Guide wire

Abstract

To shorten a surgery time.SOLUTION: A guide wire includes: a first flexible tube body 11 extending in a front-back direction; a plurality of operation wires 12 extending in the front-back direction provided inside the first flexible tube body 11 at an interval in a circumferential direction; a fastened body 13 to which the front edge of the operation wire 12 is fastened; a support body 14 provided behind the fastened body 13 for sandwiching the first flexible tube body 11 with the fastened body 13 in the front-back direction; and a penetrated body 16 provided inside in a radial direction of the first flexible tube body 11, which a plurality of the operation wires 12 penetrate in the front-back direction. An inner peripheral surface of the first flexible tube body 11 and an outer peripheral surface of the penetrated body 16 are of a non-circular shape when viewed in the front-back direction. The inner peripheral surface of the first flexible tube body 11 and the outer peripheral surface of the penetrated body 16 abut against each other so that relative rotation around a center axis O of the guide wire 1 of the first flexible tube body 11 and the penetrated body 16 is regulated.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present invention relates to a guide wire.

Background Art

[0002] Conventionally, there is known a guide wire including a first flexible tube body (outer flexible tube body 4) extending in the front-rear direction, a fixed body (tip-attached portion 41) to which the front end portion of the first flexible tube body is supported, and a support body provided behind the fixed body and sandwiching the first flexible tube body in the front-rear direction between the support body and the fixed body. Generally, a guide wire is inserted into a blood vessel and used to guide a balloon or a stent to a chronic total occlusion lesion or the like in the blood vessel while penetrating the chronic total occlusion lesion or the like in the blood vessel. When penetrating a chronic total occlusion lesion or the like with a guide wire, for example, the following procedure is taken. First, with the guide wire inserted into the microcatheter, the guide wire is advanced into the blood vessel. When reaching a chronic total occlusion lesion or the like in the blood vessel, the microcatheter is left in the blood vessel, the guide wire that has been used so far is withdrawn, and then a guide wire having a higher tip load or the like than this guide wire is inserted into the microcatheter again and pierced into the chronic total occlusion lesion or the like, and the chronic total occlusion lesion or the like is penetrated by the guide wire and the microcatheter. Then, with the microcatheter remaining in the blood vessel in a state of penetrating the chronic total occlusion lesion or the like, the guide wire having a high tip load or the like is withdrawn, the original guide wire having a low tip load or the like is inserted into the microcatheter again, and after reaching a position penetrating the chronic total occlusion lesion or the like, the microcatheter is withdrawn while leaving this guide wire.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

[0004] With conventional guidewires, in order to penetrate chronic total occlusion lesions, it is necessary to insert and remove guidewires with different bending stiffness, such as tip load, into the blood vessels and use them accordingly. Furthermore, in order to reach chronic total occlusion lesions, it is necessary to select the target vessel, for example, at a vascular bifurcation, and enter the target vessel, thus there is a need to shorten surgical time.

[0005] This invention provides a guide wire that can shorten surgical time. [Means for solving the problem]

[0006] A guide wire according to one aspect of the present invention extends in the front-rear direction Furthermore, the bending rigidity increases with compressive deformation in the front-rear direction. The device comprises a first flexible tube, a plurality of operating wires extending in the front-rear direction and provided circumferentially spaced inside the first flexible tube, a fixed body to which the front end edges of the operating wires are fixed, a support provided behind the fixed body and sandwiching the first flexible tube between itself and the fixed body in the front-rear direction, and a penetrating body provided radially inward from the first flexible tube and through which the plurality of operating wires pass in the front-rear direction. The inner circumferential surface of the first flexible tube and the outer circumferential surface of the penetrating body are non-circular when viewed from the front-rear direction, and the relative rotation of the first flexible tube and the penetrating body around the central axis of the guide wire is restricted by the contact between the inner circumferential surface of the first flexible tube and the outer circumferential surface of the penetrating body.

[0007] When all of the manipulative wires are pulled backward, the fixed object moves backward, and the first flexible tube undergoes compressive deformation in the anterior-posterior direction between itself and the support, thereby increasing the bending rigidity of the first flexible tube. Therefore, by manipulating the manipulative wires while the guidewire is inserted into the blood vessel, the bending rigidity of the first flexible tube can be changed. This allows the first flexible tube to maintain a low bending stiffness until the guidewire enters the blood vessel and reaches the chronic occluded lesion. When the guidewire penetrates the chronic occluded lesion, the manipulator wire is pulled backward to increase the bending stiffness of the first flexible tube. After penetration, the manipulator wire is released, returning the bending stiffness of the first flexible tube to its original low state. Therefore, it eliminates the need to insert and remove guidewires with different bending stiffnesses into blood vessels to penetrate chronic occluded lesions. When one of the multiple manipulative wires is pulled backward, the fixed object moves backward while tilted relative to the central axis of the guide wire. This causes the anterior end of the first flexible tube to bend toward the manipulative wire that is pulled backward. By manipulating the manipulative wire and bending the guide wire, it becomes possible to select a vessel at a vascular bifurcation and enter the target vessel. This reduces reliance on the physician's sense of touch when guiding the guide wire along a vessel to chronic total occlusion lesions, and eliminates the need to insert, remove, and replace guide wires with different anterior curvatures into vessels. Therefore, the surgical time can be shortened.

[0008] Since it is provided radially inward from the first flexible tube and has a penetrating body through which multiple operating wires pass in the front-to-back direction, it is possible to stabilize the relative positions of the multiple operating wires in the circumferential direction, and by operating the operating wires, the first flexible tube can be changed to the intended shape and bending rigidity with precision.

[0009] The inner surface of the first flexible tube and the outer surface of the object being penetrated are non-circular when viewed from the front-to-back direction, and the inner surface of the first flexible tube and the outer surface of the object being penetrated come into contact with each other. This restricts the relative rotation of the first flexible tube and the object being penetrated around the central axis of the guidewire, thereby preventing the maneuvering wire from twisting relative to the first flexible tube while the guidewire is being inserted into the blood vessel and reaching the chronic total occlusion lesion, and ensuring high maneuverability of the guidewire.

[0010] The device comprises a core shaft that extends in the front-rear direction and is formed to be elastically deformable, and is surrounded radially from the outside by a plurality of operating wires, wherein the core shaft is supported by the support so as to be movable in the front-rear direction, and the front end edge of the core shaft may be fixed to the object to be fixed.

[0011] Since the core shaft is supported by the support so as to be movable in the front-rear direction, when all of the operating wires are pulled backward, the core shaft also moves backward. Furthermore, since the front end edge of the core shaft is fixed to the fixed object, when some of the operating wires are pulled backward, the front end of the core shaft elastically deforms in accordance with the movement of the fixed object. Therefore, regardless of the operating conditions by the operating wires, not only the first flexible tube but also the core shaft contributes to the rigidity of the guide wire, making it easy to ensure the rigidity of the guide wire.

[0012] The body to be penetrated is formed in a plate shape with its front and back surfaces facing the front-to-back direction, and multiple such bodies may be provided at intervals in the front-to-back direction.

[0013] Since the objects to be penetrated are formed in a plate shape with their front and back surfaces facing the front-to-back direction, and multiple such objects are provided at intervals in the front-to-back direction, multiple operating wires can be easily attached to the objects to be penetrated, compared to cases where the objects to be penetrated are formed in a cylindrical shape extending in the front-to-back direction, for example.

[0014] The operating wire penetrates the object to be penetrated so as to be movable relative to it in the front-rear direction, and an inner flexible tube body may be provided between adjacent objects to be penetrated in the front-rear direction, and between adjacent objects to be penetrated and the object to be fixed, with both ends in the front-rear direction in contact with the object to be penetrated or the object to be fixed.

[0015] Since the operating wires penetrate the object being penetrated so that it can move relative to it in the front-to-back direction, multiple operating wires can be easily attached to the object being penetrated. Since inner flexible tubes are provided between adjacent objects to be penetrated in the front-to-back direction, and between adjacent objects to be penetrated and fixed in the front-to-back direction, with both ends in the front-to-back direction in contact with the object to be penetrated or fixed, it is possible to suppress the tendency for the distance between adjacent objects in the front-to-back direction to fluctuate significantly depending on the operating conditions of the operating wire. [Effects of the Invention]

[0016] According to the above embodiment of the present invention, the surgical time can be shortened. [Brief explanation of the drawing]

[0017] [Figure 1] This is a longitudinal cross-sectional view of a guide wire according to one embodiment. [Figure 2] This is a cross-sectional view taken along the line II-II in Figure 1. [Figure 3] Figure 1 shows the state in which all of the control wires are pulled to the rear, increasing the bending rigidity of the front end of the first flexible tube. [Modes for carrying out the invention]

[0018] An embodiment of the guidewire will be described below with reference to Figures 1 to 3. The guide wire 1 includes a first flexible tube body 11, an operating wire 12, a fixed object 13, a support 14, a core shaft 15, a penetrated object 16, and inner flexible tube bodies 17 and 18. The first flexible tube body 11, the operating wire 12, the fixed object 13, the support 14, the core shaft 15, and the inner flexible tube bodies 17 and 18 are formed of, for example, a metal material or the like. The penetrated object 16 is formed of, for example, a resin material or the like. Note that the core shaft 15, the penetrated object 16, and the inner flexible tube bodies 17 and 18 may not be provided. Further, the materials forming the first flexible tube body 11, the operating wire 12, the fixed object 13, the support 14, the core shaft 15, the penetrated object 16, and the inner flexible tube bodies 17 and 18 may be appropriately changed.

[0019] The first flexible tube body 11, the core shaft 15, and the inner flexible tube bodies 17 and 18 are arranged coaxially with a common axis. Hereinafter, this common axis is referred to as the central axis O, the side of the fixed object 13 along the central axis O is referred to as the front side, the side of the support 14 along the central axis O is referred to as the rear side, and the direction along the central axis O is referred to as the front-rear direction. When viewed from the front-rear direction, the direction intersecting the central axis O is referred to as the radial direction, and when viewed from the front-rear direction, the direction circulating around the central axis O is referred to as the circumferential direction.

[0020] The first flexible tube body 11 is a coil spring extending in the front-rear direction. Note that the first flexible tube body 11 may be a cylindrical body formed to be elastically deformable in the front-rear direction. The outer diameter of the first flexible tube body 11 is sized to be insertable into a blood vessel. The diameter of the wire forming the first flexible tube body 11 is the same over the entire length. The outer shape and size of the first flexible tube body 11 viewed from the front-rear direction are the same over the entire length in the front-rear direction. Note that the diameter of the wire forming the first flexible tube body 11 may not be the same over the entire length, and the outer shape and size of the first flexible tube body 11 viewed from the front-rear direction may not be the same over the entire length in the front-rear direction. For example, the outer diameter of the first flexible tube body 11 may become smaller toward the front. In the first flexible tube 11, the spacing between adjacent wires in the front-to-back direction (pitch spacing) is wider at the front end compared to the rear portion located behind the front end. As a result, when a compressive load is applied to the first flexible tube 11 in the front-to-back direction, the front end of the first flexible tube 11 shrinks more significantly in the front-to-back direction compared to the rear portion. Note that the pitch spacing may be the same throughout the entire first flexible tube 11.

[0021] The operating wires 12 extend in the front-rear direction and are provided in multiples inside the first flexible tube 11 at circumferential intervals. The operating wires 12 extend straight in the front-rear direction. Two or more operating wires 12 (four in the illustrated example) are provided at equal intervals in the circumferential direction. The spacing between adjacent operating wires 12 in the circumferential direction may be changed as appropriate.

[0022] The front end of the operating wire 12 is fixed to the fixed body 13. The fixed body 13 is formed in a plate shape with its front and back surfaces facing in the front-rear direction. The front end of the operating wire 12 is fixed to the rear surface of the fixed body 13, for example, by brazing or crimping. The front end of the first flexible tube 11 abuts against the rear surface of the fixed body 13. The external shapes and sizes of the fixed body 13 and the first flexible tube 11, as viewed from the front-rear direction, are the same. The front surface of the fixed body 13 is formed in a spherical shape with a projection facing forward. However, the external shapes and sizes of the fixed body 13 and the first flexible tube 11, as viewed from the front-rear direction, may be different from each other.

[0023] The support 14 is located behind the fixed object 13 and sandwiches the first flexible tube 11 between itself and the fixed object 13 in the front-rear direction. In the illustrated example, the support 14 supports a plurality of operating wires 12 so that they can move in the front-rear direction. The support 14 has a plurality of first insertion holes 14a through which the plurality of operating wires 12 are individually inserted so that they can move in the front-rear direction. The operating wires 12 pass through the support 14 in the front-rear direction. In addition, a member for supporting the operating wire 12 may be provided separately from the support body 14. Furthermore, the support body 14 may be, for example, a controller capable of operating the operating wire 12.

[0024] The core shaft 15 extends in the front-rear direction and is formed to be elastically deformable, and is surrounded radially from the outside by a plurality of operating wires 12. The core shaft 15 extends straight in the front-rear direction. The core shaft 15 is supported by a support 14 so as to be movable in the front-rear direction, and the front end edge of the core shaft 15 is fixed to the fixed body 13. The front end edge of the core shaft 15 is fixed to the rear surface of the fixed body 13 by, for example, brazing or crimping. The support 14 has a second insertion hole 14b through which the core shaft 15 is inserted so as to be movable in the front-rear direction. The second insertion hole 14b is arranged coaxially with the central axis O. The core shaft 15 penetrates the support 14 in the front-rear direction.

[0025] The pierced object 16 is located radially inward from the first flexible tube 11, and multiple operating wires 12 pass through it in the front-to-back direction. The operating wires 12 pass through the pierced object 16 so that it can move relative to it in the front-to-back direction. The pierced object 16 is formed in a plate shape with its front and back surfaces facing the front-to-back direction, and multiple pierced objects are provided spaced apart in the front-to-back direction. The operating wires 12 pass through the outer peripheral edge of the pierced object 16 in the front-to-back direction. As shown in Figure 2, the shape of the outer peripheral surface of the pierced object 16, as viewed from the front-to-back direction, is the same as the shape of the inner peripheral surface of the first flexible tube 11, as viewed from the front-to-back direction. As viewed from the front-to-back direction, the outer peripheral surface of the pierced object 16 is slightly radially inward from the inner peripheral surface of the first flexible tube 11. The object to be penetrated 16 may be formed in a cylindrical shape extending in the front-to-back direction.

[0026] The inner flexible tubes 17 and 18 are provided one at a time between adjacent objects to be penetrated 16 in the front-rear direction, and between adjacent objects to be penetrated 16 and objects to be fixed 13 in the front-rear direction. The front-rear ends of the inner flexible tubes 17 and 18 are in contact with either the object to be penetrated 16 or the object to be fixed 13. The multiple inner flexible tubes 17 and 18 form a coil spring extending in the front-rear direction. The inner flexible tubes 17 and 18 may be cylindrical. Only a portion of the multiple inner flexible tubes 17 and 18 may be formed to be elastically deformable in the front-to-back direction.

[0027] In the illustrated example, among the multiple inner flexible tubes 17 and 18, the inner flexible tube 17 located between the fixed body 13 and the penetrated body 16 has a lower spring constant than the remaining multiple inner flexible tubes 18. The former inner flexible tube 17 allows for adjustment of the length range in which the bending stiffness can be varied, and the range of variation of the bending stiffness, for example, in the guide wire 1. Furthermore, the spring constant of the inner flexible tube 17 of the former may be set to be equal to or greater than the spring constant of the inner flexible tube 18 of the latter. Also, the spring constants of the multiple inner flexible tubes 18 of the latter may be set to be different from each other.

[0028] The inner circumferential surface of the first flexible tube 11 and the outer circumferential surface of the object to be penetrated 16 are non-circular when viewed from the front-rear direction, and the inner circumferential surface of the first flexible tube 11 and the outer circumferential surface of the object to be penetrated 16 come into contact with each other, thereby restricting the relative rotation of the first flexible tube 11 and the object to be penetrated 16 about the central axis O.

[0029] In the illustrated example, the inner circumferential surface of the first flexible tube 11 and the outer circumferential surface of the object being penetrated 16 have an elliptical shape when viewed from the front-to-back direction. The major axes of the first flexible tube 11 and the object being penetrated 16 coincide with each other, and the minor axes of the first flexible tube 11 and the object being penetrated 16 coincide with each other. In other words, the circumferential orientations of the first flexible tube 11 and the object being penetrated 16 coincide with each other. One operating wire 12 is provided at each end of the first flexible tube 11 in the direction of the major axis and one at each end of the direction of the minor axis, and it penetrates each end of the outer circumferential edge of the object being penetrated 16 in the front-to-back direction.

[0030] As described above, with the guidewire 1 according to this embodiment, as shown in Figure 3, when all of the multiple manipulative wires 12 are pulled backward, the fixed body 13 moves backward, and the first flexible tube 11 is compressed and deformed in the front-rear direction between itself and the support 14, thereby increasing the bending rigidity of the first flexible tube 11. Therefore, with the guidewire 1 inserted into the blood vessel, the bending rigidity of the first flexible tube 11 can be changed by manipulating the manipulative wires 12.

[0031] This allows the first flexible tube 11 to maintain a low bending stiffness until the guidewire 1 penetrates a chronic total occlusion lesion. When the guidewire 1 is inserted into the chronic total occlusion lesion and penetrates it, the manipulator wire 12 is pulled backward to increase the bending stiffness of the first flexible tube 11. After penetration, the manipulator wire 12 is released to return the bending stiffness of the first flexible tube 11 to its original low state. Therefore, it is no longer necessary to insert and remove guidewires with different bending stiffnesses into blood vessels to penetrate chronic total occlusion lesions.

[0032] When a portion of the multiple manipulative wires 12 is pulled backward, the fixed body 13 moves backward while tilted with respect to the central axis O of the guide wire 1, causing the anterior end of the first flexible tube 11 to bend toward the manipulative wire 12 that is pulled backward. By manipulating the manipulative wire 12 and bending the guide wire 1, it is possible to select a blood vessel at a vascular bifurcation and enter the target blood vessel. This reduces reliance on the physician's sense of touch when guiding the guide wire 1 along a blood vessel to a chronic total occlusion lesion, and eliminates the need to insert, remove, and replace guide wires with different anterior end curvatures into blood vessels.

[0033] Therefore, the surgical time can be shortened.

[0034] Since the first flexible tube body 11 is provided with a penetrating body 16 located radially inward from it, and through which multiple operating wires 12 pass in the front-to-back direction, it becomes possible to stabilize the relative positions of the multiple operating wires 12 in the circumferential direction, and by operating the operating wires 12, the first flexible tube body 11 can be precisely changed to the intended shape and bending rigidity.

[0035] The inner circumferential surface of the first flexible tube 11 and the outer circumferential surface of the punctured object 16 are non-circular when viewed from the front-rear direction, and the inner circumferential surface of the first flexible tube 11 and the outer circumferential surface of the punctured object 16 come into contact with each other, thereby restricting the relative rotation of the first flexible tube 11 and the punctured object 16 about the central axis O. This makes it possible to suppress the twisting of the operating wire 12 relative to the first flexible tube 11 while the guide wire 1 is being inserted into the blood vessel and reaching the chronic total occlusion lesion, etc., thereby ensuring high operability of the guide wire 1.

[0036] Since the core shaft 15 is supported by the support 14 so as to be movable in the front-rear direction, when all of the operating wires 12 are pulled backward, the core shaft 15 also moves backward. Furthermore, since the front end edge of the core shaft 15 is fixed to the fixed body 13, when some of the operating wires 12 are pulled backward, the front end of the core shaft 15 elastically deforms in accordance with the movement of the fixed body 13. Therefore, regardless of the operating conditions of the operating wires 12, not only the first flexible tube 11 but also the core shaft 15 contribute to the rigidity of the guide wire 1, making it easy to ensure the rigidity of the guide wire 1.

[0037] Since the body to be penetrated 16 is formed in a plate shape with its front and back surfaces facing the front-to-back direction, and multiple bodies are provided spaced apart in the front-to-back direction, multiple operating wires 12 can be easily attached to the body to be penetrated 16, compared to cases where the body to be penetrated 16 is formed in a cylindrical shape extending in the front-to-back direction, for example.

[0038] Since the operating wire 12 penetrates the object to be penetrated 16 so that it can move relative to it in the front-to-back direction, multiple operating wires 12 can be easily attached to the object to be penetrated 16. Since inner flexible tubes 17 and 18, whose ends in the front-to-back direction abut against the penetrated object 16 or the fixed object 13, are provided between adjacent penetrated objects 16 in the front-to-back direction, and between adjacent penetrated objects 16 and the fixed object 13 in the front-to-back direction, it is possible to suppress the tendency for the distance between each of the aforementioned adjacent objects in the front-to-back direction to fluctuate significantly depending on the operating conditions of the operating wire 12.

[0039] It should be noted that the technical scope of the present invention is not limited to the embodiments described above, and various modifications can be made without departing from the spirit of the invention.

[0040] For example, the inner circumferential surface of the first flexible pipe body 11 and the outer circumferential surface of the body to be penetrated 16 may have angular shapes such as a triangular shape and a square shape when viewed from the front-to-back direction.

[0041] Furthermore, without departing from the spirit of the present invention, the components in the above embodiments may be replaced with well-known components as appropriate, and the above embodiments and modifications may be combined as appropriate. [Explanation of Symbols]

[0042] 1 Guidewire 11 First flexible tube body 12 Operating wires 13 Object to be fixed 14 Support 15 Core Shaft 16 Penetrated object 17, 18 Inner flexible tube

Claims

1. A first flexible pipe body that extends in the front-to-back direction and whose bending rigidity increases with compressive deformation in the front-to-back direction, Multiple operating wires are provided inside the first flexible tube body at circumferential intervals, extending in the front-rear direction, The front end edge of the operating wire is fixed to the fixed body, A support is provided behind the fixed object, and between it and the fixed object, sandwiches the first flexible tube in the front-rear direction; The device comprises a body provided radially inward from the first flexible tube, through which the plurality of operating wires pass in the front-rear direction, A guide wire in which the inner circumferential surface of the first flexible tube and the outer circumferential surface of the object to be penetrated are non-circular when viewed from the front-rear direction, and the relative rotation of the first flexible tube and the object to be penetrated about the central axis of the guide wire is restricted by the contact between the inner circumferential surface of the first flexible tube and the outer circumferential surface of the object to be penetrated.

2. It comprises a core shaft that extends in the front-rear direction and is formed to be elastically deformable, and is surrounded from the radial outside by a plurality of the aforementioned operating wires, The guide wire according to claim 1, wherein the core shaft is supported on the support so as to be movable in the front-rear direction, and the front end edge of the core shaft is fixed to the object to be fixed.

3. The guide wire according to claim 1 or 2, wherein the body to be penetrated is formed in a plate shape with its front and back surfaces facing the front-to-back direction, and a plurality of such bodies are provided at intervals in the front-to-back direction.

4. The operating wire penetrates the object to be penetrated so that it can move relative to it in the front-rear direction, The guide wire according to claim 3, wherein an inner flexible tube body is provided between adjacent objects to be penetrated in the front-rear direction, and between adjacent objects to be penetrated and the object to be fixed, with both ends in the front-rear direction in contact with the object to be penetrated or the object to be fixed.

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