JPH06315536A - Catheter for preventing reclosing of blood vessel - Google Patents

Abstract

(57) [Summary] (Modified) [Purpose] To provide a catheter for preventing vascular reocclusion which repairs rupture or compression of atheroma and reocclusion of a large occlusion site opened by a drug. A multi-channel tubular catheter tube 24 having two or more lumens which are partitioned by a partition formed inside in the axial direction and communicate with each other in the axial direction, and one of the lumens provided near the tip thereof And a first dilation body 26 having a coaxial tubular portion and a catheter provided on the catheter tube 24 on the base side of the dilation body 26 and communicating with one of the other lumens. Side hole 31 for forming a drug, a hub 34 having a plurality of flow paths communicating with the lumen of the catheter tube 24 and connected to a base end thereof, and a side hole 31.
A tubular portion that is connected to another lumen that communicates with another flow path of the hub 34 on the side closer to the base than that of the first expansion body 26, and that is coaxial with the catheter tube 24. And a second expansion body 26 having

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a catheter for preventing reocclusion of blood vessels. More specifically, the present invention is used for repairing reocclusion of a compressed or dilated occlusion part with a drug in atheroma (atheroma) rupture or angioplasty, which contributes to the induction of intravascular thrombosis. The present invention relates to a catheter for preventing reocclusion of blood vessels.

[0002]

2. Description of the Related Art When a stenosis or occlusion occurs in a blood vessel such as a blood vessel, the stenosis or occlusion of the blood vessel is opened or recanalized to improve the body fluid flow on the peripheral side of the blood vessel. Percutaneous transluminal angioplasty (PTA; Percutaneous Transluminal) using a dilatation catheter
Angioplasty: PTCA; Percutaneous Translu
minal Coronary Angioplasty).
In this angioplasty, for example, first, after percutaneously securing a blood vessel, a thin guide wire is passed through the tube portion, and this guide wire is used as a guide, and a catheter having an expandable body (balloon) at the tip portion is inserted, This expansion body is positioned in the affected area where stenosis or occlusion occurs, and then a liquid (for example, a contrast medium or physiological saline solution) is injected into this expansion body from the end hub under pressure (several atmospheric pressure to about 10 atmospheric pressure) to expand. This is performed by expanding the body toward the inner wall of the blood vessel and compressing and expanding the stenosis or occlusion.

However, such an angioplasty procedure
The amount of adjustment is very delicate, and if the force that pushes and expands the inner wall of the blood vessel by the dilator is too small, the stenosis cannot be sufficiently opened and reocclusion tends to occur. In the case of re-occlusion, it is necessary to further apply PTCA, which imposes a heavy burden on the patient, and if the blood vessel is expanded a plurality of times, the corresponding blood vessel becomes rigid and it becomes difficult to expand it by the balloon. On the other hand, if too much force is used to expand the inner wall of the blood vessel by the dilator in order to sufficiently open the stenosis, the intima of the blood vessel may be damaged or peeled off, resulting in a flap-shaped blood vessel. There is a high risk that the intima will be exposed to blood where blood clotting will occur and re-occlude. Atherosclerotic rupture, which is one of the causes of acute myocardial infarction (AMI), occurs as arteriosclerosis progresses, and similarly the intima is exposed to blood in the form of flaps, causing rapid embolism and causing thrombolysis immediately after the onset ( The prognosis is extremely poor when blood flow cannot be resumed due to PTCR). This PTC
In the case of R as well, a large amount of urokinase or the like controls thrombus generation, but there is a high risk of re-occlusion due to the flap.
When the intravascular re-occlusion due to the flap-like intimal detachment occurs, surgical treatment is required, resulting in an extremely large load on the patient.

[0004]

SUMMARY OF THE INVENTION Therefore, the object of the present invention is to provide a novel catheter for preventing reocclusion of blood vessel. It is another object of the present invention to provide a vascular re-occlusion prevention catheter that blocks both sides of a target blood vessel by expanding the balloon to prevent re-occlusion of the blood vessel by injecting / treating a predetermined drug. It is another object of the present invention to provide a revascularization preventing catheter used for repairing flap-shaped intimal detachment caused by hyperextension of blood vessels in angioplasty. A further object of the present invention is to provide a catheter for preventing re-occlusion of a blood vessel, which can fix a flap-shaped intimal detachment portion to an inner wall of a blood vessel by utilizing a blood coagulation reaction system. Another object of the present invention is to provide a catheter for preventing re-occlusion of blood vessels, which can eliminate the risk of re-occlusion caused by flap-like intimal detachment which may occur as a complication after angioplasty. Also,
In order to prevent reocclusion of the present invention, it is an object of the present invention to provide a catheter for preventing reocclusion of a blood vessel, which is used to sandwich a target blood vessel with a balloon and treat it with a drug solution.

[0005]

A multi-channel tubular catheter tube having two or more lumens which are partitioned by a partition formed inside in the axial direction and communicate with each other in the axial direction, and in the vicinity of the distal end of the catheter tube. A first dilator, which is provided and communicates with one of the lumens, and has a tubular portion coaxial with the catheter tube, and provided on the catheter tube proximal to the first dilator Hub having a side hole for drug injection formed in communication with one of the other lumens and a plurality of flow paths communicating with the lumen of the catheter tube and connected to the base end of the catheter tube And communicates with another lumen that communicates with another flow path of the hub on the side closer to the base than the side hole, or communicates with the same lumen as the first expansion body, and is coaxial with the catheter tube. Second expansion body having a simple tubular portion It is achieved by vascular reocclusion preventing catheter characterized in that it is more configurations.

[0006]

The catheter for preventing re-occlusion of blood vessels according to the present invention stops the blood flow by expanding the expansion body downstream of the site where the stenosis of the inner wall of the blood vessel is compressed / expanded by the expansion body to stop the blood flow. A drug such as an anti-cancer drug can be injected through a side hole provided on the side so that the drug acts on the dilated site. Also, in the case of flap-like intimal detachment due to intimal injury due to over-stretching in angioplasty, the blood flow is stopped by inflating the dilator at a low pressure downstream of the detached part to prevent the blood flow from the dilator. Thrombin and other coagulation promoters are injected from the side holes provided on the base side to coagulate blood at the exfoliation site, and the coagulated product is expanded and pressure-bonded to the inner wall of the blood vessel by the expansion body to cause flap-like intimal exfoliation. The part can be fixed to the inner wall of the blood vessel, thereby eliminating the risk of re-occlusion of the blood vessel.

Hereinafter, the present invention will be described more specifically based on the embodiments.

FIGS. 1 (a) to 1 (c) are sectional views of an embodiment of a catheter for preventing re-occlusion of blood vessels according to the present invention.

Catheter 2 for preventing re-occlusion of blood vessels of this embodiment
1 is divided into three lumens (lumens) 23A by the partition wall 22,
23B, 23C having a catheter tube 24 made of vinyl chloride resin, polypropylene, polyethylene or other soft thermoplastic resin or synthetic rubber such as ethylene-propylene rubber or silicone rubber having an outer diameter of about 1 to 3 mm. ing. In the vicinity of the distal end 25 of the catheter tube 24, a thin wall (0.03 to 0.1 mm) formed by blow molding or the like in advance has at least a tubular portion, more preferably a tubular portion coaxial with the catheter tube. A thermoplastic resin such as vinyl chloride resin, polypropylene, or polyethylene, or a radiation-crosslinked resin thereof, or a first expansion body 26 made of synthetic rubber such as ethylene-propylene rubber or silicone rubber is used for the catheter tube 24, for example. It is provided by being inserted into the expansion body 26 of the first expansion body 26 and liquid-tightly adhered to the outer peripheral surface of the catheter tube 24 at both side ends 27 and 28 of the first expansion body 26 with an adhesive or heat fusion. A part of the catheter tube 24 surrounded by the first expansion body 26 is
A communication hole 29 communicating with one of the lumens 23A is provided so that the inside of the first expansion body 6 communicates with the lumen 23A. Further, at the tip of the catheter tube 24,
A guide member (guide wire) 30 for facilitating the introduction of the blood vessel re-occlusion prevention catheter 21 into the narrowed portion in the blood vessel is inserted into any two of the lumens 23A, 23B and 23C, and an adhesive or the like. And the distal ends of the two lumens are liquid-tightly sealed. Further, the tip of the other lumen is also liquid-tightly sealed by an adhesive or heat fusion.

The catheter tube 24 is also provided with a side hole 31 communicating with a lumen 23B different from the lumen 23A communicating with the first expansion body 26 on the base side of the first expansion body 26. There is.

As described above, the flap-shaped peeling portion F can be more accurately set in the diffusion range of the agent such as the coagulant released from the side hole 31.
The second expansion body 36 is provided in the vicinity of the side hole 31 and closer to the base side so that the procedure can be performed more safely, but the catheter tube 24 has the first expansion body 26 as described above. And a lumen 23A communicating with the side hole 31, respectively.
23B, which has a lumen 23C different from that of 23B.
Communicates with the second expansion body 36 through the communication hole 37.

Also, the proximal end 32 of the catheter tube 24.
Is provided with a three-way hub 34 made of a thermoplastic resin such as vinyl chloride resin, polypropylene, polystyrene, or polycarbonate, which has flow channels 33A, 33B, 33C communicating with the respective lumens 3A, 3B, 3C. .

The blood vessel reocclusion preventing catheter 21 of this embodiment having such a structure can be used for the treatment of intimal injury of the blood vessel as follows.

As a complication after the percutaneous transluminal angioplasty as described above, the intima of the blood vessel is damaged as shown in FIG. 4 (a) due to the property of the blood vessel wall or the hyperextension of the dilator. , Flap-like detachment F may occur, which causes re-occlusion of blood vessels.
Check the damaged area. Next, expander 2 of appropriate size
After selecting the blood vessel reocclusion prevention catheter 21 having 6, 36 and extracting air in the lumens 23A, 23B, 23C and the first and second dilating bodies 26, 36 by a normal procedure, the catheter 21 shown in FIG. As shown in (b), the blood vessel reocclusion prevention catheter 21 is introduced into the blood vessel so that the first dilation body 26 is located on the peripheral side of the flap-shaped peeling portion F. While injecting a liquid (for example, a contrast agent, physiological saline) under pressure while confirming the internal pressure from one of the inlet ports 35A and 35C of the three-port hub 24 with a pressure gauge (not shown) using a syringe (not shown) or the like. Then, as shown in FIG. 4 (c), the first and second expansion bodies 2
6 and 36 are inflated to block the blood flow, and a blood coagulant (for example, thrombin and blood coagulation factor VIII mixed solution) is immediately injected from the other inlet port 35B of the three-port hub 24, and the blood flow shown in FIG. 4), the blood coagulant is released from the side holes 31 into the blood and diffused, thereby coagulating the blood at the peeling site as shown in FIG. 4 (e). Next, as shown in FIG. 4 (f), the liquid in the first and second expansion bodies 26, 36 is sucked and contracted, and as shown in FIG. The catheter 21 for preventing re-occlusion of blood vessel is pulled back so that the tubular portion is located. Subsequently, as shown in FIG. 4 (h), the first expansion body 26 is pressurized and injected with a liquid, and is expanded again to compress the coagulated product, and the flap-shaped peeling portion F is fixed to the inner wall of the blood vessel. Finally, as shown in FIG. 4 (i), the first expansion body 26 is contracted, and the revascularization preventing catheter 21 is removed. The remaining coagulation in the blood vessels (fibrin)
The gland-dissolving system of the living body works and is dissolved, and the inner surface of the blood vessel is smoothly prevented from being re-occluded.

2 to 3 show another embodiment of the catheter for preventing reocclusion of blood vessel according to the present invention.

The blood vessel re-occlusion prevention catheter 41 of another embodiment shown in FIG. 2 also has a second expansion body 56 like the blood vessel re-occlusion prevention catheter 21 shown in FIG. , 43 A communicating with the first expansion body 46 through the communication hole 57.

Further, as shown in FIGS. 3 (a) to 3 (e), the blood vessel reocclusion preventing catheter 61 of the present invention is subjected to the first expansion after blood coagulation by the coagulant at the flap-shaped peeling site. A third, further expansion body 66 and a second expansion body 76 are provided between the first expansion body 66 and the second expansion body 76 so that the coagulate can be immediately compressed and the flap-like detachment can be fixed to the inner wall of the blood vessel without moving the body 66. It is also possible to provide the expansion body 78 of adjacent to the side hole 71. In the catheter 61 for preventing blood vessel re-occlusion of the present embodiment, the catheter tube 64 is different from the lumens 63A, 63B, 63C communicating with the first dilation body 66, the second dilation body 76 and the side hole 71, respectively. Lumen 6
3D, and the lumen 63D communicates with the third expansion body 78 via the communication hole 79. Further, the hub 74 has a flow path 73D communicating with the lumen 63D and an introduction port 75D.

In the blood vessel re-occlusion prevention catheter 61 of this embodiment, as in the case of the blood vessel re-occlusion prevention catheter 41 shown in FIG. 2, the lumen communicating with the second dilation body 76 is the first. It is also conceivable that the lumen 63A communicates with the expansion body 66 of FIG.

In the case of FIG. 3, the parts of FIGS. 1 (a) to 1 (c) to which the reference numeral of the number obtained by subtracting 20 is attached are shown in FIG.
Cases (e) to (e) correspond to the parts shown in FIG. In addition to this embodiment, it is naturally conceivable that a guide wire cavity is provided so that a lumen and a guide wire communicating with the dilator can be inserted from the hub so that the guide wire protrudes from the distal end of the catheter.

[0020]

As described above, the present invention provides a multi-channel tubular catheter tube having two or more lumens which are partitioned by a partition wall formed in the axial direction and communicate with each other in the axial direction. A first expansion body provided near the distal end of the catheter tube and communicating with one of the lumens and having a tubular portion coaxial with the catheter tube; and a base side of the first expansion body with respect to the first expansion body. A drug injection side hole provided on the catheter tube and communicating with one of the other lumens, and a plurality of flow paths respectively communicating with the lumen of the catheter tube, and at the base end of the catheter tube. A hub which is connected and communicates with another lumen that communicates with another flow path of the hub on the side closer to the base than the side hole, or communicates with the same lumen as the first expansion body, Has a tubular part that is coaxial with the catheter tube Since it is a catheter for preventing re-occlusion of blood vessels, which is characterized in that it is composed of two dilators, when angioplasty using the dilatation catheter was performed when stenosis or occlusion of blood vessels occurred, Even if there is a risk of re-occlusion due to flap-like detachment that damages the intima of the blood vessel due to stretching, etc., the detached part can be repaired easily, safely, and quickly, and treatment is conventionally impossible. However, due to such flap-like intimal detachment, intravascular re-occlusion occurred and surgical treatment was required, and the load on the patient was very large. It also reduces medical costs.

Furthermore, it is possible to prevent reocclusion of the site of angioplasty.

[Brief description of drawings]

FIG. 1 (a) is a longitudinal sectional view of a first embodiment of a catheter for preventing re-occlusion of blood vessels according to the present invention, and FIG. 1 (b) is shown in FIG.
1A is a cross-sectional view taken along the line bb ', and FIG. 1C is a cross-sectional view taken along the line cc' of FIG. 1A.

FIG. 2 is a partial longitudinal cross-sectional view of a second embodiment of the blood vessel repair catheter of the present invention.

FIG. 3 (a) is a partial longitudinal cross-sectional view of a third embodiment of a catheter for preventing re-occlusion of blood vessels according to the present invention, and FIG. 3 (b) is a bb 'cross section of FIG. 3 (a). 3C is a plan view and FIG.
3A is a transverse cross-sectional view, FIG. 3D is a transverse cross-sectional view taken along d-d 'in FIG. 3A, and FIG. 3E is ee' in FIG.
FIG.

4 (a) to 4 (i) are views showing an example of use of the first embodiment of the revascularization preventive catheter of the present invention.

[Explanation of symbols]

21, 41, 61 ... Catheter for preventing re-occlusion of blood vessels, 23B, 23C, 43A, 43B, 63A, 63B, 6
3C, 63D ... Lumen, 24, 44, 64 ... Catheter tube, 26, 46, 66 ... Dilation body, 31, 51, 71 ... Side hole, 34, 54, 74 ... Hub, F ... Flap-shaped peeling section.

Claims (1)

[Claims] 1. A multi-channel tubular catheter tube having two or more lumens defined by a partition formed inside in the axial direction and communicating with each other in the axial direction; A first dilator communicating with one of the lumens and having a tubular portion coaxial with the catheter tube, and provided on the catheter tube proximal to the first dilator and the other A drug injection side hole communicating with one of the lumens, a hub having a plurality of flow paths respectively communicating with the lumen of the catheter tube, and a hub connected to the proximal end of the catheter tube, and this side A tubular portion coaxial with the catheter tube, which communicates with another lumen communicating with another flow path of the hub on the base side of the hole or communicates with the same lumen as the first expander. And a second extension body having A catheter for preventing reocclusion of blood vessels, which is characterized in that: