The present disclosure generally relates to an image diagnosis catheter.
The image diagnosis catheter generally has a pull-back mechanism that changes a relative position between a sheath and a drive shaft on a side close to a user in order to continuously observe a body cavity cross section (see, for example, Japanese Patent Application Publication No. 2002-360578 A). The pull-back mechanism includes an outer tube, a support tube provided radially inside the outer tube and radially outside the drive shaft, a spacer integrally connecting the outer tube with the support tube, and an inner tube provided radially inside the outer tube and radially outside the support tube and movable relative to the outer tube and the support tube in an axial direction.
When the image diagnosis catheter is used, priming is performed to fill a lumen of the image diagnosis catheter with a liquid. The priming is usually performed in a state in which the inner tube is drawn out from the outer tube.
The image diagnosis catheter in the related art has a structure in which a flow passage between an outer tube and a support tube is closed by a spacer and communicates with the inside of the support tube through a notch such as a hole or a slit provided on the support tube in the vicinity of a closed portion. For this reason, there are problems that a flow passage resistance in the pull-back mechanism is relatively large and air in the pull-back mechanism can be difficult to remove.
An image diagnosis catheter is disclosed that is capable of implementing satisfactory priming in a pull-back mechanism.
According to an aspect of the present disclosure, an image diagnosis catheter is disclosed that includes: an outer tube; a support tube provided radially inside the outer tube; a spacer integrally connecting the outer tube with the support tube; and an inner tube provided radially inside of the outer tube and radially outside of the support tube and movable relative to the outer tube and the support tube in an axial direction, in which a communication passage causing a flow passage between the outer tube and the support tube to communicate with an inside of the support tube is formed by the spacer.
According to an embodiment of the present disclosure, the image diagnosis catheter further includes a connector joined to the outer tube, in which the spacer is joined to the support tube, and the spacer has a stopper positioned between the outer tube and the connector in the axial direction.
According to an embodiment of the present disclosure, the communication passage is defined by the spacer, the outer tube, and the connector.
According to an embodiment of the present disclosure, the spacer includes a spacer body positioned between an outer circumferential surface of the support tube and an inner circumferential surface of the outer tube, and a protruding portion protruding from a distal end of the spacer body toward the distal end on the distal end side with respect to a distal end surface of the outer tube.
According to an embodiment of the present disclosure, the spacer body has a cylindrical shape, and an outer circumferential surface of the spacer body has two portions having a flat surface shape, the two portions being separated from each other in a first direction along a radial direction and extending in the axial direction.
In accordance with another aspect, an image diagnosis catheter includes: an outer tube; a support tube provided radially inside of the outer tube; a spacer configured to connect the outer tube with the support tube, and the spacer configured to form a flow passage between the outer tube and the support tube, the flow passage configured to be in communication with an inside of the support tube; and wherein the spacer includes a spacer body positioned between an outer circumferential surface of the support tube and an inner circumferential surface of the outer tube, and a protruding portion protruding from a distal end of the spacer body toward a distal end on a distal end side of the image diagnosis catheter with respect to a distal end surface of the outer tube.
In accordance with a further aspect, a spacer configured to connect an outer tube with a support tube of an image diagnosis catheter is disclosed, the spacer including: a spacer body positioned between an outer circumferential surface of the support tube and an inner circumferential surface of the outer tube; and a protruding portion protruding distally from a distal end of the spacer body.
According to the present disclosure, there can be provided an image diagnosis catheter capable of implementing satisfactory priming in a pull-back mechanism.
Hereinafter, embodiments of an image diagnosis catheter according to the present disclosure will be described in detail by giving examples with reference to the drawings.
An image diagnosis catheter 1 according to the present embodiment is a dual-type image diagnosis catheter that uses both an intravascular ultrasound (IVUS) diagnosis method and an optical coherence tomography (OCT) diagnosis method. In the dual-type image diagnosis catheter 1, there are three types of modes including a mode of acquiring a tomographic image obtained only by IVUS, a mode of acquiring a tomographic image obtained only by OCT, and a mode of acquiring a tomographic image obtained by IVUS and OCT, and these modes can be used in a switching manner. As illustrated in
As illustrated in
In the present specification, the distal end means an end on a side of the image diagnosis catheter 1 to be inserted into a body cavity, the proximal end means an end on a side of the image diagnosis catheter 1 to be held outside the body cavity, the axial direction means a direction along a central axis O of the drive shaft 9 (that is, an extending direction of the drive shaft 9), a radial direction means a direction along a straight line orthogonal to the central axis O, and a circumferential direction means a direction around the central axis O.
As illustrated in
As illustrated in
As illustrated in
As illustrated in
The drive shaft 9 can be formed by a coil shaft. The coil shaft can be formed using, for example, multi-layer coils having different winding directions. Each of the coils can be a multi-wire winding type. The coil shaft can be formed, for example, using three-layer coils of a double winding type, the number of layers and the number of wires can be appropriately changed. Each of the coils can be made of, for example, metal such as stainless steel or a nickel-titanium (Ni—Ti) alloy.
The signal transmission and reception unit 11 includes an ultrasound transmission and reception unit 11a that transmits and receives an ultrasound wave and an optical transmission and reception unit 11b that transmits and receives light. The ultrasound transmission and reception unit 11a includes a transducer that transmits an ultrasound wave based on a pulse signal into a body cavity and receives an ultrasound wave reflected from a biological tissue in the body cavity. The transducer is electrically connected to an electrical connector 15a (see
The optical transmission and reception unit 11b includes an optical element that transmits light into a body cavity and receives light reflected from a biological tissue in the body cavity. The optical element is optically connected to an optical connector 16a (see
The signal transmission and reception unit 11 is accommodated in the housing 10. A proximal end of the housing 10 is fixed to the distal end of the drive shaft 9. The housing 10 can be, for example, formed using a cylindrical tube made of metal, and can be provided with an opening 10a on a circumferential surface of the housing 10 so as not to hinder the progress of a signal transmitted and received by the signal transmission and reception unit 11. The housing 10 can be formed by, for example, laser processing or the like. The housing 10 may be formed by shaving a metal lump (or a block of metal), metal injection molding (MIM), or the like.
A distal end member 17 is provided at a distal end of the housing 10. The distal end member 17 can have a substantially hemispherical outer shape, and accordingly, can suppress friction and catching with an inner surface of the sheath 4. Note that the distal end member 17 may not be provided.
The sheath 4 has a lumen 4a into which the drive shaft 9 is inserted so that the drive shaft 9 is movable forward and backward. A tubular guide wire insertion member 18 through which a guide wire can pass is attached to the distal end of the sheath 4, which shifts a lumen for the guide wire from an axial center of the lumen of the sheath 4. The sheath 4 and the guide wire insertion member 18 are bonded by welding or the like. The guide wire insertion member 18 can be provided with a marker 19 having an radiopaque property. The marker 19 can be, for example, a tubular member made of metal having a relatively high X-ray impermeability such as platinum (Pt) or gold (Au).
A communication hole 20 that communicates with the inside and the outside of the lumen 4a is formed at the distal end of the sheath 4. Furthermore, a reinforcing member 21 joined to the guide wire insertion member 18 can be provided at a distal end of the lumen 4a of the sheath 4. The reinforcing member 21 has a through-hole formed to allow communication between the communication hole 20 and the inside of the lumen 4a disposed on the proximal end side with respect to the reinforcing member 21. The reinforcing member 21 may not be provided at the distal end of the sheath 4.
The communication hole 20 is a priming solution discharge hole for discharging a priming solution. When the image diagnosis catheter 1 is used, the priming solution can be released from the communication hole 20 to the outside to discharge a gas such as air from the inside of the sheath 4 together with the priming solution at the time of performing priming processing of filling the inside of the sheath 4 with the priming solution.
A distal-end-side portion of the sheath 4, which is a range in which the signal transmission and reception unit 11 moves in the axial direction of the sheath 4, forms a window portion having a higher signal transmission property than other portions. The sheath 4, the guide wire insertion member 18, and the reinforcing member 21 are made of a flexible material, and the material is not particularly limited. Examples of the materials of the sheath 4, the guide wire insertion member 18, and the reinforcing member 21 can include various thermoplastic elastomers such as a styrene-based material, a polyolefin-based material, a polyurethane-based material, a polyester-based material, a polyamide-based material, a polyimide-based material, a polybutadiene-based material, a transpolyisoprene-based material, a fluororubber-based material, and a chlorinated polyethylene-based material, and one or a combination of two or more of these (a polymer alloy, a polymer blend, a laminate, or the like) can also be used.
As illustrated in
The proximal end of the inner tube 6 is integrally connected to a distal end of the hub body 8a. The drive shaft 9 is extends from the inner tube 6 inside the hub body 8a.
As illustrated in
The external device 2 includes the first drive unit 2a for rotationally driving the drive shaft 9 and a second drive unit 2b for moving the drive shaft 9 in the axial direction (that is, for push-in operation and pull-back operation). The first drive unit 2a can be configured by, for example, an electric motor. The second drive unit 2b can be configured by, for example, an electric motor and a direct motion conversion mechanism. The direct motion conversion mechanism can convert rotational motion into linear motion, and can be configured by, for example, a ball screw, a rack-and-pinion mechanism, or the like.
Operation of the first drive unit 2a and operation of the second drive unit 2b are controlled by a control device 2c electrically connected to the first drive unit 2a and the second drive unit 2b. The control device 2c includes a central processing unit (CPU) and a memory. The control device 2c is electrically connected to a display 2d.
A signal received by the ultrasound transmission and reception unit 11a is transmitted to the control device 2c via the electrical connector 15a, subjected to predetermined processing, and displayed as an image on the display 2d. A signal received by the optical transmission and reception unit 11b is transmitted to the control device 2c via the optical connector 16a, subjected to predetermined processing, and displayed as an image on the display 2d.
At the time of diagnosis, the imaging core 12 moves backward at a constant speed inside the lumen 4a of the sheath 4 by the pull-back operation by the second drive unit 2b of the external device 2 in a state in which the sheath 4 is inserted into the body cavity and the imaging core 12 is rotationally driven at a constant rotational speed of about 1000 rpm (revolutions per minute) to 10000 rpm by the first drive unit 2a of the external device 2. At this time, the control device 2c of the external device 2 causes the signal transmission and reception unit 11 to transmit and receive a signal. A state of a tissue around the body cavity is displayed as an image on the display 2d based on the signal received by scanning operation performed by rotating and moving the imaging core 12 backward.
As described above, the image diagnosis catheter 1 has the pull-back mechanism 23 that changes a relative position between the sheath 4 and the drive shaft 9 on a side close to a user in order to continuously observe a body cavity cross section. As described in
In the pull-back mechanism 23, the outer tube 5, the support tube 24, the inner tube 6, and the drive shaft 9 are coaxially provided and have a common central axis O.
The relay connector 13 has a cylindrical shape, and has a proximal-end-side inner circumferential surface 13a having a columnar surface shape, and a distal-end-side inner circumferential surface 13c having a columnar surface shape connected to a distal end of the proximal end side inner circumferential surface 13a via an annular step portion 13b. An outer circumferential surface of the proximal end of the sheath 4 is joined to the distal-end-side inner circumferential surface 13c by welding or the like. An outer circumferential surface of the distal end of the outer tube 5 is joined to the proximal-end-side inner circumferential surface 13a by welding or the like.
The spacer 25 includes a spacer body 25a positioned between the outer circumferential surface of the support tube 24 and the inner circumferential surface of the outer tube 5, and a protruding portion 25b protruding from a distal end of the spacer body 25a toward the distal end on the distal end side with respect to the distal end surface of the outer tube 5. The protruding portion 25b constitutes a stopper 25c positioned between the outer tube 5 and the relay connector 13 in the axial direction. The stopper 25c has a proximal-end-side end surface whose movement toward the proximal end side is restricted by coming into contact with the distal end surface of the outer tube 5, and a distal-end-side end surface whose movement toward the distal end side is restricted by coming into contact with the step portion 13b of the relay connector 13. The spacer 25 can be made of, for example, synthetic resin or metal.
The spacer body 25a has a cylindrical shape, and the outer circumferential surface of the spacer body 25a has two portions having a flat surface shape, the two portions being separated from each other in a first direction along a radial direction and extending in the axial direction. Therefore, two axial flow passages 26 extending in the axial direction respectively at two portions separated from each other in the first direction are formed between the outer circumferential surface of the spacer body 25a and the inner circumferential surface of the outer tube 5.
The protruding portion 25b includes a base portion 25d integrally connected to the distal end of the spacer body 25a, and two protruding pieces 25e extending from a distal end of the base portion 25d toward the distal end on the distal end side with respect to a distal end of the support tube 24. Two protruding pieces 25e are separated from each other in a second direction along the radial direction and perpendicular to the first direction. An outer circumferential surface of the protruding portion 25b has two portions having a flat surface parallel to the central axis O, the two portions being separated from each other in the first direction. Therefore, two gaps 27 separated from each other in the first direction are formed between the outer circumferential surface of the protruding portion 25b and the proximal-end-side inner circumferential surface 13a of the relay connector 13. Furthermore, a gap 28 is formed between two protruding pieces 25e. The distal end of each of the axial flow passages 26 communicates with the distal end of the lumen of the support tube 24 via one gap 27 and the gap 28.
As described above, two axial flow passages 26, two gaps 27, and the gap 28 constitute a communication passage (or communication path) 29 (see
The outer circumferential surface of the distal end of the support tube 24 is joined to the inner circumferential surface of the spacer body 25a by welding or the like. The outer tube 5 and the spacer 25 are not joined. As described above, since the outer tube 5 is joined to the relay connector 13, the spacer 25 is joined to the support tube 24, and the spacer 25 has the stopper 25c, the relay connector 13, the outer tube 5, the support tube 24, and the spacer 25 can be efficiently integrated by a small number of joining portions. However, the connection strength of the pull-back mechanism 23 may be further increased by joining the outer tube 5 and the spacer 25 by welding or the like.
The support tube 24 can be formed of, for example, a single layer of a coil or a tube, or a plurality of layers of coils or tubes. The support tube 24 can be made of, for example, synthetic resin or metal. When the inner tube 6 and the drive shaft 9 are moved forward with respect to the outer tube 5 by the push-in operation, the drive shaft 9 is supported by the support tube 24 from the radially outer side. Therefore, it is possible to prevent the drive shaft 9 from being buckled in the outer tube 5, which can hinder the relatively smooth forward-movement of the drive shaft 9.
The priming is usually performed in a state in which the inner tube 6 is drawn out (i.e., extends) from the outer tube 5 (see
As described above, according to the present embodiment, since the communication passage 29 that causes the flow passage between the outer tube 5 and the support tube 24 to communicate with the inside of the support tube 24 is formed by the spacer 25, it is possible to realize satisfactory priming in the pull-back mechanism 23.
Furthermore, according to the present embodiment, since the relay connector 13 is joined to the outer tube 5, the spacer 25 is joined to the support tube 24, and the spacer 25 has the stopper 25c, the pull-back mechanism 23 that can be relatively easily assembled can be realized.
Furthermore, according to the present embodiment, since the communication passage 29 is defined by the spacer 25, the outer tube 5, and the relay connector 13, it is possible to more reliably realize satisfactory priming in the pull-back mechanism 23.
The configuration of the pull-back mechanism 23 can be changed as long as the communication passage 29 that causes the flow passage between the outer tube 5 and the support tube 24 to communicate with the inside of the support tube 24 is formed by the spacer 25. For example, the pull-back mechanism 23 may have a configuration as in a second embodiment illustrated in
In the second embodiment, the spacer 25 has a spacer body 25a and a protruding portion 25b, and the protruding portion 25b constitutes a stopper 25c. In this point, the second embodiment has the same configuration as that of the first embodiment. However, in the second embodiment, the configuration of the spacer body 25a and the protruding portion 25b is different from that of the first embodiment.
In the second embodiment, the spacer body 25a has a cylindrical shape in which one axial groove 30 extending in the axial direction is provided at one position on the outer circumferential surface. Therefore, one axial flow passage 26 extending in the axial direction can be formed between the outer circumferential surface of the spacer body 25a and the inner circumferential surface of the outer tube 5.
Furthermore, the protruding portion 25b has a cylindrical shape, and one notch 31 extending in the axial direction and connected to the axial groove 30 is provided at one portion of the protruding portion 25b in the circumferential direction. The distal end surface of the protruding portion 25b is flush (i.e., even) with the distal end surface of the support tube 24. The notch 31 extends on the outer circumferential surface of the protruding portion 25b over the entire length in the axial direction, and radially extends on the distal end surface of the protruding portion 25b from the outer circumferential surface of the support tube 24 to an outer circumferential edge of the protruding portion 25b. Therefore, in the notch 31, one gap 27 is defined by the spacer 25, the support tube 24, and the relay connector 13.
Furthermore, the distal end surface of the protruding portion 25b is in contact with the step portion 13b of the relay connector 13, and the outer diameter of the proximal-end-side inner circumferential surface 13a of the relay connector 13 is larger than the outer diameter of the support tube 24. Therefore, the gap 27 causes the axial flow passage 26 to communicate with the distal end of the lumen of the support tube 24. As described above, in the second embodiment, the communication passage 29 is configured by one axial flow passage 26 and one gap 27. Other configurations are similar to those of the first embodiment. Even with such a configuration, satisfactory priming in the pull-back mechanism 23 can be realized.
The pull-back mechanism 23 may have a configuration as in a third embodiment illustrated in
The pull-back mechanism 23 may have a configuration as in a fourth embodiment illustrated in
The pull-back mechanism 23 may have a configuration as in a fifth embodiment illustrated in
The above-described embodiment is merely an example of the present disclosure, and various modifications, for example, as described below can be made.
The image diagnosis catheter 1 can include an outer tube 5, a support tube 24 provided radially inside of the outer tube 5, a spacer 25 integrally connecting the outer tube 5 with the support tube 24, and an inner tube 6 provided radially inside of the outer tube 5 and radially outside of the support tube 24 and movable relative to the outer tube 5 and the support tube 24 in an axial direction, and can be changed as long as the communication passage 29 causing the flow passage between the outer tube 5 and the support tube 24 to communicate with the inside of the support tube 24 is formed by the spacer 25.
However, it is preferable that the image diagnosis catheter 1 includes a relay connector 13 joined to the outer tube 5, the spacer 25 is joined to the support tube 24, and the spacer 25 has the stopper 25c positioned between the outer tube 5 and the relay connector 13 in the axial direction.
Furthermore, the communication passage 29 is preferably defined by the spacer 25, the outer tube 5, and the relay connector 13.
Furthermore, the spacer 25 preferably includes a spacer body 25a positioned between the outer circumferential surface of the support tube 24 and the inner circumferential surface of the outer tube 5, and a protruding portion 25b protruding from a distal end of the spacer body 25a toward the distal end on the distal end side with respect to the distal end surface of the outer tube 5.
Furthermore, the spacer body 25a preferably has a cylindrical shape, and the outer circumferential surface of the spacer body 25a preferably has two portions having a flat surface shape, the two portions being separated from each other in a first direction along a radial direction and extending in the axial direction.
The image diagnosis catheter 1 is not limited to a dual-type image diagnosis catheter using both IVUS and OCT, and may be an image diagnosis catheter using only IVUS or only OCT.
The pull-back mechanism 23 is not limited to the configuration in which the relay connector 13 is integrally connected to the sheath 4 and the inner tube 6 is integrally connected to the hub 8, and may have a configuration in which the relay connector 13 is integrally connected to the hub 8 and the inner tube 6 is integrally connected to the sheath 4.
The detailed description above describes embodiments of an image diagnosis catheter. The invention is not limited, however, to the precise embodiments and variations described. Various changes, modifications and equivalents may occur to one skilled in the art without departing from the spirit and scope of the invention as defined in the accompanying claims. It is expressly intended that all such changes, modifications and equivalents which fall within the scope of the claims are embraced by the claims.
Number | Date | Country | Kind |
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2021-031024 | Feb 2021 | JP | national |
This application is a continuation of International Application No. PCT/JP2022/005434 filed on Feb. 10, 2022, which claims priority to Japanese Application No. 2021-0314024 filed on Feb. 26, 2021, the entire content of both of which is incorporated herein by reference.
Number | Date | Country | |
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Parent | PCT/JP2022/005434 | Feb 2022 | US |
Child | 18454146 | US |