This disclosure generally relates to an image diagnosis catheter.
An image diagnosis catheter typically has a pull-back mechanism on a side closer to a user's hand for changing a relative position between a sheath and a drive shaft in order to continuously monitor a cross section of a body cavity. The pull-back mechanism includes an outer tube and an inner tube that is disposed on the radially inner side of the outer tube and radially outer side of the drive shaft and is axially movable with the drive shaft and relative to the outer tube.
During push-forward operation with respect to the pull-back mechanism in which the inner tube is pushed into the outer tube, when the drive shaft is buckled inside the outer tube, rotation of the drive shaft may cause the drive shaft to be broken and wrenched off. For this reason, for example, Japanese Patent Publication No. 4672188 (JP 4672188 B1) discloses a pull-back mechanism in which a support tube axially movable with an outer tube is disposed on the radially outer side of a drive shaft and radially inner side of an inner tube so as not to buckle the drive shaft during push-forward operation.
However, in a support tube as disclosed in JP 4672188 B1, it is difficult to prevent buckling of a drive shaft inside an inner tube during push-forward operation.
The image diagnosis catheter disclosed here is configured so that a drive shaft is hardly buckled not only inside an outer tube but also inside an inner tube during push-forward operation.
According to an aspect of this disclosure, an image diagnosis catheter includes: an outer tube; a first support tube disposed on the radially inner side of the outer tube; a drive shaft disposed on the radially inner side of the first support tube; an inner tube disposed on the radially inner side of the outer tube and radially outer side of the first support tube; and a second support tube disposed on the radially inner side of the inner tube and radially outer side of the drive shaft, being axially movable with the drive shaft and the inner tube and relative to the outer tube and the first support tube.
As an embodiment of this disclosure, in the image diagnosis catheter, the second support tube overlaps the first support tube in a radial direction at a frontmost or distal-most position where the inner tube is pushed furthest into the outer tube.
As an embodiment of this disclosure, in the image diagnosis catheter, the second support tube overlaps the first support tube in the radial direction even at a backmost or proximal-most position where the inner tube is drawn furthest from the outer tube.
As an embodiment of this disclosure, in the image diagnosis catheter, the second support tube is disposed on the radially outer side of the first support tube.
As an embodiment of this disclosure, the image diagnosis catheter includes a hub connected to a proximal end of the inner tube, and the second support tube is connected to the hub or the inner tube in an integrated manner.
As an embodiment of this disclosure, in the image diagnosis catheter, the second support tube is disposed on the radially inner side of the first support tube.
As an embodiment of this disclosure, the image diagnosis catheter includes a hub connected to a proximal end of the inner tube, and the second support tube is connected to the hub in an integrated manner.
As an embodiment of this disclosure, in the image diagnosis catheter, the second support tube has a coil shape.
As an embodiment of this disclosure, in the image diagnosis catheter, the first support tube does not overlap the inner tube in a radial direction at a backmost or proximal-most position where the inner tube is drawn furthest from the outer tube.
According to this disclosure, it is possible to provide an image diagnosis catheter in which a drive shaft is hardly buckled not only inside an outer tube but also inside an inner tube during push-forward operation.
According to another aspect, an image diagnosis catheter comprises: an outer tube having a distal-most end; a rotatable and axially movable drive shaft disposed in the outer tube; and a signal transmitter and receiver that transmits and receives a signal. The signal transmitter and receiver is fixed to the drive shaft, is located at the distal end of the drive shaft and is axially movable and rotatable together with the drive shaft. The signal transmitter and receiver is distal of the distal-most end of the outer tube. The image diagnosis catheter also includes a first support tube positioned radially inwardly of the outer tube, with the drive shaft being positioned radially inwardly of the first support tube. An inner tube is positioned radially inwardly of the outer tube and radially outwardly of the first support tube, and a second support tube is positioned radially inwardly of the inner tube and radially outwardly of the drive shaft. The second support tube is axially movable together with the drive shaft and the inner tube, and the second support tube together with the drive shaft and the inner tube is axially movable relative to the outer tube and the first support tube.
In accordance with another aspect, a image diagnosis catheter comprises: a sheath insertable into a cavity in a living body; an outer tube fixed relative to the sheath and extending in a proximal direction away from the sheath; a drive shaft disposed in the sheath and in the outer tube; and a first support tube positioned radially inwardly of the outer tube, with the Odrive shaft being positioned radially inwardly of the first support tube. An inner tube is positioned radially inwardly of the outer tube and radially outwardly of the first support tube, and a second support tube is positioned radially inwardly of the inner tube and radially outwardly of the drive shaft, with the second support tube being axially movable together with the drive shaft and the inner tube, and the second support tube together with the drive shaft and the inner tube being axially movable relative to the outer tube and the first support tube. The second support tube has a distal-most end that is proximal of the proximal-most end of the sheath.
Hereinafter, an embodiment of this disclosure will be described in detail with reference to the drawings.
An image diagnosis catheter 1 according to this embodiment illustrated in
The image diagnosis catheter 1 includes a sheath 4 to be inserted into a body cavity such as a vascular channel (for example, coronary arteries or other blood vessels) of a living body, an outer tube 5 connected to a proximal end of the sheath 4, an inner tube 6 inserted into the outer tube 5 and movable forward and backward, a unit connector 7 that is connected to a proximal end of the outer tube 5 and holds the inner tube 6 while allowing the inner tube 6 to move forward and backward, and a hub 8 connected to a proximal end of the inner tube 6. The image diagnosis catheter 1 further includes an imaging core 12 provided with a drive shaft 9, a housing 10 fixed to a distal end of the drive shaft 9, and a signal transmitter and receiver 11 that is housed in the housing 10 and transmits and receives a signal, that is, an ultrasound wave and/or light. The imaging core 12 is inserted into the sheath 4, the outer tube 5, and the inner tube 6 and axially movable forward and backward with the inner tube 6 and relative to the sheath 4 and the outer tube 5.
In this specification, “distal end” signifies an end of the image diagnosis catheter 1 to be inserted into a body cavity, “proximal end” signifies an end of the image diagnosis catheter 1 to be held outside the body cavity, “axially (or axial direction)” signifies a direction along a central axis O of the drive shaft 9 (that is, a direction in which the drive shaft 9 extends), “radially (or radial direction)” signifies a direction along a straight line perpendicular to the central axis O, and “circumferential direction” signifies a direction around the central axis O.
As illustrated in
As illustrated in
As illustrated in
As illustrated in
The drive shaft 9 is formed of a coil shaft. Although not illustrated, the coil shaft is formed using, for example, coils with multiple layers having different winding directions. Each coil is made of, for example, metal such as stainless steel or nickel-titanium (Ni—Ti) alloy.
The signal transmitter and receiver 11 includes an ultrasound transmitter and receiver 11a that transmits and receives an ultrasound wave and an optical transmitter and receiver 11b that transmits and receives light. The ultrasound transmitter and receiver 11a includes a transducer that transmits an ultrasound wave into a body cavity based on a pulse signal 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 transmitter and receiver 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 transmitter and receiver 11 is housed 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 is formed of a cylindrical metallic tube and has a peripheral surface provided with an opening 10a so as not to hinder the progress of a signal transmitted and received by the signal transmitter and receiver 11. The housing 10 is formed by, for example, laser processing. The housing 10 may alternatively be formed by shaving a solid metal blank, metallic powder injection molding (MIM), or the like.
A distal end of the housing 10 is provided with a distal end member 17. The distal end member 17 has a substantially hemispherical outer shape so as not to cause friction against or not to hit an inner surface of the sheath 4. The distal end member 17 may be omitted.
The sheath 4 has the lumen 4a into which the drive shaft 9 is inserted or positioned while being movable forward and backward. To the distal end of the sheath 4, a tubular guide wire insertion member 18 that allows passage of a guide wire is attached at a position shifted from an axial center of the lumen 4a 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 is provided with a marker 19 having X-ray contrast properties. The marker 19 includes a tube made of metal having high radiopaque properties such as Pt or Au.
The distal end of the sheath 4 is provided with a communication hole 20 that allows communication between the inside and outside of the lumen 4a. Furthermore, a reinforcing member 21 joined to the guide wire insertion member 18 is disposed at a distal end of the lumen 4a of the sheath 4. The reinforcing member 21 has a through-hole that allows communication between the communication hole 20 and the lumen 4a disposed closer to the proximal side than the reinforcing member 21. The distal end of the sheath 4 need not necessarily be provided with the reinforcing member 21.
The communication hole 20 is a priming solution discharge hole for discharging a priming solution. When the image diagnosis catheter 1 is used, at the time of priming for filling the sheath 4 with the priming solution, the priming solution is released from the communication hole 20 to the outside so as to discharge a gas such as air from the inside of the sheath 4 together with the priming solution.
A distal end portion of the sheath 4, or an area in which the signal transmitter and receiver 11 moves in the axial direction of the sheath 4, is formed into a window having higher permeability than other portions. The sheath 4, the guide wire insertion member 18, and the reinforcing member 21 are formed of flexible materials. Examples of the materials include, but are not particularly limited to, various thermoplastic elastomers based on styrene, polyolefin, polyurethane, polyester, polyamide, polyimide, polybutadiene, trans-polyisoprene, fluoro-rubber, or chlorinated polyethylene. These examples may be used independently, or two or more of these examples (such as polymer alloy, polymer blend, and laminate) may be combined.
As illustrated in
The proximal end of the inner tube 6 is connected to a distal end of the hub body 8a in an integrated manner. The drive shaft 9 is drawn out of the inner tube 6 inside the hub body 8a.
As illustrated in
The external device 2 includes the first drive unit 2a for driving the drive shaft 9 to rotate and a second drive unit 2b for axially moving the drive shaft 9 (that is, for push-forward operation and pull-back operation). The first drive unit 2a includes, for example, an electrical motor. The second drive unit 2b includes, for example, an electrical motor and a direct motion conversion mechanism. The direct motion conversion mechanism converts rotational motions into linear motions and includes, for example, a ball screw and a rack-and-pinion mechanism.
Operations of the first drive unit 2a and 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 transmitter and receiver 11a is transmitted to the control device 2c via the electrical connector 15a, subjected to predetermined processing, and shown on the display 2d as an image. A signal received by the optical transmitter and receiver 11b is transmitted to the control device 2c via the optical connector 16a, subjected to predetermined processing, and shown on the display 2d as an image.
At diagnosis, while the sheath 4 is inserted into a body cavity and the imaging core 12 is driven by the first drive unit 2a of the external device 2 to rotate at a constant rotational speed of about 1000 to 10000 rpm, the imaging core 12 moves backward at a constant speed inside the lumen 4a of the sheath 4 due to pull-back operation by the second drive unit 2b of the external device 2. At this time, the control device 2c of the external device 2 causes the signal transmitter and receiver 11 to transmit and receive a signal. A condition of a tissue around the body cavity is shown on the display 2d as an image based on the signal received by scanning using the imaging core 12 that rotates and moves backward.
In this manner, the image diagnosis catheter 1 has a pull-back mechanism 23 on a side closer to a user's hand for changing a relative position between the sheath 4 and the drive shaft 9 in order to continuously monitor a cross section of a body cavity. As shown in
The distal end of the inner tube 6 is provided with the locking portion 14. The locking portion 14 includes an enlarged diameter portion where an outer peripheral surface of the inner tube 6 is enlarged in diameter. A back-end surface of the locking portion 14 protrudes from the outer peripheral surface of the inner tube 6 toward the radially outer side and has an annular shape centering on the central axis O. The unit connector 7 has a stopper surface 7b that abuts on the back-end surface of the locking portion 14 to restrict further backward movement of the inner tube 6. The inner tube 6 has a diameter sufficient to offer sufficient strength to the locking portion 14 as a stopper.
In this embodiment, the pull-back mechanism 23 includes a second support tube 26 disposed on the radially inner side of the inner tube 6 and radially outer side of the drive shaft 9 and axially movable with the drive shaft 9 and the inner tube 6 and relative to the outer tube 5 and the first support tube 24. In this embodiment, the second support tube 26 is disposed on the radially outer side of the first support tube 24. The second support tube 26 is connected to the hub 8 and/or the inner tube 6 in an integrated manner.
The structure for connecting the second support tube 26 and the hub 8 in an integrated manner is not particularly limited. For example, a proximal end of the second support tube 26 may be bonded to the hub 8 directly or via another member with an adhesive or the like. The structure for connecting the second support tube 26 to the inner tube 6 in an integrated manner is not particularly limited. For example, the proximal end or distal end of the second support tube 26 or a portion therebetween may be bonded to the inner tube 6 directly or via another member with an adhesive or the like. For example, a protrusion 26a (see a dashed-two dotted line in
In the pull-back mechanism 23, the outer tube 5, the first support tube 24, the inner tube 6, the drive shaft 9, and the second support tube 26 are coaxial and share the central axis O.
The relay connector 13 has a cylindrical shape, including a proximal-side inner peripheral surface 13a having a columnar shape and a distal-side inner peripheral surface 13c having a columnar shape that is connected to a distal end of the proximal-side inner peripheral surface 13a via an annular stepped portion 13b. An outer peripheral surface of the proximal end of the sheath 4 is joined to the distal-side inner peripheral surface 13c by welding or the like. An outer peripheral surface of a distal end of the outer tube 5 is joined to the proximal-side inner peripheral surface 13a by welding or the like.
The spacer 25 has a tubular shape, an outer peripheral surface of the spacer 25 is in contact with an inner peripheral surface of the distal end of the outer tube 5, and an inner peripheral surface of the spacer 25 is in contact with an outer peripheral surface of a distal end of the first support tube 24. The outer peripheral surface of the spacer 25 is joined to the inner peripheral surface of the distal end of the outer tube 5 by welding or the like, and the inner peripheral surface of the spacer 25 is joined to the outer peripheral surface of the distal end of the first support tube 24 by welding or the like. Furthermore, the spacer 25 is made of, for example, synthetic resin or metal.
The first support tube 24 is formed of, for example, a coil or a tube with a single layer or multiple layers. The first support tube 24 is made of, for example, synthetic resin or metal. Using the coiled first support tube 24 enables the priming solution to pass radially through the first support tube 24, which promotes priming inside the outer tube 5. Instead of the coil shape, the first support tube 24 may be formed into a tubular shape entirely or partially provided with meshed cutouts or the like. The first support tube 24 may be formed into a tubular shape without cutouts. In this case, in order to promote priming the inside the outer tube 5, it is preferable that the spacer 25 is provided with a channel that allows passage of the priming solution.
The second support tube 26 is formed of, for example, a coil or a tube with a single layer or multiple layers. The second support tube 26 is made of, for example, synthetic resin or metal. Using the coiled second support tube 26 enables the priming solution to pass radially through the second support tube 26, which promotes priming inside the inner tube 6. Instead of the coil shape, the second support tube 26 may be formed into a tubular shape entirely or partially provided with meshed cutouts or the like. The second support tube 26 may be formed into a tubular shape without cutouts. In this case, in order to promote priming inside the inner tube 6, it is preferable that the proximal end of the second support tube 26 is connected to the hub 8 or the inner tube 6 via a member forming a channel that allows passage of the priming solution.
When the inner tube 6, the second support tube 26, and the drive shaft 9 move forward relative to the outer tube 5 and the first support tube 24 by push-forward operation (for example, from the backmost position illustrated in
In order to enhance the effect of preventing the buckling of the drive shaft 9, it is preferable that the second support tube 26 overlaps the first support tube 24 in the radial direction at the frontmost position where the inner tube 6 is pushed furthest into the outer tube 5, and it is more preferable that the second support tube 26 overlaps the first support tube 24 in the radial direction even at the backmost position where the inner tube 6 is drawn furthest outward (proximally) from the outer tube 5 as in this embodiment. However, the length of the second support tube 26 is set within a range that does not hinder the telescopic action of the pull-back mechanism 23. For example, as in a modification illustrated in
In this embodiment, since the second support tube 26 is disposed on the radially outer side of the first support tube 24 as described above, the second support tube 26 has an inside diameter larger than that of the first support tube 24, whereby the buckling of the drive shaft 9 is prevented in a stepwise manner from the proximal side toward the distal side. Preventing the buckling of the drive shaft 9 in a stepwise manner prevents the breakage more efficiently.
However, as in another modification illustrated in
Depending on materials of the first support tube 24 or the second support tube 26, there is a possibility that the drive shaft 9 may be buckled and broken together with the first support tube 24 or the second support tube 26. The buckling is most likely to occur inside the outer tube 5 having a largest space that allows the buckling. In a case where the second support tube 26 is disposed on the radially inner side of the first support tube 24, the first support tube 24 is made to have an increased outside diameter while the second support tube 26 is kept to have a small inside diameter (that is, the first support tube 24 is made to have an increased thickness), thereby enhancing the rigidity inside the outer tube 5. Accordingly, it is possible to prevent the drive shaft 9 from being buckled and broken together with the first support tube 24 inside the outer tube 5.
As in another modification illustrated in
In this modification, the second support tube 26 may be on the radially outer side of the first support tube 24. However, as illustrated in
In this modification, the first support tube 24 does not necessarily overlap the second support tube 26 in the radial direction at the backmost position. However, as illustrated in
As described above, according to this embodiment and the modifications thereof, not only the first support tube 24 prevents the buckling of the drive shaft 9 inside the outer tube 5 during push-forward operation but also the second support tube 26 prevents the buckling of the drive shaft 9 inside the inner tube 6 during push-forward operation. Accordingly, it is possible to prevent the drive shaft 9 from being driven to rotate while being buckled inside the pull-back mechanism 23, whereby the drive shaft 9 is prevented from being broken and wrenched off.
This disclosure is not limited to the above embodiments and can be modified in various ways within the scope of the disclosure here.
Therefore, the image diagnosis catheter 1 according to the embodiment can be changed in various ways, examples of which are described below.
The image diagnosis catheter 1 according to the embodiment can be changed in various ways as long as the image diagnosis catheter 1 includes: the outer tube 5; the first support tube 24 disposed on the radially inner side of the outer tube 5; the drive shaft 9 disposed on the radially inner side of the first support tube 24; the inner tube 6 disposed on the radially inner side of the outer tube 5 and radially outer side of the first support tube 24; and the second support tube 26 disposed on the radially inner side of the inner tube 6 and radially outer side of the drive shaft 9, being axially movable with the drive shaft 9 and the inner tube 6 and relative to the outer tube 5 and the first support tube 24.
For example, without the spacer 25, the distal end of the first support tube 24 may be directly connected to the relay connector 13 or the outer tube 5 in an integrated manner using an adhesive or the like.
The pull-back mechanism 23 is not limited to the configuration in which the outer tube 5 is connected to the relay connector 13 in an integrated manner and the inner tube 6 is connected to the hub 8 in an integrated manner and may have a configuration in which the outer tube 5 is connected to the hub 8 in an integrated manner and the inner tube 6 is connected to the relay connector 13 in an integrated manner.
The image diagnosis catheter 1 is not limited to a dual-type using both IVUS and OCT and may be of a type using only IVUS or OCT.
In the image diagnosis catheter 1 according to the embodiment, it is preferable that the second support tube 26 overlaps the first support tube 24 in the radial direction at the frontmost position where the inner tube 6 is pushed furthest into the outer tube 5.
In the image diagnosis catheter 1 according to the embodiment, it is preferable that the second support tube 26 overlaps the first support tube 24 in the radial direction even at the backmost position where the inner tube 6 is drawn furthest from the outer tube 5.
In the image diagnosis catheter 1 according to the embodiment, it is preferable that the second support tube 26 is disposed on the radially outer side of the first support tube 24.
In this case, it is preferable that the image diagnosis catheter 1 includes the hub 8 connected to the proximal end of the inner tube 6, and the second support tube 26 is connected to the hub 8 or the inner tube 6 in an integrated manner.
In the image diagnosis catheter 1 according to the embodiment, it is also preferable that the second support tube 26 is disposed on the radially inner side of the first support tube 24.
In this case, it is preferable that the image diagnosis catheter 1 includes the hub 8 connected to the proximal end of the inner tube 6, and the second support tube 26 is connected to the hub 8 in an integrated manner.
In the image diagnosis catheter 1 according to the embodiment, it is preferable that the second support tube 26 has a coil shape.
In the image diagnosis catheter 1 according to the embodiment, it is preferable that the first support tube 24 does not overlap the inner tube 6 in the radial direction at the backmost position where the inner tube 6 is drawn furthest from the outer tube 5.
The detailed description above describes embodiments of an image diagnosis catheter representing examples of the new image diagnosis catheter disclosed here. The invention is not limited, however, to the precise embodiments and variations described. Various changes, modifications and equivalents can be effected by 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 that fall within the scope of the claims are embraced by the claims.
Number | Date | Country | Kind |
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2021-126235 | Jul 2021 | JP | national |
This application is a continuation of International Patent Application No. PCT/JP2022/029205 filed on Jul. 28, 2022, which claims priority to Japanese Patent Application No. 2021-126235 filed on Jul. 30, 2021, the entire content of both of which is incorporated herein by reference.
Number | Date | Country | |
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Parent | PCT/JP2022/029205 | Jul 2022 | US |
Child | 18421217 | US |