JPH05137729A - 切除用カテーテル - Google Patents

切除用カテーテル

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Publication number
JPH05137729A
JPH05137729A JP3232544A JP23254491A JPH05137729A JP H05137729 A JPH05137729 A JP H05137729A JP 3232544 A JP3232544 A JP 3232544A JP 23254491 A JP23254491 A JP 23254491A JP H05137729 A JPH05137729 A JP H05137729A
Authority
JP
Japan
Prior art keywords
wire
catheter
elongated member
ablation catheter
bending point
Prior art date
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.)
Granted
Application number
JP3232544A
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English (en)
Other versions
JP3151010B2 (ja
Inventor
Neal E Fearnot
イー．フイアノツト ニール
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cook Research Inc
Original Assignee
MED Institute Inc
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Application filed by MED Institute Inc filed Critical MED Institute Inc
Publication of JPH05137729A publication Critical patent/JPH05137729A/ja
Application granted granted Critical
Publication of JP3151010B2 publication Critical patent/JP3151010B2/ja
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B17/2202—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A61B18/10—Power sources therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B17/2202—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
    • A61B2017/22021—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter electric leads passing through the catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00059—Material properties
    • A61B2018/00071—Electrical conductivity
    • A61B2018/00077—Electrical conductivity high, i.e. electrically conducting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • A61B2018/00148—Coatings on the energy applicator with metal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01—Filters implantable into blood vessels
    • A61F2/013—Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Vascular Medicine (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Mechanical Engineering (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Materials For Medical Uses (AREA)

Abstract

(57)【要約】 【目的】患者の身体を損傷することなく、身体等の空洞
から組織または障害物を除去する切除用カテーテル提供
する。 【構成】 細長部材１１０と、接続装置１０３と、前記
細長部材に根元部を、前記接続装置の先端部を有して伸
びる少なくとも１本のワイヤ１０４とを有する体腔の内
壁から組織を切除する切除用カテーテルにおいて、前記
ワイヤは、それが伸びて移動したときワイヤケージの一
部を形成する弓状部分１０５と、ワイヤ１０５の方向に
対し側面力成分を加える少なくとも１つの屈曲点１２５
とを有することを特徴とする。

Description

【発明の詳細な説明】
【０００１】
【産業上の利用分野】本発明は、患者の血管、身体腔等
の空洞から組織または障害物を除去する除去用カテーテ
ルに関する。
【０００２】
【従来の技術】くびれた血管を貫通することは、長年の
課題であった。このために、剛性の拡張装置、気球拡張
装置、加熱気球拡張装置が使用されている。米国特許第
４７０９６９８号、第４８９０６１１号には、揃断部材
を具備したカテーテルが開示されている。
【０００３】
【発明が解決しようとする課題】本発明の課題は、前記
した従来のカテーテルを改良し、患者の身体を損傷する
ことなく、身体等の空洞から組織または障害物を除去す
る新たな除去用カテーテル提供することである。
【０００４】
【課題を解決するための手段】上記課題を解決する為
に、本発明のカテーテルは、細長部材１１０と、接続装
置１０３と、前記細長部材に根元部を、前記接続装置の
先端部を有して伸びる少なくとも１本のワイヤ１０４と
を有し、前記ワイヤは、それが伸びて移動したときワイ
ヤケージの一部を形成する弓状部分１０５と、ワイヤ弓
状部分１０５の方向に対し側面力成分を加える少なくと
も１つの屈曲点１２５とを有し、ワイヤと血管の内壁と
の接触力を増加させることを特徴とする。
【０００５】
【実施例】図１において、カテーテル１００は、シャフ
トである細長部材１１０を有し、血管等の人体の孔に挿
入される。この細長部材１１０は、その先端部で４個の
ラセン状のフレキシブルなワイヤ１０４を有し、これで
ワイヤバスケット１５０を形成している。各ワイヤ１０
４は、アークを形成する弓状部分１０５と細長部材１１
０の先端部から伸びた根元部とを有し、これらがワイヤ
ケージを形成し内壁と接触し、更に超音波トランデュー
サ１０１に接続されている。ワイヤ１０４は、更に、ハ
ブ１０３のような先端部を終端する手段（接続装置）を
有する。カテーテル１００は、一般的な方法（まず血管
にワイヤガイドを挿入し、次いでそのワイヤガイドに沿
ってカテーテルを挿入する）で、経皮的に血管内に挿入
される。
【０００６】ワイヤガイド１０２は、ハブ１０３を縦方
向に貫通する孔１０７を貫通して伸び、更に、細長部材
１１０の孔１１１を貫通して伸びる。あるいは、ワイヤ
ガイド１０２は、ハブ１０３に固定され、ワイヤガイド
１０２がワイヤの動きを制御できるようにする。ワイヤ
ガイド１０２の血管内への挿入後、カテーテル１００
は、ワイヤガイド１０２を介して血管内に挿入される。
ワイヤ１０４は、カテーテル１００が血管内に移動する
につれて、血管の内壁に接触する。血管内の障害物
（例：血栓）に達すると、ワイヤ１０４の端部がこの障
害物を通過し、その後後退する。この後退プロセスで、
ワイヤ１０４の弓状部分１０５は、血管の内壁に接触
し、そこから障害物を分離する。このため、この弓状部
分１０５は接触部分とも称される。ワイヤバスケット１
５０は、縫合材料からなる複数の糸１１２を医療用接着
剤でワイヤ１０４に複数の離れた場所に接着して形成さ
れた粒子収集ネットである。この複数の糸１１２で形成
されたネットは、カテーテルが血管内に移動するにつれ
て、ワイヤバスケット１５０により内壁から分離された
物体を捕獲する。
【０００７】各ワイヤ１０４は、細長部材１１０の先端
部から屈曲点１２５に伸びる非接触部分１２３を有す
る。この屈曲点１２５からワイヤは、弓状部分１０５を
形成するような角度で軸方向から外側に伸び、手術時に
体内の内壁と係合する。この弓状部分１０５は、ワイヤ
１０４に対し約９０゜以下の角度をなして屈曲点１２５
を形成する。この角度は、９０゜よりはるか小さいのが
好ましい。接触部分である弓状部分１０５は、血管等の
孔の内径に合致し、この角度もこの要件に合う必要があ
る。各ワイヤは、弓状部分１０５からその先端部に伸
び、あるいは、第２の屈曲点１２１まで接触部分である
弓状部分１０５として伸びる。この屈曲点１２１からそ
の先端部まで非接触部分１２０として伸びる。ワイヤの
各弓状部分１０５は、ほぼラセン状で、その弓状部分１
０５が細長部材１１０の軸方向に対する角度は、非接触
部分１２０と非接触部分１２３とがなす角度よりはるか
に大きい。屈曲点１２５の非接触部分１２３は、ワイヤ
の軸方向に対し側面方向の力成分（すなわち、外方向の
力成分）を形成するよう、曲げられる。この曲げ角度
は、約５゜から９０゜以上の角度であるが、約９０゜以
下が好ましい。
【０００８】非接触部分１２０は、血管内へのカテーテ
ルの挿入と閉塞した障害物の通過を容易にする。屈曲点
１２１と屈曲点１２５の正確な角度は、図２に示されて
いる。例えば、ワイヤ１０４は、ステンレススチール製
で、その直径は、０．００６−０．０１インチである。
あるいは、所定の転移温度以上で超柔軟性を示す合金ワ
イヤ（例：ニチノール（Ｎｉｔｉｎｏｌ）、ニッケルー
チタン合金）が用いられる。タンタルを含有すると、放
射線治療により適応可能である。
【０００９】４本のワイヤの弓状部分１０５は、重なり
合ったように形成される（図３）。図を明瞭にするた
め、図３には、ワイヤ１３１、ワイヤ１３２のみが図示
されている。ワイヤ１３１は、超音波トランデューサ１
０１の点１３３から出て、ワイヤ１３２は、超音波トラ
ンデューサ１０１の点１３５から出る。ワイヤ１３１
は、ワイヤ１３２にワイヤバスケット１５０の周囲１／
４程オーバラップし、この部分は、オーバラップ部分１
３７として図示されている。同様に、ワイヤ１３２は、
点１３４から出た隣接するワイヤ（図３には図示せず）
の部分とオーバラップする。点１３４から出たワイヤ
は、同様に、超音波トランデューサ１０１のエンドキャ
ップ上の点１３６から出たワイヤとオーバラップする。
かくして、ワイヤバスケット１５０は、血管の内壁に対
し周囲に伸びた切断面を提供する。
【００１０】このオーバラップする程度は、ワイヤバス
ケットが十分に伸びて、ワイヤが血管の内壁と常に接触
するようにする。十分拡張した時、オーバラップ部分
は、必要はないが、あれば好ましい。
【００１１】カテーテル１００の閉塞された血管への挿
入を容易にするために、カテーテル１００は、外部シー
スすなわち、ガイドカテーテルを具備し、細長部材１１
０を保持し、特に、圧縮された状態にワイヤバスケット
１５０を保持する。図４において、細長部材１１０とワ
イヤバスケット１５０とは、外部シース１４０内に保持
され、内壁２１０と閉塞物２００とを有する血管２１１
内に配置される。カテーテルの挿入準備において、ワイ
ヤガイド１０２は、周知の放射線手術方法を用いて、血
管内に挿入される。細長部材１１０とワイヤバスケット
１５０とは、外部シース１４０内に配置しつつ、ワイヤ
ガイド１０２に沿って挿入される。好ましくは、シース
は、血管２１１の内壁２１０上の閉塞物２００により形
成された閉塞領域を越えて伸る。外部シース１４０は後
退し、ワイヤバスケット１５０が拡張された状態になる
ようにする（図５）。その後、細長部材１１０は、弓状
部分１０５を閉塞物２００に接触させるようにしながら
引き戻し、障害物を管壁から分離する（図６）。障害物
を壁から切断除去すると、ワイヤ１０４の間に伸びた糸
１１２により形成されるネットに収集される。このよう
にして、障害堆積物は、血管の壁から除去され、カテー
テルが引かれるにつれて、粒子は除去される。ネットを
形成する糸は、縫合糸で適当な引っ張り強さを有し、外
部シース１４０内に引かれた時、ワイヤバスケット１５
０が崩れたときにも干渉しないフレキシブルなフイラメ
ントである。また、拡張したバスケットは、前方に押さ
れ、血管から障害物を分離する。
【００１２】図７において、調整ロッド１６０は、細長
部材１１０を貫通して軸方向に伸びる。調整ロッド１６
０は、ハブ１０３に固定された先端部を有し、その根元
部には、ハンドル１７４を具備する。調整ロッド１６０
は、細長部材１１０内の孔１６２にスライド可能に係合
する。ハンドル１７４が細長部材１１０から離れるよう
な方向への調整ロッド１６０の移動により、ハブ１０３
が細長部材１１０の方向に移動し、ワイヤ１０４が側面
方向に伸びる。このため、ワイヤバスケット１５０の横
断面積が増加する。逆に、ハンドル１７４が細長部材１
１０方向に移動するような方向に調整ロッド１６０が移
動すると、ハブ１０３は、細長部材１１０から離れる方
向に移動し、ワイヤ１０４が軸方向に縮み、ワイヤバス
ケット１５０の横断面積が減少する。すなわち、ワイヤ
バスケット１５０の周囲は、ハブ１０３が細長部材１１
０の方向に移動するにつれて拡大し、逆に、ワイヤバス
ケット１５０の周囲は、ハブ１０３が細長部材１１０か
ら離れる方向に移動するにつれて減少する。調整ロッド
１６０には、目盛り１７２が付され、この目盛り１７２
は、ワイヤバスケット１５０の拡張程度に相当し、外科
医がこれを用いて、血管内のバスケットの拡張程度を正
確に知ることができる。ロックリング１６６は、細長部
材１１０の端部１６８に係合する。ロックリング１６６
が細長部材１１０の主要部方向に移動するにつれて、細
長部材１１０の端部１６８は、圧縮されて、調整ロッド
１６０を所望の位置に維持する。ワイヤガイド１０２
は、調整ロッド１６０の孔１７０内に配置される。
【００１３】図８において、ネット２０２は、ワイヤバ
スケット１５０の切断除去動作後、閉塞物２００収集す
る。ネット２０２は、ガーゼ状材料または、ナイロン製
網で形成され、屈曲点１２１に隣接したワイヤ１０４に
固着される。このネット２０２は、カテーテル１００の
先端部のハブ１０３を越えて、軸方向に伸びる。また、
このネット２０２には、その先端部に中央部開口２０１
を具備し、ワイヤガイド１０２の通路が形成される。
【００１４】ワイヤ１０４の切断動作を強め、コレステ
ロール、プラーク、軟組織、胆嚢の粘膜を溶解するため
に、切断ワイヤは、そこに流される電流により加熱され
得る。これは、ハブ１０３内にワイヤ１０４を相互接続
することにより、達成される（図９）。ワイヤ１０４
は、導体対２１２により、接続される。個別の導体を使
用する代わりに、適当な方法で電気接点に接続される。
電流が細長部材１１０のワイヤ１０４に端子２０８によ
り印加される（図９）。ワイヤ１０４は、コネクタ２１
３でスイッチ２０４に接続され、このスイッチ２０４に
加熱の為に、電流がケーブル２０６から印加される。こ
のスイッチ２０４は、公知のスイッチ構成で、導体対２
１２の１つに入力電流が印加される。帰還電流が導体対
２１２の他の１つに入る。スイッチ２０４には、ボタン
２０５が具備され、このボタン２０５は、ケーブル２０
６から導体対２１２への入力電流の制御に使用され、一
方、残りの導体対は、ケーブル２０６の帰還電流リード
に接続される。
【００１５】ワイヤ１０４の切断動作は、更に、振動動
作で強められる。超音波トランデューサ１０１内のバイ
ブレータ２０３が、ワイヤ１０４に接続され、超音波振
動を切断ワイヤに伝える。このバイブレータ２０３は、
細長部材１１０内の超音波トランデューサ１０１内に埋
設される物であればいかなるものでもよい。超音波トラ
ンデューサ１０１へのパワーは、スイッチ２０４に接続
されたワイヤ対２０９により与えられ、ケーブル２０６
を介してスイッチ２０４に接続され、ボタン２０７の操
作により、動作する。このボタン２０７は、細長部材１
１０の先端部近傍に配置され、外科医がワイヤ１０４に
振動動作を選択的に加えられるようにするのがよい。
【００１６】
【発明の効果】以上述べた本発明の切除カテーテルは、
胆嚢の底内に挿入され、胆嚢の粘膜を切除する。拡張可
能なワイヤは、拡大され、粘膜層に係合し、無線周波数
の電流を印加し、粘膜層を加熱し、凝結させる。この粘
膜層の切除は、胆石の形成を防止する。また、このカテ
ーテルは、尿道の尿石の除去用にも使用できる。特に、
男性の前立線尿道で使用される。また、腸のポリープの
除去にも用いられる。
【図面の簡単な説明】
【図１】本発明の切除カテーテルの一実施例を示す斜視
図である。
【図２】図１の実施例の側面図である。
【図３】図２の線３ー３に沿った部分断面図である。
【図４】本発明の切除カテーテルが細長部材でカバーさ
れて血管内に挿入された状態図である。
【図５】図４の後、本発明の切除カテーテルの細長部材
が引き抜かれた状態図である。
【図６】図５の後、本発明の切除カテーテルのワイヤが
血管内の閉塞物を切除している状態図である。
【図７】本発明の切除カテーテルに種々の付属物が付い
た状態を示す図である。
【図８】本発明の切除カテーテルの他の実施例を示す斜
視図である。
【図９】本発明の切除カテーテルに電気的付属物が付い
た状態を示す図である。
【符号の説明】
１００ カテーテル １０１ 超音波トランデューサ １０２ ワイヤガイド １０３ ハブ １０４ ワイヤ １０５ 弓状部分（接触部分） １１０ 細長部材（シャフト） １１２ 糸 １２０ 非接触部分 １２１ 屈曲点 １２２ 糸 １２３ 非接触部分 １２５ 屈曲点 １３１ ワイヤ １３２ ワイヤ １３３ 点 １３４ 点 １３５ 点 １３６ 点 １４０ 外部シース １５０ ワイヤバスケット １６０ 調整ロッド １６６ ロックリング １６８ 端部 １７２ 目盛り １７４ ハンドル １７５ 肩部 ２００ 閉塞物 ２０１ 中央部開口 ２０２ ネット ２０４ スイッチ ２０５ ボタン ２０６ ケーブル ２０７ ボタン ２０８ 端子 ２０９ ワイヤ対 ２１０ 内壁 ２１１ 血管 ２１２ 導体対 ２１３ コネクタ

Claims (11)

    【特許請求の範囲】
  1. 【請求項１】 細長部材（１１０）と、 接続装置（１０３）と、 前記細長部材に根元部を、前記接続装置の先端部を有し
    て伸びる少なくとも１本のワイヤ（１０４）とを有する
    体腔の内壁から組織を切除する切除用カテーテルにおい
    て、 前記ワイヤは、それが伸びて移動したときワイヤケージ
    の一部を形成する弓状部分（１０５）と、ワイヤ（１０
    ５）の方向に対し側面力成分を加える少なくとも１つの
    屈曲点（１２５）とを有することを特徴とする切除用カ
    テーテル。
  2. 【請求項２】 前記ワイヤと同様に配置される複数のワ
    イヤを有することを特徴とする請求項１の切除用カテー
    テル。
  3. 【請求項３】 前記各ワイヤは、第２の屈曲点を有し、
    第１の屈曲点と第２の屈曲点との間の部分が前記内壁に
    接触することを特徴とする請求項１または２の切除用カ
    テーテル。
  4. 【請求項４】 それぞれの屈曲点に隣接する前記第１の
    屈曲点と第２の屈曲点との間の部分は、その部分がラセ
    ン状の弓状部分を形成するような角度を成し、 前記のラセン状の弓状部分は、隣接するワイヤのそれと
    重なり、前記ワイヤケージが拡張し、内壁との接触が維
    持できることを特徴とする請求項３の切除用カテーテ
    ル。
  5. 【請求項５】 前記角度は、９０゜以下の範囲にあり、 前記各部分は、前記細長部材の軸方向に直交するライン
    状部分を形成することを特徴とする請求項４の切除用カ
    テーテル。
  6. 【請求項６】 前記ワイヤケージの拡張を制御する手段
    （１６０、１６６）を有し、 前記制御手段は、前記接続装置（１０３）と細長部材
    （１１０）に機械的に結合され、細長部材の根元部と接
    続装置との間の距離が制御可能であることを特徴とする
    請求項１、２、３、４、５のいずれかの切除用カテーテ
    ル。
  7. 【請求項７】 前記細長部材は、ワイヤガイド（１０
    ２）の挿入用中空通路（１１１）を有し、 前記ワイヤガイドは、接続装置に貫通して固定されるこ
    とを特徴とする請求項１、２、３、４、５、６のいずれ
    かの切除用カテーテル。
  8. 【請求項８】 前記各ワイヤは、導電性で、前記組織の
    除去用に加熱可能であることを特徴とする請求項１、
    ２、３、４、５、６、７のいずれかの切除用カテーテ
    ル。
  9. 【請求項９】 振動を発生させる振動生成手段（１０
    １）を前記各ワイヤ（１０４）に接触して有することを
    特徴とする請求項１、２、３、４、５、６、７、８のい
    ずれかの切除用カテーテル。
  10. 【請求項１０】 細長部材とワイヤケージとを収納する
    軸方向通路を有する外部シース（１４０）を有すること
    を特徴とする請求項１、２、３、４、５、６、７、８、
    ９のいずれかの切除用カテーテル。
  11. 【請求項１１】 ワイヤケージに付属した切除された組
    織を収納するネット（２０２）を有することを特徴とす
    る請求項３、６、７、８、９、１０のいずれかの切除用
    カテーテル。
JP23254491A 1990-08-21 1991-08-21 切除用カテーテル Expired - Lifetime JP3151010B2 (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US570384 1990-08-21
US07/570,384 US5100423A (en) 1990-08-21 1990-08-21 Ablation catheter

Publications (2)

Publication Number Publication Date
JPH05137729A true JPH05137729A (ja) 1993-06-01
JP3151010B2 JP3151010B2 (ja) 2001-04-03

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Country Link
US (1) US5100423A (ja)
EP (1) EP0472368B1 (ja)
JP (1) JP3151010B2 (ja)
AT (1) ATE124231T1 (ja)
AU (1) AU643552B2 (ja)
CA (1) CA2049146C (ja)
DE (1) DE69110794T2 (ja)
ES (1) ES2073687T3 (ja)

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ES2073687T3 (es) 1995-08-16
AU643552B2 (en) 1993-11-18
ATE124231T1 (de) 1995-07-15
EP0472368B1 (en) 1995-06-28
EP0472368A3 (en) 1992-03-11
CA2049146C (en) 2001-09-11
JP3151010B2 (ja) 2001-04-03
CA2049146A1 (en) 1992-02-22
AU8267591A (en) 1992-02-27
US5100423A (en) 1992-03-31

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