JP7403617B1 - catheter - Google Patents

Abstract

The present invention provides a catheter suitable for a procedure in which the catheter is passed through the subclavian artery and inserted into a predetermined blood vessel. A catheter 1 is a flexible shaft 2 whose at least the distal end side is inserted into the body, and has a lumen through which a guide member is inserted and a curved shaft when the guide member is not inserted into the lumen. a shaft 2 having a curved portion 14; an expandable balloon 4 provided on the shaft 2 on the distal side of the curved portion 14; a radiographic imaging unit 8 provided on the shaft 2 and whose position corresponds to the curved portion 14; Equipped with. [Selection diagram] Figure 1

Description

The present disclosure relates to catheters.

A catheter is a member inserted into the body for diagnosis or treatment. For example, Patent Document 1 discloses a guiding catheter that is inserted into a blood vessel and guides a stent to a target site in the blood vessel.

Japanese Patent Application Publication No. 2004-357805

A known technique is to insert a catheter for guiding a medical device such as a stent from the right or left subclavian artery into the right or left common carotid artery. As a result of extensive studies, the inventors of the present invention have found a catheter suitable for a procedure in which the catheter is passed through the subclavian artery and inserted into a predetermined blood vessel including the common carotid artery.

The present disclosure has been made in view of these circumstances, and an object thereof is to provide a catheter suitable for a procedure in which the catheter is passed through the subclavian artery and inserted into a predetermined blood vessel.

An aspect of the present disclosure is a catheter that is inserted into a predetermined blood vessel through the right subclavian artery or the left subclavian artery to guide a medical device. This catheter is a flexible shaft that is inserted into the body at least on the distal end side, and has a lumen through which a guide member is inserted, and a curved portion that is bent when the guide member is not inserted into the lumen. an expandable balloon provided on the distal side of the curved portion of the shaft; and a radiographic imaging unit provided on the shaft and whose position corresponds to the curved portion.

Another aspect of the present disclosure is a catheter that is inserted into a predetermined blood vessel through the right subclavian artery or the left subclavian artery to guide a medical device. This catheter is a flexible shaft that is inserted into the body at least at its distal end, and includes a lumen through which a medical device is inserted, and a curved portion that is bent into a curved shape by operating a handle provided at the proximal end of the shaft. An expandable balloon is provided on the distal side of the curved portion of the shaft, and a radiographic imaging unit is provided on the shaft and is positioned in correspondence with the curved portion.

Arbitrary combinations of the above components and expressions of the present disclosure converted between methods, devices, systems, etc. are also effective as aspects of the present disclosure.

According to the present disclosure, it is possible to provide a catheter suitable for a procedure in which the catheter is passed through the subclavian artery and inserted into a predetermined blood vessel.

FIG. 2 is a side view of a catheter according to an embodiment. FIG. 2(A) is a sectional view of the shaft. FIG. 2(B) is an enlarged view of the curved portion. It is a side view of a guide member. FIGS. 4(A) to 4(I) are diagrams illustrating the first procedure. FIGS. 5(A) to 5(H) are diagrams for explaining the second procedure. FIGS. 6(A) to 6(H) are diagrams illustrating the second procedure. FIGS. 7(A) to 7(H) are diagrams illustrating the third technique. FIGS. 8(A) to 8(E) are diagrams illustrating the third technique. FIGS. 9(A) to 9(H) are diagrams illustrating the fourth technique.

Hereinafter, the present disclosure will be described based on preferred embodiments with reference to the drawings. The embodiments are illustrative rather than limiting the present disclosure, and all features and combinations thereof described in the embodiments are not necessarily essential to the present disclosure. Identical or equivalent components, members, and processes shown in each drawing are designated by the same reference numerals, and redundant explanations will be omitted as appropriate. Further, the scale and shape of each part shown in each figure are set for convenience to facilitate explanation, and should not be interpreted in a limited manner unless otherwise mentioned. Furthermore, when terms such as "first" and "second" are used in this specification or the claims, unless otherwise specified, these terms do not indicate any order or importance; This is to distinguish between this and other configurations. Furthermore, in each drawing, some members that are not important for explaining the embodiments are omitted.

FIG. 1 is a side view of a catheter 1 according to an embodiment. FIG. 2(A) is a sectional view of the shaft 2. FIG. 2(B) is an enlarged view of the curved portion 14. In FIG. 1, the balloon 4 is shown in an expanded state. Further, in FIG. 1, illustration of the cover 10 is omitted. FIG. 2(A) shows a cross section perpendicular to the axis of the shaft 2. FIG. 2(B) shows a state in which the cover 10 is seen through.

The catheter 1 according to the present embodiment is a catheter that passes through the right subclavian artery 28 or the left subclavian artery 30 and is inserted into a predetermined blood vessel to guide a medical device (not shown). Examples of the predetermined blood vessels include the common carotid artery, external carotid artery, internal carotid artery, subclavian artery, brachiocephalic artery, and vertebral artery. In this embodiment, a procedure for inserting a catheter into a blood vessel will be described using the right common carotid artery 32 or the left common carotid artery 34 as an example of a predetermined blood vessel. The catheter 1 includes an elongated shaft 2, a balloon 4, a handle 6, a radiographic imaging section 8, and a cover 10. In this embodiment, "long" means that the ratio of the first length in the longitudinal direction to the second length in the direction perpendicular to the longitudinal direction (first length/second length) is, for example, 5 or more. Say something. The first length is the length in the direction in which the axis of the shaft 2 extends when the entire shaft 2 is extended linearly.

The shaft 2 is made of a flexible tubular body, and at least its distal end side is inserted into the body. The shaft 2 is constructed from known flexible materials including resins such as polyolefin, polytetrafluoroethylene, polyether block amide, polyamide, polyurethane, and silicone. The first length of the shaft 2 is, for example, 600 mm to 1800 mm. The shaft 2 has a lumen 12 and a curved portion 14. The lumen 12 extends from one end of the shaft 2 to the other end, and a guide member 18 (see FIG. 3), which will be described later, and a medical device are inserted therethrough. The curved portion 14 has a curved shape when the guide member 18 is not inserted into the lumen 12 (when no external force is applied to the shaft 2).

For example, the curved portion 14 is V-shaped (bent shape) or U-shaped (curved shape). The region of the shaft 2 from the balloon 4 to the front of the curved portion 14 and the region from the handle 6 to the front of the curved portion 14 are linear when the guide member 18 is not inserted into the lumen 12, and are in a straight line with respect to each other. Extends in the intersecting direction. For example, the angle between the two regions is an acute angle.

The balloon 4 is provided around the axis of the shaft 2 on the tip side (distal end side) of the curved portion 14 of the shaft 2 . Balloon 4 is approximately spherical. Hereinafter, the side of the catheter 1 or shaft 2 on which the balloon 4 is provided will be simply referred to as the "distal end side". The balloon 4 is expandable by fluid supplied from the proximal end side of the shaft 2 . The fluid is, for example, physiological saline. The balloon 4 is constructed of known flexible materials including resins such as polyolefin, polytetrafluoroethylene, polyether block amide, polyamide, polyurethane, and silicone.

The handle 6 is provided on the proximal end side of the shaft 2. Hereinafter, the side of the catheter 1 or shaft 2 on which the handle 6 is provided will be simply referred to as the "proximal end side" as appropriate. The handle 6 is placed outside the body when the catheter 1 is used, and is grasped or operated by an operator. The handle 6 has a first port 6a and a second port 6b.

The first port 6a is connected to the base end of a fluid lumen (not shown) provided in the shaft 2. The tip of the fluid lumen is connected to the balloon 4. By flowing fluid into the first port 6a, the fluid is supplied to the balloon 4 and the balloon 4 is expanded. Further, by discharging the fluid from the first port 6a, the fluid is discharged from the balloon 4, and the balloon 4 is deflated. The second port 6b is connected to the proximal end of the lumen 12. The guide member 18 and the medical device are inserted into and removed from the lumen 12 via the second port 6b.

The radiographic imaging part 8 is provided on the shaft 2, and its position with the curved part 14 is matched according to a predetermined rule. That is, the distance of the radiographic imaging section 8 from the curved section 14 is determined. Therefore, the operator of the catheter 1 can know the position of the curved section 14 from the position of the radiographic section 8 by knowing in advance the rules regarding the positional relationship between the curved section 14 and the radiographic section 8 . The radiographic contrast section 8 is a so-called contrast marker, and is made of a radiopaque material such as Au or Pt. The radiation is, for example, an X-ray. The operator of the catheter 1 can confirm the position of the radiographic imaging part 8 and, by extension, the position of the curved part 14 based on the radiographic image.

Preferably, the position of the radiographic imaging part 8 and the position of the apex of the curved part 14 are correlated. The catheter 1 of this embodiment has one radiographic imaging section 8 , and the radiographic imaging section 8 is arranged at the apex of the curved section 14 . In other words, the distance of the radiographic imaging unit 8 from the vertex is substantially 0. In this case, the distance between the radiographic imaging unit 8 and the vertex is 0, which corresponds to the above-mentioned rule. The apex of the curved portion 14 is the bottommost part (the most protruding part) of the V-shape or U-shape. Note that the catheter 1 may have a plurality of radiographic contrast units 8. For example, as shown by the two-dot chain line in FIG. 2(B), the catheter 1 has two radiographic contrast sections 8. One of the radiographic imaging units 8 is provided at a position shifted from the apex by a predetermined distance L toward the distal end. The other radiographic imaging unit 8 is provided at a position shifted from the apex by the same distance L toward the proximal end. That is, the two radiographic contrast units 8 are arranged at the apex so that an isosceles triangle is formed, with the vertex of the curved portion 14 as the apex angle and the two radiographic contrast units 8 as the two base angles. In this case, the above-mentioned rule corresponds to the fact that the two radiographic contrast units 8 are shifted from the apex by a predetermined distance L in opposite directions.

The cover 10 covers at least the radiographic imaging section 8 and the boundaries 16a, 16b of the shaft 2. The cover 10 is constructed from known flexible materials including resins such as polyolefin, polytetrafluoroethylene, polyether block amide, polyamide, polyurethane, and silicone. The cover 10 of this embodiment covers the proximal boundary 16a of the cover 10 and the shaft 2, the distal boundary 16b of the cover 10 and the shaft 2, and the entire radiographic imaging section 8. When the curved portion 14 is elastically deformed, the edge portion of the radiographic imaging portion 8 may protrude from the surface of the shaft 2. By covering the boundaries 16a and 16b with the cover 10, it is possible to prevent the edge portion of the radiographic imaging unit 8 from coming into direct contact with the inner wall of the blood vessel or the like. Note that when the catheter 1 has a plurality of radiographic contrast sections 8, it is preferable that a cover 10 is provided for each radiographic contrast section 8.

FIG. 3 is a side view of the guide member 18. Guide member 18 includes a guide wire 20 and a child catheter 22. The guide wire 20 is a long body made of stainless steel or the like, and has flexibility and bending rigidity. Child catheter 22 has an elongated shaft 24 and a handle 26. The shaft 24 is made of a flexible tubular body. Shaft 24 is constructed from known flexible materials including resins such as polyolefin, polytetrafluoroethylene, polyether block amide, polyamide, polyurethane, and silicone. Like the shaft 2, the shaft 24 has a lumen (not shown) and a curved portion 25. A guide wire 20 is inserted through the lumen.

The handle 26 is provided on the proximal end side of the shaft 24. The handle 26 is placed outside the body when the catheter 1 is used, and is grasped or operated by an operator. Handle 26 has a third port 26a. The third port 26a is connected to the proximal end of the lumen. The guide wire 20 is inserted into and removed from the lumen via the third port 26a.

Next, how the catheter 1 is used will be explained. The catheter 1 is inserted from the right subclavian artery 28 or the left subclavian artery 30 into the right common carotid artery 32 or the left common carotid artery 34. Various medical devices are then inserted into the lumen 12 and guided by the catheter 1 into the carotid artery and further into the blood vessel beyond the carotid artery. Examples of medical devices include stents, balloons, coils, thrombus removal catheters, contrast catheters, microcatheters, and guiding catheters.

The first to fourth techniques of passing the catheter 1 through the right subclavian artery 28 and inserting it into the right common carotid artery 32 or the left common carotid artery 34 will be described below. The first technique is a technique (push-in method) in which the catheter 1 is passed through the right subclavian artery 28 and inserted into the right common carotid artery 32. The second procedure is a procedure in which the catheter 1 is passed through the right subclavian artery 28 and inserted into the right common carotid artery 32, and the procedure is different from the first procedure (DAT/Pull-back method). The third procedure is a procedure (DAT/Pull-back method) in which the catheter 1 is passed through the right subclavian artery 28 and inserted into the left common carotid artery 34. The fourth procedure is a procedure in which the catheter 1 is passed through the right subclavian artery 28 and inserted into the left common carotid artery 34, and is a procedure different from the third procedure (Push-in method).

In each procedure, for example, a TRA (Trans-Radial-Approach) method is used, and the guide member 18 and catheter 1 are inserted into the body from the right radial artery. Note that the guide member 18 and catheter 1 may be inserted from the ulnar artery or brachial artery.

In either procedure, the catheter 1 advances inside the body while elastically deforming the curved portion 14 along the guide member 18 inserted into the body by the insertion operation by the operator. During this process, the curved portion 14 may become straight. Then, when the guide member 18 is pulled out from the lumen 12 at a predetermined position, the shape of the curved portion 14 is restored. The curved portion 14 whose shape has been restored extends along the two blood vessels at the connection between the two blood vessels. For example, at the junction between the right subclavian artery 28 and the right common carotid artery 32, in other words, at the branch point from the innominate artery 33 to the right subclavian artery 28 and the right common carotid artery 32, the right subclavian artery 28 and the right common carotid artery It is arranged along the carotid artery 32. Thereby, displacement of the catheter 1 can be suppressed.

(1st procedure)
FIGS. 4(A) to 4(I) are diagrams illustrating the first procedure. Note that illustration of the radiographic imaging unit 8 and the cover 10 is omitted in FIGS. 4(A) to 4(I). As shown in FIG. 4(A), the guide wire 20 and child catheter 22 are advanced from the right radial artery to the ascending aorta 36 via the right subclavian artery 28 prior to the catheter 1. At least at one time, daughter catheter 22 precedes guidewire 20. Since the child catheter 22 has the curved portion 25, the direction of the tip of the child catheter 22 can be changed by rotating the handle 26 or the like. Thereby, the direction in which the guide wire 20 moves can be controlled. With the guide wire 20 and child catheter 22 advanced into the ascending aorta 36, the catheter 1 is advanced into the right subclavian artery 28 along the child catheter 22.

Next, as shown in FIG. 4(B), the child catheter 22 and guide wire 20 are advanced into the aortic arch 38. Next, as shown in FIG. 4(C), the tips of the child catheter 22 and guide wire 20 are moved to the entrance of the right common carotid artery 32. Next, as shown in FIG. 4(D), the child catheter 22 and guide wire 20 are advanced into the right common carotid artery 32. Next, as shown in FIG. 4(E), the guide wire 20 is advanced into the right external carotid artery 40. Next, as shown in FIG. 4(F), the secondary catheter 22 is advanced into the right external carotid artery 40.

Subsequently, as shown in FIG. 4(G), the guide wire 20 is pulled out, and a guide wire 20a that is harder than the guide wire 20 is inserted. Next, as shown in FIG. 4(H), the catheter 1 is advanced into the right common carotid artery 32. Next, as shown in FIG. 4(I), the child catheter 22 and guide wire 20a are retreated. Through the above procedure, the catheter 1 can be inserted from the right subclavian artery 28 to the right common carotid artery 32. When the catheter 1 is inserted into the right common carotid artery 32 from the right subclavian artery 28 and the guide wire 20 and child catheter 22 are pulled out, the curved portion 14 connects the right subclavian artery 28 and the right common carotid artery 32. It is placed along both blood vessels at the junction.

Balloon 4 is then expanded. Thereby, the position of the catheter 1 can be fixed. Furthermore, blood flow beyond the balloon 4 can be stopped. Then, a medical device is inserted into the lumen 12 instead of the guide member 18. The medical device is guided closer to the brain than the balloon 4 and is subjected to various treatments. For example, when the medical device is a stent, the stent is deployed within the blood vessel beyond the balloon 4 and is used to dilate a narrowed blood vessel.

When the catheter 1 enters the right common carotid artery 32 from the right subclavian artery 28 along the child catheter 22, the curved portion 14 deforms along the child catheter 22. Therefore, it is difficult to confirm the position of the curved portion 14 based on its shape. If the curved portion 14 is deviated from the position where it should be placed, the curved portion 14 may get caught on the inner wall of the blood vessel when the child catheter 22 is pulled out and the shape of the curved portion 14 is restored, causing damage to the blood vessel. Furthermore, there is a risk that the curved portion 14 may be pushed against the inner wall of the blood vessel, causing the catheter 1 to be displaced or fall out of the right common carotid artery 32. Further, a portion of the shaft 2 other than the curved portion 14, that is, a straight portion, may be forcibly bent at the connection portion between the right subclavian artery 28 and the right common carotid artery 32, and there is a risk that this portion may kink. Furthermore, if a medical device with high rigidity is inserted into a straight portion that is forcibly bent, there is a risk that the portion may kink.

On the other hand, the catheter 1 has a radiographic imaging section 8 whose position is associated with the curved section 14 . Therefore, by confirming the position of the radiographic imaging unit 8 from outside the body, the position of the curved portion 14 can be determined. Therefore, the curved portion 14 can be placed at a desired position more accurately. As a result, damage to blood vessels and catheter 1 can be suppressed. Further, it is possible to avoid redoing the procedure due to misalignment or falling off of the catheter 1. Therefore, the catheter 1 can be suitably used for the first procedure.

(Second procedure)
FIGS. 5(A) to 5(H) and FIGS. 6(A) to 6(H) are diagrams illustrating the second procedure. Note that in FIGS. 5(A) to 5(H) and FIGS. 6(A) to 6(H), illustrations of the radiographic imaging unit 8 and the cover 10 are omitted. As shown in FIG. 5(A), the guide wire 20 and child catheter 22 are advanced from the right radial artery to the ascending aorta 36 via the right subclavian artery 28 prior to the catheter 1. With the guide wire 20 and child catheter 22 advanced into the ascending aorta 36, the catheter 1 is advanced into the right subclavian artery 28 along the child catheter 22.

Next, as shown in FIG. 5(B), the child catheter 22 and guide wire 20 are advanced into the aortic arch 38. Next, as shown in FIG. 5(C), the guide wire 20 is advanced into the descending aorta 42. Next, as shown in FIGS. 5(D) and 5(E), the child catheter 22 is advanced into the descending aorta 42. Next, as shown in FIG. 5(F), the guide wire 20 is pulled out, and a guide wire 20a that is harder than the guide wire 20 is inserted. Next, as shown in FIG. 5(G), the catheter 1 is advanced into the aortic arch 38. At this time, the catheter 1 is advanced until the curved portion 14 reaches the downstream of the ascending aorta 36 or the upstream of the aortic arch 38. Next, as shown in FIG. 5(H), the child catheter 22 and the guide wire 20a are retreated to the proximal end side of the curved portion 14. As a result, the shape of the curved portion 14 is restored, and the apex of the curved portion 14 enters the upstream side of the ascending aorta 36. That is, the curved portion 14 is dropped into the ascending aorta 36.

Next, as shown in FIG. 6(A), FIG. 6(B), FIG. 6(C), and FIG. 6(D), by rotating the handle 6, etc., the tip of the catheter 1 is pulled from inside the aortic arch 38 to the right. It is moved to the entrance of the common carotid artery 32. Next, as shown in FIG. 6(E), the child catheter 22 and guide wire 20 are advanced into the right common carotid artery 32. Next, as shown in FIGS. 6(F) and 6(G), the catheter 1 is advanced into the right common carotid artery 32. Next, as shown in FIG. 6(H), the guide wire 20 and secondary catheter 22 are retreated. Through the above procedure, the catheter 1 can be inserted from the right subclavian artery 28 to the right common carotid artery 32. When the catheter 1 is inserted into the right common carotid artery 32 from the right subclavian artery 28 and the guide wire 20 and child catheter 22 are pulled out, the curved portion 14 connects the right subclavian artery 28 and the right common carotid artery 32. It is placed along both blood vessels at the junction. The subsequent operations are similar to those for the first technique.

Also in the second procedure, by confirming the position of the radiographic contrast part 8, the curved part 14 can be more accurately aligned with the connection part between the right subclavian artery 28 and the right common carotid artery 32. Moreover, the curved portion 14 can be dropped into the ascending aorta 36 more reliably. As a result, damage to blood vessels and catheter 1 can be suppressed. Further, it is possible to avoid redoing the procedure due to misalignment or falling off of the catheter 1. Therefore, the catheter 1 can be suitably used for the second procedure.

(Third procedure)
FIGS. 7(A) to 7(H) and FIGS. 8(A) to 8(E) are diagrams for explaining the third procedure. Note that in FIGS. 7(A) to 7(H) and FIGS. 8(A) to 8(E), illustrations of the radiographic imaging unit 8 and the cover 10 are omitted. As shown in FIG. 7(A), the guide wire 20 and child catheter 22 are advanced from the right radial artery to the ascending aorta 36 via the right subclavian artery 28 prior to the catheter 1. With the guide wire 20 and child catheter 22 advanced into the ascending aorta 36, the catheter 1 is advanced into the right subclavian artery 28 along the child catheter 22.

Next, as shown in FIG. 7(B), the child catheter 22 and guide wire 20 are advanced into the aortic arch 38. Next, as shown in FIG. 7(C), the guide wire 20 is advanced into the descending aorta 42. Next, as shown in FIGS. 7(D) and 7(E), the child catheter 22 is advanced into the descending aorta 42. Next, as shown in FIG. 7(F), the guide wire 20 is pulled out, and a guide wire 20a that is harder than the guide wire 20 is inserted. Next, as shown in FIG. 7(G), the catheter 1 is advanced into the aortic arch 38. At this time, the catheter 1 is advanced until the curved portion 14 reaches the downstream of the ascending aorta 36 or the upstream of the aortic arch 38. Next, as shown in FIG. 7(H), the child catheter 22 and the guide wire 20a are retreated to the proximal end side of the curved portion 14. As a result, the shape of the curved portion 14 is restored, and the apex of the curved portion 14 enters the upstream side of the ascending aorta 36. That is, the curved portion 14 is dropped into the ascending aorta 36.

Subsequently, as shown in FIGS. 8(A) and 8(B), the tip of the catheter 1 is moved from within the aortic arch 38 to the entrance of the left common carotid artery 34 by rotating the handle 6 or the like. Next, as shown in FIG. 8(C), the child catheter 22 and guide wire 20 are advanced into the left common carotid artery 34. Next, as shown in FIG. 8(D), the catheter 1 is advanced into the left common carotid artery 34. Next, as shown in FIG. 8(E), the guide wire 20 and child catheter 22 are retreated. By the above procedure, the catheter 1 can be inserted from the right subclavian artery 28 into the left common carotid artery 34. With the catheter 1 inserted into the left common carotid artery 34 from the right subclavian artery 28 and the guide wire 20 and child catheter 22 pulled out, the curved portion 14 is inserted along the brachiocephalic artery 33 and the left common carotid artery 34. Placed. The subsequent operations are similar to those for the first technique.

In the third procedure as well, by confirming the position of the radiographic contrast section 8, the curved section 14 can be more accurately aligned along the brachiocephalic artery 33 and the left common carotid artery 34. Moreover, the curved portion 14 can be dropped into the ascending aorta 36 more reliably. As a result, damage to blood vessels and catheter 1 can be suppressed. Further, it is possible to avoid redoing the procedure due to misalignment or falling off of the catheter 1. Therefore, the catheter 1 can be suitably used for the third procedure.

(4th procedure)
FIGS. 9(A) to 9(H) are diagrams illustrating the fourth technique. Note that illustration of the radiographic imaging unit 8 and the cover 10 is omitted in FIGS. 9(A) to 9(H). As shown in FIG. 9(A), the guide wire 20 and child catheter 22 are advanced from the right radial artery to the ascending aorta 36 via the right subclavian artery 28 prior to the catheter 1. With the guide wire 20 and child catheter 22 advanced into the ascending aorta 36, the catheter 1 is advanced into the right subclavian artery 28 along the child catheter 22. Next, as shown in FIG. 9(B), the tip of the child catheter 22 is moved to the entrance of the left common carotid artery 34. Next, as shown in FIG. 9(C), the secondary catheter 22 is advanced into the left common carotid artery 34.

Subsequently, as shown in FIG. 9(D), the guide wire 20 is advanced into the left external carotid artery 44. Next, as shown in FIG. 9(E), the child catheter 22 is advanced into the left external carotid artery 44. Next, as shown in FIG. 9(F), the guide wire 20 is pulled out, and a guide wire 20a that is harder than the guide wire 20 is inserted. Next, as shown in FIG. 9(G), the catheter 1 is advanced into the left common carotid artery 34. Next, as shown in FIG. 9(H), the child catheter 22 and guide wire 20a are retreated. By the above procedure, the catheter 1 can be inserted from the right subclavian artery 28 into the left common carotid artery 34. With the catheter 1 inserted into the left common carotid artery 34 from the right subclavian artery 28 and the guide wire 20 and child catheter 22 pulled out, the curved portion 14 is inserted along the brachiocephalic artery 33 and the left common carotid artery 34. Placed. The subsequent operations are similar to those for the first technique.

In the fourth procedure as well, by confirming the position of the radiographic contrast section 8, the curved section 14 can be more accurately aligned along the brachiocephalic artery 33 and the left common carotid artery 34. As a result, damage to blood vessels and catheter 1 can be suppressed. Further, it is possible to avoid redoing the procedure due to misalignment or falling off of the catheter 1. Therefore, the catheter 1 can be suitably used for the fourth procedure.

When inserting the catheter 1 from the left subclavian artery 30 into the right common carotid artery 32 or the left common carotid artery 34, techniques similar to the first to fourth techniques can be used. Therefore, problems similar to those in the first to fourth procedures may occur. On the other hand, according to the catheter 1 of the present embodiment, the same effects as in the first to fourth procedures can be achieved.

Also, when inserting the catheter 1 into a blood vessel other than the right common carotid artery 32 and the left common carotid artery 34, such as the external carotid artery, internal carotid artery, subclavian artery, brachiocephalic artery, or vertebral artery, the first procedure to A technique similar to the fourth technique can be used. Therefore, problems similar to those in the first to fourth procedures may occur. On the other hand, according to the catheter 1 of the present embodiment, the same effects as in the first to fourth procedures can be achieved.

The embodiments of the present disclosure have been described above in detail. The embodiments described above merely show specific examples for carrying out the present disclosure. The content of the embodiments does not limit the technical scope of the present disclosure, and many designs such as changes, additions, and deletions of constituent elements may be made without departing from the spirit of the present disclosure as defined in the claims. Changes are possible. A new embodiment with a design change has the effects of each of the combined embodiments and modifications. In the embodiments described above, contents that allow such design changes are emphasized by adding expressions such as "in this embodiment" or "in this embodiment"; Design changes are allowed even if there is no content. Any combination of components included in each embodiment is also effective as an aspect of the present disclosure. The hatching added to the cross section of the drawing does not limit the material of the hatched object.

The curved portion 14 described in the embodiment has a curved shape when the guide member 18 is not inserted into the lumen 12, that is, when no external force is applied to the shaft 2. That is, the curved portion 14 is provided during the molding stage of the shaft 2. However, the bending section 14 is not limited to this configuration. For example, the shaft 2 may be linear when no external force is applied, and the curved portion 14 may appear when the shaft 2 is bent and deformed by operating the handle 6. The deformation of the shaft 2 by operating the handle 6 can be realized by a conventionally known structure, such as a structure in which a pull wire inserted through the shaft 2 is pulled by the handle 6. Further, in the catheter 1 in which the curved portion 14 appears by operating the handle 6, the guide member 18 may not be used. In this case, only a medical device can be inserted into the lumen 12.

Embodiments may be specified by the items described below.
[First item]
A catheter (1) that passes through a right subclavian artery (28) or a left subclavian artery (30) and is inserted into a predetermined blood vessel (32, 34) to guide a medical device,
A flexible shaft (2) whose at least the distal end side is inserted into the body, a lumen (12) through which the guide member (18) is inserted, and where the guide member (18) is not inserted through the lumen (12). a shaft (2) having a bent portion (14) in a bent state;
an expandable balloon (4) provided on the distal side of the curved portion (14) of the shaft (2);
a radiographic imaging part (8) provided on the shaft (2) and having a position associated with the curved part (14);
Catheter (1).
[Second item]
The radiographic contrast section (8) is arranged at the apex of the curved section (14).
Catheter (1) according to the first item.
[Third item]
The catheter (1) comprises at least two radiographic sections (8),
One radiographic imaging unit (8) is arranged at a position shifted from the apex of the curved part (14) by a predetermined distance toward the distal end of the shaft (2),
The other radiographic imaging unit (8) is arranged at a position shifted from the apex by a predetermined distance toward the proximal end of the shaft (2).
The catheter (1) according to either the first item or the second item.
[4th item]
comprising a cover (10) that covers at least the border of the radiographic part 8 and the shaft 2;
The catheter (1) according to any one of the first to third items.
[Item 5]
A catheter (1) that passes through a right subclavian artery (28) or a left subclavian artery (30) and is inserted into a predetermined blood vessel (32, 34) to guide a medical device,
A flexible shaft (2) with at least its distal end inserted into the body, a lumen (12) through which a medical device is inserted, and operation of a handle (6) provided on the proximal end of the shaft (2). a shaft (2) having a curved portion (14) having a curved shape;
an expandable balloon (4) provided on the distal side of the curved portion (14) of the shaft (2);
a radiographic imaging part (8) provided on the shaft (2) and having a position associated with the curved part (14);
Catheter (1).

1 catheter, 2 shaft, 4 balloon, 8 radiographic contrast section, 10 cover, 12 lumen, 14 curved section, 16 border, 18 guide member, 28 right subclavian artery, 30 left subclavian artery, 32 right common carotid artery, 34 Left common carotid artery.

Claims (5)

A catheter that passes through the right subclavian artery or the left subclavian artery and is inserted into a predetermined blood vessel to guide a medical device,
A flexible shaft whose at least a distal end side is inserted into the body, and a lumen through which a guide member and the medical device are inserted, and a curved portion that is bent when the guide member is not inserted into the lumen. a shaft having a
an expandable balloon provided on the distal side of the curved portion of the shaft;
a radiographic imaging unit provided on the shaft and having a position associated with the curved portion;
catheter. The radiographic contrast section is arranged at the apex of the curved section ,
The predetermined blood vessel is a common carotid artery, an external carotid artery, an internal carotid artery, a subclavian artery, an innominate artery, or a vertebral artery.
The catheter according to claim 1. The catheter includes at least two of the radiographic imaging units,
One of the radiographic imaging units is disposed at a position shifted toward the distal end of the shaft by a predetermined distance from the apex of the curved part,
The other radiographic imaging unit is disposed at a position shifted from the apex by the predetermined distance toward the proximal end of the shaft ,
The predetermined blood vessel is a common carotid artery, an external carotid artery, an internal carotid artery, a subclavian artery, an innominate artery, or a vertebral artery.
The catheter according to claim 1 or 2. comprising a cover that covers at least a boundary of the radiographic imaging unit and the shaft;
The catheter according to claim 1 or 2. A catheter that passes through the right subclavian artery or the left subclavian artery and is inserted into a predetermined blood vessel to guide a medical device,
A flexible shaft that is inserted into the body at least on the distal end side, and has a lumen through which the medical device is inserted, and a curved portion that is bent into a bent shape by operating a handle provided on the proximal end side of the shaft. shaft and
an expandable balloon provided on the distal side of the curved portion of the shaft;
a radiographic imaging unit provided on the shaft and having a position associated with the curved portion;
catheter.

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