟持部41Fの内径と略同一である。第1部分31及び第2部分32は、硬さがそれぞれ相違する。第1部分31の硬さは、第2部分32の硬さよりも硬い。
<
The
線状部材3の第1部分31と第2部分32との境界部分に、閉塞部材36が設けられる。閉塞部材36は円錐台状を有する。線状部材3は、閉塞部材36の中心を貫通する。閉塞部材36のうち第1部分31側の底面の径は、第2部分32側の底面の径よりも小さい。線状部材3は、閉塞部材36のうち第2部分32側の底面にはんだ付けされる。これによって、閉塞部材36は線状部材3に固定される。
A closing
線状部材3の第1部分31は、連結部材4の第1貫通孔41Eに挿通可能である。第1部分31のうち、第1貫通孔41Eに挿通する部分よりも先端側の一部は、第1開口411から突出する。第1部分31の先端側の端部は挟持部41Fに挿通する。なお、第1部分31の外径と挟持部41Fの内径は略同一である。このため、第1部分31の先端側の端部は、挟持部41Fの内壁によって挟持される。
The
以下、第1部分31の先端側の端部が挟持部41Fによって挟持された場合の医療装置1Aの状態を、「支持状態」という。支持状態において、線状部材3のうち第1開口411から突出する部分の一部であって第1凹部42内に配置される部分を、「突出部3A」という。突出部3Aは、延伸方向に沿って延びる。より詳細には、突出部3Aは、延伸方向に対して僅かに傾斜した方向に延びる。延伸方向に対する突出部3Aの傾斜角度は特段限定されないが、例えば傾斜角度は、0度~45度の何れかの角度となる。支持状態において、閉塞部材36は第2開口412に基端側から嵌り、第2開口412を閉塞する。閉塞部材36が第2開口412に嵌った状態で、線状部材3は第2開口412に保持され、連結部材4に対して相対移動不能となる。
Hereinafter, the state of the
支持状態において、基端側に向かう方向の力が線状部材3に作用した場合を例示する。この場合、線状部材3の第1部分31の先端側の端部は挟持部41Fから離脱し、閉塞部材36は第2開口412から離脱する。以下、第1部分31の先端側の端部が挟持部41Fから離脱した場合の医療装置1Aの状態を、「脱離状態」という。脱離状態において、線状部材3は第2開口412に保持されず、連結部材4に対して相対移動可能となる。以上のように、挟持部41Fは、線状部材3の先端側の端部を脱離可能に支持することによって、医療装置1Aを支持状態と脱離状態との何れかの状態に切り換えることができる。
Exemplifies a case where a force in a direction toward the proximal end acts on the
<留置部材9>
留置部材9は、誘導部材2よりも先端側に配置される。留置部材9は、芯金91、ワイヤ92、及び、環状部93を有する。芯金91は棒状を有し、延伸方向に沿って延びる。芯金91は屈曲可能である。芯金91の両端部の形状は、半球形である。ワイヤ92は、芯金91の両端部を除く部分にコイル状に巻回される。ワイヤ92の材料として、生体への影響が小さいプラチナ、タングステン、金、タンタル、イリジウム、及び、これらの合金の何れかが使用される。環状部93は、紐状の部材の両端部が芯金91の基端側の端部に接続されることによって、環状に形成される。環状部93は可撓性を有する。以下、環状部93の内側の閉塞された領域を、「閉領域93A」という。環状部93の閉領域93Aの形状は、外力が作用することに応じて変形する。
<
The indwelling
支持状態において、環状部93の閉領域93Aに線状部材3の突出部3Aが挿通する。なお、線状部材3の先端側の端部は、挟持部41Fによって挟持されている。環状部93は突出部3Aから脱離しない。このため、支持状態において、留置部材9は連結部材4に連結される。一方、医療装置1Aが支持状態から脱離状態に変化することに応じて、線状部材3の先端側の端部は挟持部41Fから離脱する。環状部93は突出部3Aから離脱可能となる。このため、線状部材3において、留置部材9は連結部材4から脱離可能となる。
In the support state, the protruding
<医療装置1Aの使用方法>
連結部材4の挟持部41Fに線状部材3の先端側の端部が挟持され、且つ、閉塞部材36が連結部材4の第2開口412に嵌められた状態とされる。これによって、医療装置1Aは支持状態とされる。留置部材9は、線状部材3によって連結部材4に連結される。医療装置1Aは、留置部材9が進行方向の先頭に配置された状態で、生体内に配置された非図示のカテーテル内に挿通される。
<How to use
The end portion of the
図2(a)に示すように、使用者は、誘導部材2を操作してカテーテル内に順次送り出す(矢印Y11)。留置部材9は、先端側に向かう方向の力を誘導部材2から受ける(矢印Y12)。医療装置1Aは、先端側に向けてカテーテル内を移動する。使用者は、誘導部材2の送り出し量を調整することによって、生体内の所望位置まで留置部材9を誘導する。図2(b)に示すように、留置部材9が所望位置に到達した場合、使用者は、誘導部材2の送り出し操作を停止させる。留置部材9は所望位置に配置される。
As shown in FIG. 2 (a), the user operates the
図2(c)に示すように、使用者は、誘導部材2を保持した状態で線状部材3を操作し、線状部材3に対して基端側に向かう方向の力を作用させる。なお、連結部材4の基端側への移動は、誘導部材2の先端側の端部に突起部43が接触することによって規制される。このため、線状部材3の先端側の端部は、挟持部41Fから離脱する。閉塞部材36は第2開口412から離脱する。線状部材3は基端側に移動する(矢印Y13)。線状部材3の突出部3Aは、留置部材9の環状部93の閉領域93Aから外れる。留置部材9は、連結部材4から脱離可能な状態になる。
As shown in FIG. 2C, the user operates the
図2(d)に示すように、使用者は、線状部材3を更に基端側に移動させる(矢印Y14)。これによって、線状部材3の第1部分31は第1貫通孔41Eから外れる。使用者は、誘導部材2に対して基端側に向かう方向の力を作用させる。誘導部材2及び連結部材4は、基端側に移動する。(矢印Y15)。なお、留置部材9は連結部材4から脱離しているので、留置部材9は所望位置に留置される。誘導部材2、線状部材3、及び、連結部材4は、カテーテル外に取り出される。
As shown in FIG. 2D, the user moves the
<第1実施形態の作用、効果>
医療装置1Aの留置部材9は、連結部材4に連結された状態で、誘導部材2によって生体内の所望位置(例えば、動脈瘤の発生部位)まで誘導される(矢印Y11、Y12、図2(a)参照)。所望位置に留置部材9が配置された(図2(b)参照)後、線状部材3が基端側に移動した場合(矢印Y13、図2(c)参照)、線状部材3の先端側の端部は挟持部41Fから脱離する。これによって、留置部材9は連結部材4から脱離し、生体内の所望位置に留置される。ここで留置部材9は、環状部93に線状部材3が挿通されることによって連結部材4に連結される。従って、上記の過程で線状部材3が基端側に移動しても、線状部材3から留置部材9に対して力が作用し難い。従って、連結部材4から留置部材9が脱離される場合において、脳動脈瘤の発生部位に力が作用する可能性が軽減され、且つ、線状部材3の移動に応じた力の反動で留置部材9が所望位置から移動することが抑制される。従って、医療装置1Aは、生体内の所望位置まで留置部材9が誘導された後、連結部材4から留置部材9を適切に脱離できる。
<Operation and Effect of First Embodiment>
The indwelling
挟持部41Fは、線状部材3の第1部分31よりも径の小さい有底状の孔である。挟持部41Fは、線状部材3の先端側の端部を内壁で挟持することによって、線状部材3が脱離することを抑制できる。一方、挟持部41Fは、基端側に向かう方向の力が線状部材3に作用したことに応じて、線状部材3を脱離できる。つまり、医療装置1Aは、支持状態から脱離状態に切り換えることが可能な機構を、挟持部41Fによって容易に実現できる。
The sandwiching
連結部材4は、第1凹部42を有する。第1貫通孔41Eの第1開口411は、凹部底面42Bの中心に設けられる。挟持部41Fは、凹部側面42Aに設けられる。このため、線状部材3の突出部3Aは、第1開口411から挟持部41Fに向けて、延伸方向と傾斜する方向に延びる。なお、留置部材9の脱離の過程で線状部材3が基端側に移動する場合、環状部93のうち突出部3Aとの接触部分に対し、基端側に向かう方向の力が作用する場合がある。この場合、突出部3Aが延伸方向に対して傾斜するので、突出部3Aから環状部93に対して作用する力の延伸方向の成分は、突出部3Aが延伸方向に延びる場合と比べて小さくなる。このため、医療装置1Aは、線状部材3の移動に応じて留置部材9に作用する基端側に向かう方向の力を抑制できる。従って、医療装置1Aは、線状部材3の移動に応じた力の反動で留置部材9が所望位置から移動することを抑制できる。
The connecting
線状部材3に閉塞部材36が設けられる。閉塞部材36は、第2開口412に嵌った状態で線状部材3を第2開口412に保持し、連結部材4に対して線状部材3を相対移動不能とする。このため、閉塞部材36は、誘導部材2による留置部材9の誘導時、線状部材3が基端側に移動することを抑制できる。又、閉塞部材36は、第2開口412から脱離した状態で線状部材3を第2開口412に保持せず、連結部材4に対して線状部材3を相対移動可能とする。このため、閉塞部材36は、連結部材4からの留置部材9の脱離時、線状部材3の先端側の端部を挟持部41Fから容易に脱離させることができる。なお、線状部材3の第1部分31の硬さは、第2部分32の硬さよりも硬い。このため、挟持部41Fは、線状部材3の第1部分31を安定的に挟持し易い。従って、医療装置1Aは、挟持部41Fによって線状部材3を脱離可能に挟持することが容易に可能となる。
A closing
連結部材4の突起部43の外径は、誘導部材2の外径L12と略同一であり、誘導部材2の内径L11よりも大きい。このため、突起部43を誘導部材2に接触させることによって、誘導部材2に対して連結部材4を容易に位置決めできる。又、連結部材4から留置部材9を脱離するために線状部材3が操作される場合、連結部材4は誘導部材2に対して基端側に移動不能となる。つまり、連結部材4の基端側への移動は、突起部43によって抑制される。従って、医療装置1Aは、線状部材3を基端側に移動させたことに応じて連結部材4が基端側に移動することを抑制し、支持状態から脱離状態に適切に切り換えることができる。
The outer diameter of the
<第1実施形態の変形例>
挟持部41Fは有底状の孔に限定されない。例えば挟持部41Fは、凹部側面42Aに設けられたスリット状の切れ目であってもよい。切れ目は、対向する2つの壁部によって形成されてもよい。この場合、挟持部41Fは、2つの壁部の間に線状部材3の先端側の端部を挟持してもよい。又、線状部材3の先端側の端部が凹部側面42Aに接着剤等で剥離可能に接着されてもよい。線状部材3に対して基端側に向かう方向の力が作用した場合、凹部側面42Aから線状部材3が剥離してもよい。
<Modification of First Embodiment>
The clamping
第1凹部42の凹部底面42Bは、延伸方向と直交する向きに対して傾斜してもよい。挟持部41Fは、凹部底面42Bに設けられてもよい。この場合、線状部材3の突出部3Aは、第1開口411から先端側に延び、基端側に屈曲して基端側に延び、先端側の端部が挟持部41Fに挟持されてもよい。第1開口411は凹部側面42Aに設けられてもよい。
The
第1貫通孔41Eは、延伸方向に延びていてもよい。第1開口411は、第1凹部42の凹部底面42Bの中心に形成されてもよい。この場合、線状部材3の第1部分31は、第1貫通孔41Eに沿って延伸方向に延び、第1開口411で曲折してもよい。線状部材3の突出部3Aは、延伸方向と傾斜する方向に延びてもよい。
The first through
線状部材3に閉塞部材36は設けられなくてもよい。線状部材3は、連結部材4に対して常に移動可能であってもよい。線状部材3の第1部分31のうち、挟持部41Fによって挟持される部分の硬さと、それ以外の部分の硬さとが相違してもよい。この場合、線状部材3のうち挟持部41Fによって挟持される部分の硬さが、それ以外の部分の硬さよりも硬くてもよい。線状部材3は、全域にわたって均一な硬さを有していてもよい。連結部材4は本体部41のみ有し、突起部43を有していなくてもよい。連結部材4の外径は、全域に亘ってL13であってもよい。
The closing
連結部材4は、延伸方向と直交し且つ外側に向けて突出する突出部を備えてもよい。誘導部材2には、連結部材4の突出部と嵌合可能な孔が形成されていてもよい。突出部と孔とが嵌合されることで、連結部材4と誘導部材2とがより強固に接続される。なお、誘導部材2に形成される孔は、有底の孔でも貫通孔でもよい。なお、突出部と孔とは夫々、複数設けられてもよい。
The connecting
<第2実施形態>
図3、図4を参照し、第2実施形態における医療装置1Bについて説明する。第2実施形態では、第1実施形態における連結部材4の代わりに、連結部材5が使用される。誘導部材2、線状部材3、及び、留置部材9は、第1実施形態と同一であるので、説明を省略する。
Second Embodiment
A
<連結部材5>
連結部材5は、本体部51及び突起部53を有する。本体部51及び突起部53は、それぞれ、第1実施形態の連結部材4(図1参照)における本体部41及び突起部43に対応する。本体部51の本体側面51A及び本体底面51B、51Cは、それぞれ、連結部材4の本体部41の本体側面41A及び本体底面41B、41Cに対応する。本体側面51Aには、直交方向に凹む第2凹部52が形成される。第2凹部52の断面形状は円形である。第2凹部52は、凹部側面52A及び凹部底面52Bを有する。凹部側面52Aは、第2凹部52の側面に対応し、延伸方向と直交する。凹部底面52Bは、第2凹部52の底面に対応し、延伸方向と平行に延びる。
<Connecting
The connecting
本体部51は第1貫通孔51Eを有する。第1貫通孔51Eは、凹部側面52Aの基端側の部分と本体底面51Cとの間に亘って延びる。第1貫通孔51Eによって凹部側面52Aに形成される開口を、「第1開口511」という。第1貫通孔51Eによって本体底面51Cに形成される開口を、「第2開口512」という。第2開口512は、本体底面51Cの中心に設けられる。第1貫通孔51Eは、第2開口512から第1開口511に向けて延伸方向に延びる。
The
本体部51は挟持部51Fを有する。挟持部51Fは、凹部側面52Aの先端側の部分と本体底面51Bとの間に亘って延びる貫通孔である。挟持部51Fの内径は、第1貫通孔51Eの内径よりも小さく、線状部材3の第1部分31の外径と略同一である。挟持部51Fは延伸方向に延びる。挟持部51Fによって凹部側面52Aに形成される開口を、「開口513」という。挟持部51Fによって本体底面51Bに形成される開口を、「開口514」という。開口514は、本体底面51Bの中心に設けられる。挟持部51Fは、開口514から開口513に向けて延伸方向に延びる。第1貫通孔51E及び挟持部51Fは、延伸方向に一直線状に配列される。このため、第1貫通孔51Eの第1開口511と、挟持部51Fの開口513とは、第2凹部52を挟んで延伸方向に並んで配置される。
The
線状部材3の第1部分31は、第1貫通孔51E及び挟持部51Fに挿通可能である。第1部分31のうち、第1貫通孔51Eに挿通する部分よりも先端側の一部は、第1開口511から突出する。第1部分31は、第2凹部52を延伸方向に横切る。第1部分31の先端側の部分は、挟持部51Fに挿通する。第1部分31の先端側の端部は、本体底面51Bの開口514から先端側に僅かに突出する。なお、第1部分31の外径と挟持部51Fの内径は略同一である。このため、第1部分31の先端側の部分は、挟持部51Fの内壁によって挟持される。
The
第1部分31の先端側の部分が挟持部51Fによって挟持された場合の医療装置1Bの状態は、「支持状態」に対応する。支持状態において、線状部材3のうち第1開口511から突出する部分の一部であって第2凹部52内に配置される部分は、「突出部3A」に対応する。突出部3Aは、延伸方向に沿って延びる。より詳細には、突出部3Aは、延伸方向と平行に延びる。支持状態において、閉塞部材36は第2開口512に基端側から嵌り、第2開口512を閉塞する。閉塞部材36が第2開口512に嵌った状態で、線状部材3は第2開口512に保持される。
The state of the
支持状態において、基端側に向かう方向の力が線状部材3に作用した場合を例示する。この場合、第1部分31の先端側の部分は挟持部51Fから離脱し、閉塞部材36は第2開口512から離脱する。第1部分31の先端側の部分が挟持部51Fから離脱した場合の医療装置1Bの状態は、「脱離状態」に対応する。脱離状態において、線状部材3は第2開口512に保持されない。
Exemplifies a case where a force in a direction toward the proximal end acts on the
本体部51は第2貫通孔51Gを有する。第2貫通孔51Gは、凹部側面52Aの先端側の部分と本体底面51Bとの間に亘って延びる。第2貫通孔51Gの内径は、第1貫通孔51Eの内径よりも大きい。第2貫通孔51Gによって凹部側面52Aに形成される開口を、「開口515」という。第2貫通孔51Gによって本体底面51Bに連通する開口を、「開口516」という。開口516は、本体底面51Bの中心から外側にずれた位置に設けられる。第2貫通孔51Gは、開口516から開口515に向けて延伸方向に延びる。
The
留置部材9の環状部93は、開口516から第2貫通孔51Gに挿通する。環状部93の基端側の部分は、開口515から第2凹部52内部に突出する。支持状態において、環状部93の閉領域93Aに線状部材3の突出部3Aが挿通する。なお、線状部材3の先端側の部分は、挟持部51Fによって挟持されている。環状部93は突出部3Aから脱離しない。このため、支持状態において、留置部材9は連結部材5に連結される。一方、医療装置1Bが支持状態から脱離状態に変化することに応じて、線状部材3の先端側の部分は挟持部51Fから離脱する。環状部93は突出部3Aから離脱可能となる。このため、脱離状態において、留置部材9は連結部材4から脱離可能となる。
The
<医療装置1Bの使用方法>
医療装置1Bの使用方法は、医療装置1Aの使用方法と同一である。以下、簡略的に説明する。図4(a)に示すように、使用者は、医療装置1Bの誘導部材2を操作してカテーテル内に順次送り出す(矢印Y21)。留置部材9は、先端側に向かう方向の力を誘導部材2から受ける(矢印Y22)。図4(b)に示すように、留置部材9は所望位置に到達する。図4(c)に示すように、使用者は、誘導部材2を保持した状態で線状部材3を操作し、線状部材3に対して基端側に向かう方向の力を作用させる。線状部材3の先端側の端部が挟持部51Fから離脱する。線状部材3は基端側に移動する(矢印Y23)。線状部材3の突出部3Aは、留置部材9の環状部93の閉領域93Aから外れる。留置部材9は、連結部材4から脱離可能な状態になる。
<How to use
The usage method of the
図4(d)に示すように、使用者は、線状部材3を更に基端側に移動させる(矢印Y24)。使用者は、誘導部材2に対して基端側に向かう方向の力を作用させる。誘導部材2及び連結部材4は、基端側に移動する(矢印Y25)。留置部材9は所望位置に留置される。誘導部材2、線状部材3、及び、連結部材5は、カテーテル外に取り出される。
As shown in FIG. 4D, the user moves the
<第2実施形態の作用、効果>
以下、第1実施形態と異なる効果についてのみ説明する。医療装置1Bにおいて、第1貫通孔51E及び挟持部51Fは、延伸方向に一直線状に配列される。線状部材3の突出部3Aは、延伸方向と平行に延びる。このため、医療装置1Bは、線状部材3が第1開口511近傍で屈曲することを抑制できるので、線状部材3を基端側にスムーズに移動させることができる。従って、使用者は、線状部材3の先端側の端部が挟持部51Fに挟持された状態から、線状部材3の先端側の端部が挟持部51Fから離脱した状態に容易に切り換えることができる。
<Operation and Effect of Second Embodiment>
Hereinafter, only effects different from the first embodiment will be described. In the
医療装置1Bにおいて、連結部材5の本体側面51Aに第2凹部52が設けられる。第2凹部52は直交方向に凹む。第2凹部52の内部において、環状部93の閉領域93Aに線状部材3の突出部3Aが挿通する。このため、留置部材9の誘導時、線状部材3の突出部3A及び環状部93に対して、進行方向の前方から外部の物体が接触し難い。従って、医療装置1Bは、線状部材3に環状部93が挿通された状態を安定化できるので、誘導部材2による留置部材9の誘導時に線状部材3が環状部93から脱離することを抑制できる。
In the
挟持部51F及び第2貫通孔51Gは、第2凹部52の凹部側面52Aの先端側の部分と本体底面51Bとの間に亘って延びる。留置部材9の環状部93は、第2貫通孔51Gに挿通する。このため、留置部材9の誘導時、線状部材3の突出部3A及び環状部93に対して、直交方向の外側から外部の物体が接触し難い。従って、医療装置1Bは、線状部材3に環状部93が挿通された状態を安定化できるので、誘導部材2による留置部材9の誘導時に線状部材3が環状部93から脱離することを抑制できる。又、誘導部材2による留置部材9の誘導をスムーズに実行できる。
The sandwiching
<第2実施形態の変形例>
第1貫通孔51Eの第1開口511と、挟持部51Fの開口513とは、半径方向にずれた位置に配置されてもよい。第1貫通孔51Eの延びる方向は、延伸方向に対して傾斜してもよい。この場合、挟持部51Fは、第1貫通孔51Eに沿って先端側に延びる仮想直線上に沿って配置されてもよい。突出部3Aは、延伸方向に対して傾斜する方向に延びてもよい。挟持部51Fは、凹部底面52Bに設けられていてもよい。
<Modification of Second Embodiment>
The
例えば図5に示すように、連結部材5の本体部51のうち、第2凹部52よりも先端側の部分、即ち、図3において本体部51のうち第2貫通孔51Gが設けられている部分の周辺部分が切り欠かれていてもよい。この場合、誘導部材2の内面21と、本体部51のうち第2凹部52の先端側の部分との間に隙間が形成される。留置部材9の環状部93は、この隙間を介して、第2凹部52の内部まで延びていてもよい。
For example, as shown in FIG. 5, a portion of the
<第3実施形態>
図6、図7を参照し、第3実施形態における医療装置1Cについて説明する。第3実施形態では、第1実施形態における連結部材4の代わりに、連結部材6が使用される。誘導部材2、線状部材3、及び、留置部材9は、第1実施形態と同一であるので、説明を省略する。
<Third Embodiment>
A
<連結部材6>
連結部材6は、第1連結部材6A及び第2連結部材6Bを有する。第1連結部材6Aの形状は円柱状である。第1連結部材6Aの中心は、延伸方向に沿って延びる。第1連結部材6Aの外径は、第1実施形態における連結部材4の本体部41(図1参照)、及び、第2実施形態における連結部材5の本体部51(図3参照)の外径と等しく、L13であり、誘導部材2の内径L11と略同一である。第1連結部材6Aは、連結側面60A、及び、連結底面60B、60Cを有する。連結側面60Aは、第1連結部材6Aの側面に対応する。連結底面60Bは、第1連結部材6Aの先端側の底面に対応する。連結底面60Cは、第1連結部材6Aの基端側の底面に対応する。第1連結部材6Aは貫通孔60Eを有する。貫通孔60Eは、第1連結部材6Aの中心を通り、連結底面60B、60C間に亘って延伸方向に延びる。貫通孔60Eによって連結底面60Bに形成される開口を、「開口601」といい、連結底面60Cに形成される開口を、「第2開口602」という。
<Connecting
The connecting
第2連結部材6Bは、本体部61及び突起部63を有する。本体部61及び突起部63は、それぞれ、第1実施形態の連結部材4(図1参照)における本体部41及び突起部43に対応する。本体部61の本体側面61A及び本体底面61B、61Cは、それぞれ、第1実施形態における連結部材4の本体部41の本体側面41A及び本体底面41B、41Cに対応する。本体底面61Bには、基端側に向けて凹む第3凹部62が形成される。第3凹部62は、凹部側面62A及び凹部底面62Bを有する。凹部側面62A及び凹部底面62Bは、それぞれ、第1実施形態における第1凹部42の凹部側面42A及び凹部底面42Bに対応する。第2連結部材6Bは、第1連結部材6Aの先端側に配置される。第2連結部材6Bの本体底面61Cと、第1連結部材6Aの連結底面60Bとは、互いに切離可能である。
The second connecting
本体部61は、第1貫通孔61E及び貫通孔61Gを有する。第1貫通孔61Eは、凹部側面62Aと本体側面61Aとの間に亘って直交方向に延びる。第1貫通孔61Eによって凹部側面62Aに形成される開口を、「第1開口611」という。第1貫通孔61Eによって本体側面61Aに形成される開口を、「開口612」という。貫通孔61Gは、凹部側面62Aのうち第1開口611と対向する部分と本体側面61Aとの間に亘って直交方向に延びる。貫通孔60Eによって凹部側面62Aに形成される開口を、「開口613」という。貫通孔60Eによって本体側面61Aに形成される開口を、「開口614」という。第1貫通孔61E及び貫通孔60Eは、直交方向に一直線状に並ぶ。
The
本体側面61Aに溝66、67が形成される。溝66は、開口612から基端側に向けて延伸方向に延びる。溝67は、開口614から基端側に向けて延伸方向に延びる。溝66、67の深さは、線状部材3の第1部分31の径よりも僅かに大きい。
線状部材3の第1部分31は、第1連結部材6Aの貫通孔60E、第1連結部材6Aの連結底面60Bと第2連結部材6Bの本体底面61Cとの間、溝66、第1貫通孔61E、第3凹部62内、貫通孔61G、及び、溝67を順番に通過する。第1部分31の先端側の部分は、第1連結部材6Aの連結底面60B及び第2連結部材6Bの本体底面61Cの間に配置される。第1連結部材6Aと第2連結部材6Bとが接触した状態で、連結底面60Bと本体底面61Cとの間に第1部分31の先端側の部分が挟持される。以下、連結底面60Bと本体底面61Cとのそれぞれのうち、第1部分31の先端側の部分を挟持する部分を、「挟持部61F」という。
The
線状部材3の第1部分31の先端側の部分が挟持部61Fによって挟持された場合の医療装置1Cの状態は、「支持状態」に対応する。支持状態において、線状部材3のうち第1開口611から突出する部分の一部であって第3凹部62内に配置される部分は、「突出部3A」に対応する。突出部3Aは直交方向に延びる。
The state of the
保持部37は、線状部材3の第1部分31と第2部分32との境界部分、即ち、線状部材3のうち突出部3Aよりも基端側の部分を、第1連結部材6Aの連結底面60Cに形成された第2開口602に移動不能に保持する。保持部37は、線状部材3の移動に応じて第1連結部材6Aを基端側に移動させる。この場合、連結底面60Bと本体底面61Cとの間に隙間が生じる。線状部材3の第1部分31の先端側の部分は、挟持部61Fから離脱する。第1部分31の先端側の部分が挟持部61Fから離脱した場合の医療装置1Cの状態は、「脱離状態」に対応する。
The holding
支持状態において、環状部93の閉領域93Aに線状部材3の突出部3Aが挿通する。なお、線状部材3の先端側の部分は挟持部61Fによって挟持されている。環状部93は突出部3Aから脱離しない。このため、支持状態において、留置部材9は連結部材6に連結される。一方、医療装置1Cが支持状態から脱離状態に変化することに応じて、線状部材3の先端側の部分は挟持部61Fから離脱する。環状部93は突出部3Aから離脱可能となる。このため、脱離状態において、留置部材9は連結部材6から脱離可能となる。
In the support state, the protruding
<医療装置1Cの使用方法>
医療装置1Cの使用方法は、医療装置1Aの使用方法と同一である。以下、簡略的に説明する。図7(a)に示すように、使用者は、医療装置1Cの誘導部材2を操作してカテーテル内に順次送り出す(矢印Y31)。留置部材9は、先端側に向かう方向の力を誘導部材2から受ける(矢印Y32)。図7(b)に示すように、留置部材9は所望位置に到達する。図7(c)に示すように、使用者は、誘導部材2を保持した状態で線状部材3を操作し、線状部材3に対して基端側に向かう方向の力を作用させる。線状部材3が基端側に移動することに応じ、連結部材6の第1連結部材6Aは基端側に移動する。第1連結部材6Aと第2連結部材6Bとの間に隙間が生じる。このため、線状部材3の先端側の部分は、挟持部61Fから離脱する。線状部材3及び第1連結部材6Aは基端側に移動する(矢印Y33)。線状部材3の突出部3Aは、留置部材9の環状部93の閉領域93Aから外れる。留置部材9は、連結部材6から脱離可能な状態になる。
<How to use
The usage method of the
図7(d)に示すように、使用者は、線状部材3を更に基端側に移動させる(矢印Y34)。使用者は、誘導部材2に対して基端側に向かう方向の力を作用させる。誘導部材2及び連結部材6は、基端側に移動する。(矢印Y35)。留置部材9は所望位置に留置される。誘導部材2、線状部材3、及び、連結部材6は、カテーテル外に取り出される。
As shown in FIG. 7D, the user moves the
<第3実施形態の作用、効果>
以下、第1実施形態及び第2実施形態と異なる効果についてのみ説明する。連結部材6は、第1連結部材6A及び第2連結部材6Bを有する。支持状態において、線状部材3の先端側の部分は、第1連結部材6A及び第2連結部材6Bの接触部分に形成される挟持部61Fによって挟持される。この場合、医療装置1Cは、第1連結部材6A及び第2連結部材6Bが互いに押し付けられる力を強めることによって、挟持部61Fによって線状部材3を強く挟持できる。従って、医療装置1Cは、誘導部材2による留置部材9の誘導時に線状部材3が挟持部61Fから外れることを適切に抑制できる。一方、医療装置1Cは、線状部材3が基端側に移動した場合、第1連結部材6A及び第2連結部材6Bが互いに押し付けられる力を容易に弱めることができる。従って、医療装置1Cは、線状部材3の移動によって支持状態から脱離状態に容易に切り換えることができる。
<Operation and Effect of Third Embodiment>
Hereinafter, only effects different from those of the first embodiment and the second embodiment will be described. The connecting
第2連結部材6Bの本体部61は、第3凹部62を有する。第1貫通孔61Eの第1開口611、及び、貫通孔61Gの開口613は、直交方向に対向する。この場合、線状部材3の突出部3Aは延伸方向に対して直交する。なお、突出部3Aが延伸方向に対して交差する場合の角度が直角に近づく程、線状部材3を基端側に移動させたことに応じて留置部材9に作用する力の延伸方向の成分は小さくなる。又、突出部3Aが延伸方向に対して直交する方向に延びる場合、線状部材3を基端側に移動させたことに応じて留置部材9に作用する力の延伸方向の成分は、最も小さくなる。従って、医療装置1Cは、線状部材3の移動に応じた力の反動で留置部材9が所望位置から移動することを、更に効果的に抑制できる。
The
保持部37は、線状部材3に対して第1連結部材6Aを移動不能に保持する。この場合、医療装置1Cは、第1連結部材6A及び第2連結部材6Bが互いに強く押し付けられた状態を、保持部37によって維持できる。又、線状部材3の基端側への移動に応じ、線状部材3に保持された第1連結部材6Aを移動させることができるので、第1連結部材6A及び第2連結部材の互いに押し付けられる力を容易に弱めることができる。従って、医療装置1Cは、線状部材3が基端側に移動したことに応じて、支持状態から脱離状態に容易に切り換えることができる。
The holding
<第3実施形態の変形例>
第1貫通孔61Eは、本体底面61Cの中心から第3凹部62の凹部底面62Bに向けて、延伸方向に延びてもよい。第1開口611は、凹部底面62Bの中心に設けられてもよい。線状部材3の第1部分31は、第1貫通孔61Eを通って延伸方向に延びてもよい。線状部材3の突出部3Aは、第1開口611から、凹部側面62Aに設けられた開口613に向けて、延伸方向と傾斜する方向に延びてもよい。又、例えば図8に示すように、第1貫通孔61Eは、本体部61の内部に形成されてもよい。第1貫通孔61Eは、本体底面61Cの中心から凹部側面62Aの第1開口611に亘って、本体部61の内部を延びてもよい。
<Modification of Third Embodiment>
The first through
<第4実施形態>
図9、図10を参照し、第4実施形態における医療装置1Dについて説明する。第4実施形態では、第1実施形態における連結部材4の代わりに、連結部材7が使用される。誘導部材2、線状部材3、及び、留置部材9は、第1実施形態と同一であるので、説明を省略する。
<Fourth embodiment>
A
<連結部材7>
連結部材7は、第1連結部材7A及び第2連結部材7Bを有する。第2連結部材7Bの形状は、第3実施形態における第2連結部材6B(図6参照)と略同一である。第2連結部材7Bの本体部71及び突起部73は、それぞれ、本体部61及び突起部63(図6参照)に対応する。本体部71の本体側面71A及び本体底面71B、71Cは、それぞれ、本体部61の本体側面61A及び本体底面61B、61C(図6参照)に対応する。第3凹部72は、第3凹部62(図6参照)に対応する。第3凹部72の凹部側面72A及び凹部底面72Bは、それぞれ、第3凹部62の凹部側面62A及び凹部底面62B(図6参照)に対応する。本体部71の第1貫通孔71E及び貫通孔71Gは、それぞれ、第1貫通孔61E及び貫通孔61G(図6参照)に対応する。第1貫通孔71Eの第1開口711、開口712、及び、貫通孔71Gの開口713、714は、それぞれ、第1開口611、開口612、613、614(図6参照)に対応する。本体部71の溝76、77は、それぞれ、本体部61の溝66、67(図6参照)に対応する。
<Connecting
The connecting
第2連結部材7Bが第2連結部材6Bと異なる点は、本体底面71Cの中心に、先端側に向けて凹んだ嵌合部75が設けられる点である。嵌合部75は、嵌合側面75A及び嵌合底面75Bを有する。嵌合側面75Aは嵌合部75の側面に対応し、嵌合底面75Bは嵌合部75の底面に対応する。嵌合部75の内径は、嵌合底面75Bに向かう程小さくなる。嵌合部75の内径は、第3凹部72の内径よりも小さい。
The second connecting
第1連結部材7Aの形状は円錐台である。第1連結部材7Aの中心は、延伸方向に沿って延びる。第1連結部材7Aは、連結側面70A、及び、連結底面70B、70Cを有する。連結側面70Aは、第1連結部材7Aの側面に対応する。連結底面70Bは、第1連結部材7Aの先端側の底面に対応する。連結底面70Cは、第1連結部材7Aの基端側の底面に対応する。連結底面70Bの径は、連結底面70Cの径よりも小さい。第1連結部材7Aは、第2連結部材7Bの嵌合部75に嵌合可能である。
The shape of the first connecting
第1連結部材7Aは貫通孔70Eを有する。貫通孔70Eは、連結底面70Cの中心から先端側に向けて延伸方向に延び、第1連結部材7Aの内部で外側に屈曲し、連結側面70Aまで直交方向に延びる。貫通孔70Eによって連結側面70Aに形成される開口を、「開口701」といい、連結底面70Cに形成される開口を、「第2開口702」という。保持部37は、線状部材3の第1部分31と第2部分32との境界部分を、第1連結部材7Aの連結底面70Cに形成された第2開口702に移動不能に保持する。
The first connecting
線状部材3の第1部分31は、第1連結部材7Aの貫通孔70E、第2連結部材7Bの本体底面71Cの基端側、溝76、第1貫通孔71E、第3凹部72内、貫通孔71G、溝77、及び、第2連結部材7Bの本体底面71Cの基端側を順番に通過する。第1部分31の先端側の部分は、第1連結部材7Aの連結側面70A及び第2連結部材7Bの嵌合側面75Aの間に配置される。第1連結部材7Aが第2連結部材7Bに嵌合した状態で、連結側面70Aと嵌合側面75Aとの間に第1部分31の先端側の部分が挟持される。以下、連結側面70Aと嵌合側面75Aとのそれぞれのうち、第1部分31の先端側の部分を挟持する部分を、「挟持部71F」という。
The
第1部分31の先端側の端部が挟持部71Fによって挟持された場合の医療装置1Dの状態は、「支持状態」に対応する。支持状態において、線状部材3のうち第1開口711から突出する部分の一部であって第3凹部72内に配置される部分は、「突出部3A」に対応する。突出部3Aは直交方向に延びる。
The state of the
保持部37は、線状部材3の移動に応じて第1連結部材7Aを基端側に移動させる。この場合、連結側面70Aと嵌合側面75Aとの間に隙間が生じる。線状部材3の第1部分31の先端側の部分は挟持部71Fから離脱する。第1部分31の先端側の端部が挟持部71Fから離脱した場合の医療装置1Dの状態は、「脱離状態」に対応する。
The holding
支持状態において、環状部93の閉領域93Aに線状部材3の突出部3Aが挿通する。なお、線状部材3の先端側の部分は挟持部71Fによって挟持されている。環状部93は突出部3Aから脱離しない。このため、支持状態において、留置部材9は連結部材7に連結される。一方、医療装置1Dが支持状態から脱離状態に変化することに応じて、突出部3Aの先端側の部分は挟持部71Fから離脱する。環状部93は突出部3Aから離脱可能となる。このため、脱離状態において、留置部材9は連結部材7から脱離可能となる。
In the support state, the protruding
<医療装置1Dの使用方法>
医療装置1Dの使用方法は、医療装置1Cの使用方法と同一である。以下、簡略的に説明する。図10(a)に示すように、使用者は、医療装置1Dの誘導部材2の基端側をカテーテル内に順次送り出す(矢印Y41、Y42)。図10(b)に示すように、留置部材9が所望位置に到達する。図10(c)に示すように、使用者は、線状部材3に対して基端側に向かう方向の力を作用させる。線状部材3が基端側に移動することに応じ、第1連結部材7Aと第2連結部材7Bとの間に隙間が生じる。線状部材3の先端側の部分は、挟持部71Fから離脱する。線状部材3及び第1連結部材7Aは基端側に移動する(矢印Y43)。線状部材3の突出部3Aは、留置部材9の環状部93の閉領域93Aから外れる。図10(d)に示すように、使用者は、線状部材3を更に基端側に移動させる(矢印Y44)。使用者は、誘導部材2に対して基端側に向かう方向の力を作用させる。誘導部材2及び連結部材7は、基端側に移動する(矢印Y45)。留置部材9は所望位置に留置される。
<How to use
The usage method of the
<第4実施形態の作用、効果>
以下、第1~第3実施形態と異なる効果についてのみ説明する。医療装置1Dは、第1連結部材7A及び第2連結部材7Bを有する。第1連結部材7Aは、第2連結部材7Bの嵌合部75に嵌合する。支持状態において、線状部材3の先端側の部分は、第1連結部材7A及び嵌合部75によって形成される挟持部71Fに挟持される。この場合、医療装置1Dは、第1連結部材7A及び第2連結部材7Bが互いに強く押し付けられた状態を、嵌合部75によって維持できる。従って、医療装置1Dは、線状部材3の第1部分31の先端側の部分を、挟持部71Fによって適切に挟持できる。
<Operation and Effect of Fourth Embodiment>
Only the effects different from those of the first to third embodiments will be described below. The
<第4実施形態の変形例>
第1貫通孔71Eは、嵌合部75の嵌合底面75Bの中心から第3凹部72の凹部底面72Bに向けて、延伸方向に延びてもよい。第1開口711は、凹部底面72Bの中心に設けられてもよい。線状部材3の第1部分31は、第1貫通孔71Eを通って延伸方向に延びてもよい。線状部材3の突出部3Aは、第1開口711から、凹部側面72Aに設けられた開口713に向けて、延伸方向と傾斜する方向に延びてもよい。又、例えば図11に示すように、第1貫通孔71Eは、嵌合底面75Bの中心から凹部側面72Aの第1開口711に亘って、本体部71の内部に形成されてもよい。第1貫通孔71Eは、嵌合底面75Bの中心から凹部側面72Aの第1開口711に亘って、本体部71の内部を延びてもよい。
<Modification of Fourth Embodiment>
The first through
Claims (15)
前記誘導部材の内部に、前記延伸方向に沿って移動可能に挿通される線状部材と、
前記誘導部材の前記先端側に設けられた連結部材であって、
前記線状部材の一部が挿通する貫通孔であって、前記線状部材の前記先端側が突出する第1開口を有する第1貫通孔、及び、
前記線状部材の前記先端側の端部を脱離可能に支持する支持部であって、前記線状部材が前記基端側に移動することに応じ、前記線状部材の前記先端側の端部を支持した支持状態から、前記線状部材の前記先端側の端部が脱離した脱離状態に切り換え可能な支持部
を有する連結部材と、
前記線状部材のうち前記第1開口から突出する突出部が挿通される環状部を有する留置部材と
を備え
前記留置部材は、
前記支持状態で前記連結部材に連結し、前記脱離状態で前記連結部材から脱離することを特徴とする医療装置。 A cylindrical guide member extending in the extending direction between the proximal end and the distal end;
Inside the guide member, a linear member that is movably inserted along the extending direction;
A connecting member provided on the distal end side of the guide member,
A through hole through which a part of the linear member is inserted, the first through hole having a first opening from which the tip side of the linear member protrudes; and
A support portion that removably supports an end portion on the distal end side of the linear member, wherein the end of the linear member on the distal end side according to the movement of the linear member to the proximal end side A connecting member having a support part that can be switched from a support state supporting a part to a detached state in which the end of the linear member is detached.
An indwelling member having an annular portion through which a projecting portion projecting from the first opening of the linear member is inserted;
A medical device, wherein the medical device is connected to the connecting member in the supporting state and is detached from the connecting member in the detached state.
前記第1凹部は、前記延伸方向と交差する面である底面と、前記延伸方向と平行な面である側面とを有し、
前記第1開口は、前記第1凹部の前記底面に設けられ、
前記支持部は、前記第1凹部の前記側面に設けられたことを特徴とする請求項2に記載の医療装置。 The connecting member has a first recess recessed toward the base end side at an end portion on the distal end side,
The first recess has a bottom surface that is a surface that intersects the extending direction, and a side surface that is a surface parallel to the extending direction,
The first opening is provided on the bottom surface of the first recess,
The medical device according to claim 2, wherein the support portion is provided on the side surface of the first recess.
前記第2凹部は、前記延伸方向と交差する面である側面を有し、
前記第1開口、及び、前記支持部は、前記第2凹部の前記側面に設けられたことを特徴とする請求項4に記載の医療装置。 The connecting member has a second recess recessed in a direction intersecting the extending direction on a surface extending along the extending direction,
The second recess has a side surface that is a surface intersecting with the extending direction,
The medical device according to claim 4, wherein the first opening and the support portion are provided on the side surface of the second recess.
前記閉塞部材は、
前記第2開口に前記線状部材が保持された状態と、前記第2開口に前記線状部材が保持されない状態とに切り換え可能であることを特徴とする請求項2から6の何れかに記載の医療装置。 The linear member includes a closing member that closes the second opening opposite to the first opening in the first through hole,
The closing member is
The switchable state between the state in which the linear member is held in the second opening and the state in which the linear member is not held in the second opening is provided. Medical equipment.
前記支持部は、
前記第1連結部材及び前記第2連結部材が接触する部分で前記線状部材の前記先端側の端部を挟持することを特徴とする請求項1に記載の医療装置。 The connecting member includes a first connecting member and a second connecting member that can contact and separate from each other,
The support part is
The medical device according to claim 1, wherein an end portion on the distal end side of the linear member is clamped at a portion where the first connecting member and the second connecting member are in contact with each other.
前記第3凹部は、前記延伸方向と交差する面である底面と、前記延伸方向と平行な面である側面とを有し、
前記第1開口は、前記第3凹部の前記底面又は前記側面に設けられたことを特徴とする請求項10に記載の医療装置。 The second connecting member has a third recessed portion that is recessed toward the proximal end side at an end portion on the distal end side,
The third recess has a bottom surface that is a surface intersecting the stretching direction, and a side surface that is a surface parallel to the stretching direction,
The medical device according to claim 10, wherein the first opening is provided on the bottom surface or the side surface of the third recess.
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Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2007007417A (en) * | 2005-06-30 | 2007-01-18 | Cordis Neurovascular Inc | Stretch-resistant embolic coil delivery system with mechanical release mechanism |
| JP2009513274A (en) * | 2005-10-31 | 2009-04-02 | バイオメリックス コープ | CONNECTING AND RELEASE DEVICE AND METHOD FOR ASSEMBLING AND USING THE SAME |
-
2017
- 2017-12-12 WO PCT/JP2017/044608 patent/WO2018110561A1/en not_active Ceased
- 2017-12-12 JP JP2018556697A patent/JP6905995B2/en active Active
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2007007417A (en) * | 2005-06-30 | 2007-01-18 | Cordis Neurovascular Inc | Stretch-resistant embolic coil delivery system with mechanical release mechanism |
| JP2009513274A (en) * | 2005-10-31 | 2009-04-02 | バイオメリックス コープ | CONNECTING AND RELEASE DEVICE AND METHOD FOR ASSEMBLING AND USING THE SAME |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2022146135A (en) * | 2021-03-22 | 2022-10-05 | 朝日インテック株式会社 | delivery system |
| JP7548851B2 (en) | 2021-03-22 | 2024-09-10 | 朝日インテック株式会社 | Delivery System |
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