This application claims priority to Japanese Application No. 2013-222631, which was filed on Oct. 25, 2013, the entire contents of which are incorporated herein by reference.
The disclosed embodiments relate to a medical device. Specifically, the disclosed embodiments relate to a medical guide wire used as a guide when inserting a catheter into a blood vessel, a gastrointestinal tract, a ureter and the like; inserting an indwelling device; and the like.
A guide wire is used to guide a catheter when inserting the catheter into a blood vessel, a gastrointestinal tract, a ureter and the like for treatment and examination; to guide insertion of an indwelling device; and the like.
In general, a guide wire must be flexible so that an inner wall of a blood vessel, a gastrointestinal tract and the like will not be damaged during insertion. In particular, excellent flexibility is required for a distal portion of the guide wire. For example, Japanese Patent Laid-Open No. H10-323395 discloses a guide wire in which flexibility is improved by providing a shaft formed with a stranded wire. Further, Japanese Patent Laid-Open No. 2001-293092 discloses a guide wire in which a shaft comprises a core wire and two or more fine wires interwound around the core wire, but does not comprise the core wire at a distal portion thereof, thereby achieving higher flexibility at the distal portion as compared with that at the body portion.
Meanwhile, in recent years, the range of intended uses for a guide wire has been increasingly expanding. In particular, since blood vessels are intricately bended, a guide wire used for blood vessels often requires more excellent flexibility at a distal portion thereof in order to improve the guide wire's ability to track blood vessels (“followability”). A guide wire comprising a shaft formed with a stranded wire as disclosed in Japanese Patent Laid-Open No. H10-323395 and Japanese Patent Laid-Open No. 2001-293092 has excellent flexibility. However, different problems may arise when fine wires in the stranded wire are made thinner in order to further improve flexibility. For example, the followability for blood vessels may decrease due to decreased rigidity and rotary torque transmutability of a guide wire. Furthermore, the delicate interactions at a distal portion which can typically be sensed through a grip by an operator operating a guide wire from the outside of the body may not be well transmitted. For example, the operator might not perceive resistance produced when the distal portion of the guide wire inside the body makes contact with a wall surface of a blood vessel and the like, or resistance produced when the distal portion of the guide wire bumps against a stenosed section.
An object of the disclosed embodiments is to provide a guide wire which has excellent flexibility at a distal portion thereof, followability for a complex structure such as a blood vessel, and transmittability of delicate interactions such as resistance produced when the distal portion slides in contact with a wall surface of a blood vessel and the like, and resistance produced when the distal portion bumps against a stenosed section.
A guide wire according to the first embodiment comprises a core shaft and a coil body covering a distal portion of the core shaft, the coil body being formed by helically winding a stranded wire having three or more elemental wires interwound together, and the stranded wire being hollow and having a first void at the center thereof.
Further, a guide wire according to the second embodiment comprises a core shaft, a first coil body covering a distal portion of the core shaft, a second coil body covering the distal portion of the core shaft and connected to a proximal end of the first coil body, and a third coil body arranged within the first coil body and the second coil body and covering the distal portion of the core shaft, the first coil body being formed by helically winding a stranded wire having three or more elemental wires interwound together, and the stranded wire being hollow and having a first void at the center thereof, wherein an interface between the first coil body and the second coil body is joined only with the third coil body.
The guide wire according to the first embodiment comprises a core shaft and a coil body, the coil body being formed by helically winding a stranded wire having three or more elemental wires interwound together, and the stranded wire being hollow and having a first void, but not a core wire at the center thereof. Since the coil body formed by helically winding a stranded wire having a first void at the center is provided as described above, a distal portion of the guide wire is excellent in flexibility, is capable of moving flexibly, and shows excellent followability for a blood vessel and the like. Furthermore, it has excellent transmutability of delicate interactions such as vibration due to resistance produced at the distal portion of the guide wire. Moreover, since the unevenness on a surface of the coil body is small, the guide wire can smoothly slide along a wall surface of a blood vessel, a gastrointestinal tract, a ureter and the like.
The guide wire according to the second embodiment comprises a core shaft, a first coil body covering a distal portion of the core shaft, a second coil body connected to a proximal end of the first coil body and covering the distal portion of the core shaft, and a third coil body arranged within the first coil body and the second coil body and covering the distal portion of the core shaft, the first coil body being formed by helically winding a stranded wire having three or more elemental wires interwound together, and the stranded wire being hollow and having a first void but not a core wire at the center thereof. Further, an interface between the first coil body and the second coil body is joined only with the third coil body. Since the coil body formed by helically winding a stranded wire having a first void at the center is provided as described above, the distal portion of the guide wire is excellent in flexibility, is capable of moving flexibly, and shows excellent followability for a blood vessel and the like. Furthermore, it has excellent transmutability of delicate interactions such as vibration due to resistance produced at the distal portion. Moreover, since the unevenness on a surface of the coil body is small, the guide wire can smoothly slide along a wall surface of a blood vessel, a gastrointestinal tract, a ureter and the like. Furthermore, since multiple coil bodies such as the first coil body, the second coil body and the third coil body are provided and an interface joining only these coil bodies is provided, flexibility, rotary torque transmutability and the like can be easily adjusted by the configuration of the coil bodies.
Various embodiments will be described below with reference to the drawings, but the present invention shall not be limited to the embodiments.
A coil body 1 used in the guide wire is formed by helically winding a stranded wire 11 having three or more elemental wires interwound together.
The stranded wire 11 comprises three or more elemental wires interwound together. The lower limit of the number of elemental wires in the stranded wire 11 is preferably 3 while the upper limit is preferably 8, more preferably 6. In
Further, the stranded wire may comprise elemental wires having different diameters as shown in
As shown in
Using a number of elemental wires in the above number ranges will ensure the formation of the first voids 116, 215 and 319 at the center of the resulting stranded wires 11, 21 and 31, and confer the shape stability on the stranded wires 11, 21 and 31. Moreover, in a case where the stranded wires 11, 21 and 31, which are to be helically wound into a coil body, are used to form coil bodies, the unevenness produced on a surface of the coil body will be small. Therefore, a distal portion of a guide wire obtained using the above coil body will smoothly slide along a vessel wall of a blood vessel and the like.
The stranded wires 11, 21 and 31 are formed by interwinding three or more elemental wires together. There is no particular limitation for the manner of interwinding as long as the resulting stranded wires 11, 21 and 31 are hollow and have the first voids 116, 215 and 319 at the center. However, the stranded wires 11, 21 and 31 are preferably formed by helically interwinding three or more elemental wires together in the same pitch and direction because the shape stability, shape uniformity and surface smoothness of the resulting stranded wires are improved. Further, with respect to elemental wires that are adjacent each other, one elemental wire is preferably interwound over another elemental wire in the direction of interwinding.
Details will be described with reference to
Although a case in which 5 elemental wires are interwound together is described above, a similar strategy can be applied to a case where 4 elemental wires are interwound together as shown in
Materials for elemental wires include stainless steel, superelastic alloys such as a Ni—Ti alloy and the like. The three or more elemental wires may be made of the same material, or elemental wires made of different materials may be used in combination.
The shape of a cross-section of an elemental wire may be, for example, circular, elliptical and polygonal such as square and rectangle, but is preferably circular because excellent interwinding properties, shape stability of the resulting stranded wire and smoothness of a surface of the resulting stranded wire can be obtained.
In a case where a shape of a cross-section of an elemental wire is circular as shown in
The above stranded wires 11, 21 and 31 do not have core wires but have the first voids 116, 215 and 319 at the center. Therefore, the relative positional relationship among three or more elemental wires in the stranded wires 11, 21 and 31 may change depending on the force applied to the stranded wires 11, 21 and 31. For example, when the stranded wires 11, 21 and 31 are helically wound, the stranded wires 11, 21 and 31 which are straight or curved will be transformed into a helical form. When undergoing this transformation, the relative positional relationship among the elemental wires may change to some extent. As a result of this, the stranded wires 11, 21 and 31 will be more easily helically wound, and in addition, unevenness will be less likely formed on a surface of the resulting helically wound coil body. Further, even after preparing a guide wire using a coil body obtained by helically winding the stranded wires 11, 21 and 31, the coil body may undergo deformation to some extent when advancing in a winding blood vessel and the like. Even in that case, the relative positional relationship among three or more elemental wires in the stranded wires 11, 21 and 31 will change to some extent as the coil body undergoes deformation to control the repelling force against the deformation of the coil body. This can confer excellent flexibility and followability for a blood vessel and the like on the coil body.
Meanwhile, since the elemental wires 211, 212, 213 and 214 are wound together, even in a case where the relative positional relationship among the elemental wires 211, 212, 213 and 214 changes to some extent, the elemental wires 211, 212, 213 and 214 will not fall apart by unwinding, and the shapes of the stranded wire 21 and the coil body 2 formed by helically winding the stranded wire 21 will not be destroyed.
As described above, the stranded wires 11, 21 and 31 having the first voids 116, 215 and 319 at the center show excellent flexibility for deformation. Therefore, coil bodies formed by helically winding the stranded wires 11, 21 and 31 as described above show less unevenness on their surfaces enabling easy sliding, and further have excellent flexibility as well as excellent followability for a blood vessel and the like.
The above stranded wire is to be helically wound into a coil body.
As shown in
Further, there is no particular limitation for the relationship between the direction of interwinding the elemental wires in the stranded wires 11 and 21, and the direction of winding the stranded wires 11 and 21 in the coil bodies 1 and 2. In a case where the coil bodies 1 and 2 are formed by helically winding the stranded wires 11 and 21 interwound in the counterclockwise direction, the coil bodies 1 and 2 may be wound in either a clockwise or counterclockwise fashion. Further, in a case where the coil bodies 1 and 2 are formed by helically winding the stranded wires 11 and 21 interwound in the clockwise direction, the coil bodies 1 and 2 may also be wound in either a clockwise or counterclockwise fashion.
A guide wire 4 comprises a core shaft 5 and the coil body 2 covering a distal portion 51 of the core shaft 5. The coil body 2 is formed by helically winding the above stranded wire 21.
The guide wire 4 is a flexible elongated article, and the length and diameter thereof can be suitably selected depending on the range of intended uses. The upper limit of the length is generally 4000 mm, and preferably 2500 mm. The lower limit of the length is generally 500 mm, and preferably 1000 mm. In the first aspect, the length of the guide wire 4 is about 1800 mm. Further, in general, the maximum diameter of a cross section of the guide wire 4 is from 0.05 mm to 0.5 mm.
The above core shaft 5 is a flexible elongated member, and has a length and maximum diameter depending on the length and maximum diameter of the guide wire 4. The shape of a cross-section of the core shaft 5 may be any of circular, elliptical and polygonal such as square and rectangle, but is generally and preferably circular.
The core shaft 5 comprises a distal portion 51 located in a distal end to be inserted into the body upon treatment, examination and the like, and a body portion 52 located proximally of the distal portion 51.
In a case where the distal portion 51 is tapered in diameter toward the distal side to improve flexibility toward the distal side, and in a case where the guide wire 4 is intended for treating a blood vessel in the heart, the distal portion 51 is generally provided in a region from the distal end of the guide wire 4 up to 400 mm axially toward the proximal end. For example, the distal portion 51 is gradually tapered toward the distal end by providing a tapered portion 511 tapered in diameter toward the distal end. At the distal end of the tapered portion 511, a reduced diameter portion 512 extending in the axial direction with the substantially same diameter is arranged. The distal end of the reduced diameter portion 512 is joined with the distal end of the coil body 2 through a joint. There is no particular limitation for the joint as long as it has a smooth shape so that the distal end of the guide wire 4 does not damage a wall surface of a blood vessel and the like, and a conventionally known joining method may be used. In general, as shown in
Note that the core shaft is not limited to having a single tapered portion as described above, but two or more may be formed.
The distal end tip 61 has a smooth distal surface comprising a curved surface such as a hemispherical surface so that a blood vessel and the like are not damaged upon contact with the distal end tip. There is no particular limitation for a method of forming the distal end tip as long as the distal end of the core shaft 5 can be joined with the distal end of the coil body 2. For example, the distal end tip 61 is preferably formed by assembling components such as the core shaft 5 and the coil body 2, and then providing a brazing material to the distal end to join the distal end of the core shaft 5 with the distal end of the coil body 2 by brazing.
In the guide wire 4 as shown in
The body portion 52 of the core shaft 5 corresponds to a portion extending from a proximal end of the distal portion 51 in the axial direction with the substantially same diameter, and is a portion other than the distal portion 51 of the core shaft 5. The distal end of the body portion 52 is to be inserted into the body following the distal portion 51 upon treatment and examination while a proximal end remains exposed outside the body.
For materials for the core shaft 5, conventionally known materials can be used. They include stainless steel, superelastic alloys such as a Ni—Ti alloy, a piano wire and the like. Among others, stainless steel is preferred. The entire core shaft 5 may be made of the same material, or different materials may be used in part.
The coil body 2 formed by helically winding the above stranded wire 21 comprising 4 elemental wires and having the first void 215 at the center can be used as a coil body, but the coil body 1 comprising the above stranded wires 11 may also be used. The coil body 2 is joined with the distal end tip 61 at the distal end, and a proximal end thereof is joined with the core shaft 5 near the proximal end of the distal portion 51 of the core shaft 5 by a conventionally known joining method such as brazing, soldering and adhesion with an adhesive.
As shown in
The stranded wire 21 is helically wound tightly so that adjacent coils of the coil body formed by the stranded wire 21 make contact with each other, and a configuration as shown in
There is no particular limitation for methods of manufacturing the above guide wire 4, but they include, for example, the following methods.
First, the coil body 2 is made by winding three or more elemental wires 211, 212, 213 and 214 together to form the stranded wire 21, and helically winding the resulting stranded wire 21 over a core material having a desired diameter, and then withdrawing the core material. Then, the core shaft 5 fabricated into a desired shape is inserted into the coil body 2. The coil body 2 is aligned with the core shaft 5, and then the proximal end of the coil body 2 is joined with the outer periphery of the core shaft 5 by a conventionally known joining method such as brazing, soldering, and adhesion with an adhesive. Then the distal end of the coil body 2 is joined with the distal end of the core shaft 5 with a brazing material and the like. When joining the distal end of the coil body 2 with the distal end of the core shaft 5 using a brazing material and the like, the distal end tip 61 is formed.
A guide wire 7, which is intended for treating a blood vessel in the heart and the like, comprises a core shaft 8, a first coil body 91 covering a distal portion 81 of the core shaft 8, a second coil body 92 covering the distal portion 81 of the core shaft 8 and connected to a proximal end of the first coil body 91, and a third coil body 93 arranged within the first coil body 91 and the second coil body 92 and covering the distal portion 81 of the core shaft 8.
The core shaft 8, which is similar to the core shaft 5 according to the first aspect, comprises the distal portion 81 located at a distal end to be inserted into the body upon treatment, examination and the like, and a body portion 82 located proximally of the distal portion 81.
In the guide wire 7 as shown in
Further, the distal end of the distal portion 81 is joined with the distal end tip 62, but a configuration may also be possible in which the distal end of the distal portion 81 is spaced from the distal end tip 62, and the distal portion 81 is not joined with the distal end tip 62 as in the case of the first aspect. In that case, the core shaft 8 is preferably connected to the distal end tip 62 via a safe wire and the like.
The first coil body 91 covers the outer periphery of the distal end including the distal end of the distal portion 81 of the core shaft 8, and is formed by helically winding the stranded wire 911 having three or more elemental wires wound together.
The first coil body 91 is joined with the distal end tip 62 at the distal end, and the proximal end is joined with the distal end of the second coil body 92 and an intermediate portion of the third coil body 93 at an interface portion 63. The distal end tip 62 has a similar configuration as the above distal end tip 61 according to the previous embodiment. The first coil body 91 is joined with the distal end tip 62 in a similar joining fashion as the coil body 2 joined with the distal end tip 61. A conventionally known joining method such as brazing, soldering and adhesion with an adhesive may be used for joining at the interface portion 63.
For the stranded wire 911, one similar to the stranded wire 21 previously described may be used. In short, the first coil body 91 has a similar configuration as the coil body 2.
In
The first coil body 91 covers the outer periphery of the distal end including the distal end of the distal portion 81 of the core shaft 8, and preferably covers a region preferably at least up to 20 mm from the distal end of the guide wire 7 toward the proximal end in the axial direction, and more preferably at least up to 30 mm.
The above second coil body 92 is provided continuously at the proximal end of the first coil body 91. The outer diameter of the second coil body 92 is substantially the same as that of the proximal end of the first coil body 91. The second coil body 92 covers the outer periphery of a portion of the distal portion 81 of the core shaft 8 that the first coil body 91 does not cover. The distal end of the second coil body 92 is joined with the proximal end of the first coil body 91 and the intermediate portion of the third coil body 93 via the interface portion 63. The proximal end of the second coil body 92 is joined near the proximal end of the distal portion 81 of the core shaft 8 by a conventionally known joining method such as brazing, soldering and adhesion with an adhesive.
The second coil body 92 may be formed with a coil body similar to the first coil body 91. However, it is preferred to be appropriately selected for use from conventionally known other coil bodies. Conventionally known coil bodies include a coil body formed by helically winding an elemental wire, and a coil body formed by helically winding a stranded wire comprising two or more elemental wires and having a core wire.
Materials for an elemental wire used for the second coil body 92 include stainless steel, superelastic alloys such as a Ni—Ti alloy and the like.
The third coil body 93 is arranged within the first coil body 91 and the second coil body 92, and covers the outer periphery of the distal end including the distal end of the distal portion 81 of the core shaft 8. The distal end of the third coil body 93 is joined with the distal end tip 62, and the proximal end is joined with the core shaft 8 at a position between the interface portion 63 and the proximal end of the second coil body 92 by a conventionally known joining method such as brazing, soldering and adhesion with an adhesive. The third coil body 93 is joined with the distal end tip 62 in a similar joining fashion as the coil body 2 joined with the distal end tip 61 in the first aspect.
The third coil body 93 is arranged within the first coil body 91 and the second coil body 92, and is a conventionally used so-called inner coil. The third coil body 93 may be formed with a coil body similar to the first coil body 91. However, it is preferred to be appropriately selected for use from conventionally known inner coils. Conventionally known inner coils include a coil body formed by helically winding a stranded wire comprising two or more elemental wires and having a core wire, a coil body formed by helically winding an elemental wire and the like.
Materials for an elemental wire used for the third coil body 93 include stainless steel, superelastic alloys such as a Ni—Ti alloy and the like.
The interface portion 63 is joined with the proximal end of the first coil body 91, with the distal end of the second coil body 92 and with the intermediate portion of the third coil body 93, but not with the core shaft 8. As described above, since only the first to third coil bodies 91, 92 and 93 are joined via the interface portion 63, the flexibility of the first to third coil bodies 91, 92 and 93 is not impaired by the interface portion 63. In addition, since the first to third coil bodies 91, 92 and 93 are joined together, the guide wire 7 has excellent rigidity, rotary torque transmutability and the like.
Because the outer periphery of the distal portion 81 including the distal end of the core shaft 8 is covered with the first coil body 91, the distal portion of the guide wire 7 is excellent in flexibility and followability for a blood vessel and the like. Further, it has excellent transmutability, to the hand of an operator, of delicate vibration produced at the first coil body 91 when the distal portion of the guide wire 7 makes contact with a wall surface of a blood vessel and the like or with a stenosed section. Further, since the second coil body 92 is connected to the proximal end of the first coil body 91, the flexibility, followability for a blood vessel and the like, rotary torque transmutability, rigidity and the like can be easily and appropriately adjusted by appropriately selecting the second coil body 92 depending on a range of intended uses and desired physical properties. Further, since the third coil body 93 is arranged within the first coil body 91 and the second coil body 92, the flexibility of the distal portion can be easily improved while maintaining excellent rotary torque transmutability by appropriately selecting the third coil body 93 depending on a range of intended uses and desired physical properties. Furthermore, since the interface portion 63 joins with only the proximal end of the first coil body 91, the distal end of the second coil body 92 and the intermediate portion of the third coil body 93, but not with the core shaft 8, the flexibility, rotary torque transmutability and the like is not impaired by the interface portion 63.
There is no particular limitation for methods of manufacturing the above guide wire 7, but they include, for example, the following methods.
First, the first coil body 91 is made by interwinding three or more elemental wires to form the stranded wire 911 having a first void at the center, helically winding the resulting stranded wire 911 over a core material having a desired diameter, and then withdrawing the core material. Further, by a similar method, the second coil body 92 and the third coil body 93 are made by separately winding an elemental wire or a stranded wire in a helical fashion. Next, the core shaft 8 fabricated into a desired shape is inserted into the third coil body 93, and the third coil body 93 is aligned with the core shaft 8. Then the proximal end of the third coil body 93 is joined with the core shaft 8 by a conventionally known joining method such as brazing, soldering, and adhesion with an adhesive. Then, the third coil body 93 and the core shaft 8 are inserted into the second coil body 92, and the second coil body 92 is aligned with the core shaft 8. Then the proximal end of the second coil body 92 is joined with the core shaft 8 by a conventionally known joining method such as brazing, soldering, and adhesion with an adhesive. Further, the third coil body 93 and the core shaft 8 are inserted into the first coil body 91, and the distal end of the second coil body 92 is aligned with the proximal end of the first coil body 91. Then the proximal end of the first coil body 91, the distal end of the second coil body 92 and the intermediate portion of the third coil body 93 are joined by a conventionally known joining method such as brazing, soldering, and adhesion with an adhesive to form the interface portion 63. Finally, the distal end of the first coil body 91, the distal end of the third coil body 93 and the distal end of the core shaft 8 are joined using a brazing material. At this time, the distal end tip 62 comprising the brazing material is formed.
Next, a method of using the guide wire 4 according to the first aspect and the guide wire 7 according to the second aspect for treatment and examination will be described with reference to a case in which they are used for a stenosed section formed in a coronary artery of the heart.
The guide wires 4 and 7 are inserted into an artery from the femoral region and the like, and allowed to pass through the aortic arch to advance toward the stenosed section formed in the coronary artery, which is a target site for treatment. At this time, an operator such as a doctor applies pushing force and torque to the guide wires 4 and 7. The guide wires 4 and 7 have excellent flexibility in the distal portion and followability for a blood vessel and the like. Therefore, even in the case of complicatedly bended blood vessels, they are allowed to smoothly follow a blood vessel without damaging a wall of the blood vessel and to smoothly advance towards the stenosed section. Further, the guide wire 7 has the first coil body 91, the second coil body 92 and the third coil body 93. Therefore, insertion properties when applying such pushing force, rotary torque transmutability when applying torque, and the like can be easily adjusted by appropriately selecting the second coil body 92 and the third coil body 93. Furthermore, the guide wires 4 and 7 are excellent in the transmutability of delicate interactions such as resistance produced when the distal portion slides in contact with a wall surface of a blood vessel and the like, and resistance produced when the distal portion bumps against a stenosed section and the like. Therefore, an operator can advance the guide wire while sensing resistance applied to the distal portion.
After the guide wires 4 and 7 reach a target site for treatment, for example, a therapeutic catheter such as a balloon catheter and a treatment device-introducing catheter is inserted into the body along the guide wires 4 and 7 to perform treatment such as dilation of a stenosed section.
A coil body 10 is formed by helically winding a stranded wire 101.
The stranded wire 101 is formed by helically interwinding 4 circular elemental wires comprising stainless steel and having a circular cross section of about 0.03 mm in diameter around a circular core wire (an elemental wire) comprising stainless steel and having a circular cross section of about 0.015 mm in diameter. The stranded wire is interwound as in the above embodiments 1 and 2 except that the core wire is used.
A surface of the coil body 10 formed with the stranded wire 101 having a core wire at the center, which is as shown in
Number | Date | Country | Kind |
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2013-222631 | Oct 2013 | JP | national |