JPH0546424Y2 - - Google Patents

Description

[Detailed description of the invention] "Industrial application field" This invention is used to temporarily stop the flow of blood in blood vessels, for example, when an aneurysm or varicose vein ruptures or when there is intracerebral hemorrhage. Concerning blood duct obstruction devices.

"Prior Art" For example, when an artery or vein ruptures or when there is intracerebral hemorrhage, it may not be possible to immediately provide treatment due to the amount of bleeding. In such cases, treatment is performed after temporarily stopping the blood flow using a blood duct occluding device.

As such a blood duct occluding device, one is known that is made of a metal coil, and when inserted into a blood vessel, the device tangles randomly to occlude the blood duct. This type of blood duct occluding device can be inserted by simply inserting a guide tube such as a catheter into the blood vessel, inserting the occluding device into the guide tube and pushing it out with a pusher, etc., and can stop the blood flow quickly and reliably. It has the advantage of being able to stop bleeding.

As an example of such a blood duct obturator, as shown in FIG. 11, a wire 2 made of stainless steel or the like is formed into a coil shape to form a primary coil 2a, and this primary coil 2a is formed into a randomly entwined state to form a second coil. A secondary coil 2b is known.

In order to insert this blood channel obturator 1 into a blood vessel, first, a catheter is percutaneously inserted into the blood vessel using a puncture needle and placed at a predetermined location. Next, a method is adopted in which a blood path occlusion device is inserted into the catheter, pushed out with a pusher, etc., and inserted into the blood vessel. That is, as shown in FIG.
The secondary coil 2b, which is tangled so as to occlude the blood path, is stretched by hand, for example, in the direction of the arrow in FIG. Insert within 4. Then, the catheter 4 is pushed out from the tip of the catheter 4 into the blood vessel 3 by the pusher 5. Obturator 1
When pushed out into the blood vessel 3, it returns to the state of the secondary coil 2b due to its elastic restoring force, occluding the inside of the blood vessel and stopping the flow of blood.

``Problem to be solved by the invention'' However, in the blood duct occluding device 1 made of such a coil, it was difficult to completely occlude the blood duct only with the coil because a gap was created between the pitches of the coils. . For this reason, attempts have been made to insert Dacron fibers or the like between the pitches of the coil to enhance the occlusion effect, but this sometimes makes it difficult for the coil to shrink in diameter, making it difficult to insert it through a catheter.

Furthermore, in order to tightly entangle the coils within the blood vessel to enhance the occlusion effect, the length of the primary coil 2a needs to be sufficiently long. Therefore,
As shown in FIG. 6, when the secondary coil 2b is stretched linearly by an external force when inserted into the catheter 4, the length l of the primary coil 2a becomes considerably long. For this reason, the frictional resistance during insertion into the catheter 4 increased, making it impossible to push it out smoothly.

For this reason, in practice, the primary coil 2a is inserted into a linear guide tube (cartridge), this guide tube is inserted into a catheter, guided into the blood vessel, and pushed out from the guide tube by a pusher. . However, with this method, because the guide tube is straight, it is difficult to enter into bent blood vessels.
There were restrictions on where it could be applied.

SUMMARY OF THE INVENTION Therefore, an object of the present invention is to provide a blood path occlusion device that can more completely occlude a blood path and is easy to insert into a blood vessel.

"Means for Solving the Problems" In order to achieve the above object, the blood duct occlusion device of the present invention has a tube having a thickness and flexibility that can be inserted into a blood vessel, and a distal end of the tube that can be separated. placed,
A cylindrical member whose tip portion is expandable in diameter and has an annular rib formed on the inner periphery; and a diameter-expanding member disposed inside the cylindrical member and locked in a predetermined position by the rib. and an operating wire having one end connected to the diameter expanding member, the other end extending outside through the cylindrical member and the tube, and having a notch portion that can be cut by applying a predetermined tension. The inner periphery of the cylindrical member is divided by the ribs into a distal end portion with a large inner diameter and a proximal end portion with a small inner diameter, and the inner diameter of the proximal portion is smaller than the diameter of the enlarged diameter member. It is characterized by being formed smaller than the outer diameter of.

"Operation" When using the blood duct obstruction device of the present invention, first,
A cylindrical member is placed at the tip of the tube, and a diameter expanding member is placed near the tip of the cylindrical member where the inner diameter is large.
An operating line connected to the diameter expanding member is extended to the outside through the cylindrical member and the tube. and,
The operating wire is pulled appropriately to bring the cylindrical member into contact with the tip of the tube, and in this state, the tube is inserted into the blood vessel, and the tip of the tube is placed in the part of the blood vessel that is desired to be occluded. At this time, since the diameter expanding member is installed near the tip of the cylindrical member where the inner diameter is large,
The cylindrical member is in a reduced diameter state and can be easily inserted into a blood vessel. Furthermore, since the tube is flexible, it can be inserted into curved blood vessels.

Next, the operating wire is pulled to move the diameter-expanding member from the distal end portion of the cylindrical member to the proximal end portion of the cylindrical member, and the expanded diameter member is fitted into that portion. Since the inner diameter of the proximal portion is smaller than the outer diameter of the diameter-expanding member, when the diameter-expanding member is inserted, the tip of the cylindrical member expands in diameter to occlude the inside of the blood vessel. When the operating wire is further pulled in this state, the operating wire is cut at the notch, and the cylindrical member is separated from the tube and left in the blood vessel together with the diameter expanding member. In this way, since the diameter of the tip of the cylindrical member is expanded to close the inside of the blood vessel, a more reliable occlusion effect can be obtained than in the case of using a coil.

"Embodiment" FIGS. 1 to 5 show an embodiment of a blood duct obturator according to the present invention. Fig. 1 shows the state when the blood duct obturator is inserted into the blood vessel, Fig. 2 shows the state where the diameter of the cylindrical member is expanded within the blood vessel, and Fig.
The figure shows a state in which the cylindrical member is placed in a blood vessel. Moreover, FIG. 4 shows a sectional view of the cylindrical member, and FIG. 5 shows a perspective view of the cylindrical member. Note that 14 in the figure represents a blood vessel.

This blood vessel obturator 12 is made of silicone resin, for example.
Flexible tube 1 made of polyethylene resin, etc.
It is equipped with 6. This tube 16 is made thick enough to be inserted into a blood vessel. tube 1
As 6, a general catheter or the like can also be used.

At the tip of this tube 16, there is a tube 16.
A cylindrical member 18 having approximately the same diameter is in contact with the cylindrical member 18 . As the material of the cylindrical member, synthetic resins such as nylon, Teflon, polyethylene, etc. are preferably used, but metals such as stainless steel may also be used. Annular ribs 22 and 24 are formed on the inner periphery of the cylindrical member 18 at predetermined intervals in the axial direction. The inner periphery of the cylindrical member 18 is divided into a tip end portion 26 and a base end portion 28 with the rib 22 as a boundary. Note that the proximal end portion 28 is sandwiched between the rib 22 and the rib 26.

As shown in FIG. 4, the inner diameter m of the distal end portion 26 is larger than the inner diameter m' of the proximal end portion 28. As shown in FIG. In addition, the inner diameter of the proximal portion 28
m' is set to be smaller than the outer diameter of a diameter expanding member 32, which will be described later. Furthermore, the inner diameter n of the rib 24 closer to the proximal end is smaller than the inner diameter n of the rib 22 closer to the distal end.
n′ is formed smaller.

Furthermore, as shown in FIG. 5, a plurality of slits 34 are formed along the axial direction at the tip of the cylindrical member 18, and the slits 35 divide the tip into a plurality of parts to expand the diameter. It is considered possible. Note that the distal end portion 20 of the cylindrical member 18 is made of
Preferably, it is rounded.

Inside this cylindrical member 18, a spherical enlarged diameter member 32 is provided.
is located. In this embodiment, the diameter expanding member 32 is made of a stainless steel ball, but it may be made of other metal or synthetic resin. Diameter expanding member 32
An operating wire 30 made of metal such as stainless steel or synthetic resin is connected to the control wire 30 . The operating line 30 passes through the cylindrical member 18 and the tube 16 and extends from the base end of the tube 16 to the outside. Further, a notch portion 30a is formed in the middle of the operating line 30, which is cut at that portion when a tension of a predetermined value or more is applied.

Next, a method of using this blood vessel obturator 12 will be explained.

The spherical expanding diameter member 32 is disposed near the tip end portion 26 of the cylindrical member 18, and the operating line 30 is connected to the cylindrical member 18.
and extends through the tube 16 to the outside from the proximal end of the tube 16. In the case of this embodiment, the expanding diameter member 32 is disposed at the tip-side portion 26, partially protrudes from the tip of the cylindrical member 18, and has a rounded tip. Further, since the inner diameter m of the tip-side portion 26 is formed to be large, the diameter of the cylindrical member 18 is hardly expanded even if the diameter expanding member 32 is disposed.

In this state, the tube 16 is percutaneously inserted into the blood vessel 14 using a puncture needle or the like while applying a certain amount of tension to the operating wire 30 and bringing the cylindrical member 18 into contact with the distal end of the tube 16 . In this case, tube 1
6 may be inserted directly into the blood vessel 14, or may be inserted via a catheter or the like into which the tube 16 can be inserted. Since the cylindrical member 18 has approximately the same diameter as the tube 16 and the tube 16 is flexible, it can be easily inserted into the curved path of the blood vessel 16.

After the tube 16 is inserted into the blood vessel 14 in this manner, the cylindrical member 18 at the distal end of the tube 16 is placed at a desired position for occlusion. And the operation line 30
is pulled to draw the expanding diameter member 32 toward the base side, and move it over the rib 22 to the base-side portion 28. In this part, the expanding diameter member 32 is connected to the rib 22
and the ribs 24 and are locked. Since the inner diameter m' of the proximal portion 28 is smaller than the outer diameter of the expanding diameter member 32, as shown in FIG.
The slit 34 is opened and the tip of the tube is expanded in diameter, and the blood vessel 1 is opened.
4 is blocked. The enlarged diameter of the cylindrical member 18 is such that a sufficient occluding effect can be obtained.
The thickness is preferably 3 to 8 mm.

Thereafter, when the operating wire 30 is pulled more strongly, the operating wire 30 is cut at the notch 30a, and the cylindrical member 18 is separated from the tube 16 and placed in the blood vessel 14, as shown in FIG. . The tube 16 and the operating wire 30 are pulled out from within the blood vessel 14. In this way, the cylindrical member 18 with an enlarged diameter can be placed in the blood vessel 14 and occluded, thereby stopping the blood flow.

FIG. 6 shows another embodiment of the blood vessel obturator of the present invention.

In the embodiment shown in FIGS. 1 to 5, the tube 16 and the cylindrical member 18 are in a separated state from the beginning, but in this embodiment, the tube 36 and the cylindrical member 18 are connected. It is designed to be separated after being inserted into the blood vessel 14. FIG. 6 shows a state in which the tube 36 and the cylindrical member 18 are separated.

A tube 36 made of silicone resin, polyethylene, or the like is connected to the cylindrical member 18 by means such as welding, adhesion, or integral molding. A heating element 38 made of a metal coil made of a material with high electrical resistance is buried in the connecting portion in an annular shape. Further, lead wires 38a, 3 for energizing the heating element 38 are provided.
8b is buried along the axial direction of the tube 36, taken out from the base end of the tube 36, and connected to a power source (not shown). In addition, the heating element 38
The lead wires 38a and 38b do not necessarily need to be embedded in the wall of the tube 36, and may be bonded along the inner or outer wall of the tube 36, for example.

Therefore, in this blood duct obstruction device 12,
The cylindrical member 18 and the tube 36 are inserted into the blood vessel 14 in a connected state, and the operating wire 30 is pulled to fit the diameter expanding member 32 into the proximal portion 28 to expand the diameter of the cylindrical member 18. After further pulling the operating wire 30 and cutting it at the notch, the lead wires 38a, 38
b is energized to heat the heating element 38. By heating, the connection portion between the cylindrical member 18 and the tube 36 is melted and separated, and the cylindrical member 18 is placed in the blood vessel 14.

7 to 9 show different examples of the diameter expanding member in the blood vessel obturator of the present invention.

In the diameter expanding member 40 shown in FIG. 7, an intermediate portion 40a has a cylindrical shape, and a distal end portion 40b and a proximal end portion 40c have a conical shape. The diameter expanding member 42 shown in FIG. 8 has a conical tip portion 42a and a hemispherical proximal portion 42b. The diameter expanding member 44 in FIG. 9 has a conical shape with the top directed toward the proximal end. In this way, various shapes can be used as the diameter expanding member.

FIG. 10 shows still another embodiment of the blood vessel obturator of the present invention.

In this blood channel obturator 12, a reduced diameter portion 46a is formed at the distal end of the tube 46, and the reduced diameter portion 46a is inserted into the inner periphery of the proximal end of the cylindrical member 48 in such a manner that it can freely come out. Therefore, when inserting the blood vessel obturator 12, the tube 46 and the cylindrical member 48
This can prevent the axis from being misaligned. Further, the tip 50 of the cylindrical member 48 is formed thinner than other portions, and is divided by a plurality of slits 34 along the axial direction. The inner periphery of the cylindrical member 48 has 3
Three annular ribs 52, 53, and 54 are formed at predetermined intervals, and the intermediate rib 53 defines a portion 56 near the tip with a large inner diameter and a portion 56 near the proximal end with a small inner diameter.

In this embodiment, the spherical expanding diameter member 32 is disposed at the distal end portion 55 and held between the ribs 52 and 53 when the blood channel obturator 12 is inserted.
Then, after being inserted into a predetermined position within a blood vessel, when the operating wire 30 is pulled, the diameter expanding member 32 is inserted into the rib 53.
It moves over the proximal end portion 55 and into the proximal end portion 56 having a small inner diameter, and fits between the ribs 53 and 54. At this time, since the inner diameter of the proximal end portion 56 is smaller than the outer diameter of the expanding diameter member 32, the slit 34 of the cylindrical member 48 is opened and the tip 56 is opened.
0 expands. In this case, the tube tip 50 is connected to the expanding diameter member 3.
2, the amount of diameter expansion is relatively large.

"Effect of the invention" As explained above, according to the invention, since the diameter of the cylindrical member is expanded to occlude the inside of the blood vessel, a more reliable occlusion effect can be obtained than when using a coil or the like. can. In addition, a cylindrical member is placed at the tip of the flexible tube, and the cylindrical member is inserted into the blood vessel with its diameter not expanded. It is easy to insert into routes and can be applied to a wider range of locations. Furthermore,
After inserting the tube into the blood vessel, the diameter of the cylindrical member is expanded mechanically by pulling the operating wire and moving the diameter expansion member, so the diameter of the cylindrical member is reliably expanded and operational errors are prevented. be able to.

[Brief explanation of the drawing]

FIG. 1 is a sectional view showing a state in which a blood duct occlusion device according to an embodiment of the present invention is inserted into a blood vessel, FIG. The figure is a sectional view showing the tubular member of the blood duct obturator placed in a blood vessel, FIG. 4 is a sectional view of the cylindrical member of the blood duct obturator, and FIG. 5 is a perspective view of the cylindrical member. FIG. 6 is a cross-sectional view showing a blood duct obturator according to another embodiment of the present invention, and FIGS. 7, 8, and 9 are perspective views showing different examples of the diameter expanding member in the blood duct obturator of the present invention. , FIG. 10 is a cross-sectional view showing a blood duct obturator according to still another embodiment of the present invention, FIG. 11 is a perspective view showing a conventional blood duct occluding device in a state in which its shape has been restored, and FIG. 12 is a sectional view of a conventional blood duct occluding device. FIG. 2 is an explanatory diagram showing a method of inserting the . In the figure, 12 is a blood vessel obturator, 14 is a blood vessel, 16 is a tube, 18 is a cylindrical member, 22 and 24 are ribs,
26 is a portion near the distal end, 28 is a portion near the proximal end, 30
is an operating line, 30a is a notch, 32 is a diameter expanding member, 3
4 is slit, 36 is tube, 40, 42, 4
4 is a diameter expanding member, 46 is a tube, 48 is a cylindrical member, 52, 53, 54 are ribs, 55 is a portion near the tip, and 56 is a portion near the base end.

Claims (1)

[Claims for Utility Model Registration] A tube having a thickness and flexibility that can be inserted into a blood vessel;
A cylindrical member whose tip portion is expandable in diameter and has an annular rib formed on the inner periphery; and a diameter-expanding member disposed inside the cylindrical member and locked in a predetermined position by the rib. and an operating wire having one end connected to the diameter expanding member, the other end extending outside through the cylindrical member and the tube, and having a notch portion that can be cut by applying a predetermined tension. The inner periphery of the cylindrical member is divided by the ribs into a distal end portion with a large inner diameter and a proximal end portion with a small inner diameter, and the inner diameter of the proximal portion is smaller than the diameter of the enlarged diameter member. A blood duct obstruction device characterized in that it is formed smaller than the outer diameter of the device.