Tubular body delivery device for medical use

Abstract

The present invention relates to a medical tubular body delivery device. A medical tubular body delivery device which does not reduce operability and is not easily kinked is provided. It has an outer tube in which a medical tubular body is disposed in an inner cavity, a guide wire insertion member disposed on a proximal side of the medical tubular body, and an inner insertion member disposed in the inner cavity of the outer tube, a through path is formed in the guide wire insertion member, a guide wire tube is disposed in the through path, a portion of the inner insertion member is fixed to the guide wire insertion member, a portion of the inner insertion member on a proximal side of the fixed region has a protection member on the outside, the protection member has an area reduction interval in which a cross-sectional area in a cross section perpendicular to an axial direction decreases toward a distal end, and the protection member in the area reduction interval is biased toward a side opposite the guide wire tube with respect to the inner insertion member.

Description

TECHNICAL FIELD

[0001] The present application relates to a medical tubular body delivery device. BACKGROUND

[0002] In recent years, a minimally invasive treatment technique of delivering and disposing a medical tubular body to a lesion in a body has been developed. As the medical tubular body, for example, a stent, a stent graft, an occlusion device, an infusion catheter, a prosthetic valve, or the like can be used. Among them, the stent is generally a medical tubular body for treating various diseases caused by stenosis or occlusion of a blood vessel or other body lumen.

[0003] In this technique, a delivery device that delivers and disposes a medical tubular body to a lesion in a body lumen is used. The delivery device has an outer tube, and delivers the medical tubular body to the lesion in the body lumen while holding the medical tubular body in the inner cavity of the outer tube. After the delivery, the medical tubular body can be disposed at the lesion by releasing the medical tubular body from the inner cavity of the outer tube. Devices that deliver such a medical tubular body are disclosed in Patent Documents 1 to 3, for example.

[0004] In the device that delivers the medical tubular body, it is required that the ease of operation at the hand side be easily transferred to the followability at the distal side, and the operability be good so that the device can be smoothly inserted along the body lumen without resistance, and it is required that the device not easily cause deformation, kinking, or breakage when used.

[0005] Patent Document 1: Japanese Patent Application Publication No. 2006-515206

[0006] Patent Document 2: U.S. Patent Application Publication No. 2008 / 0255655

[0007] Patent Document 3: Japanese Patent Application Publication No. 2012-45043

[0008] In Figure 1 an example of an embodiment of an existing medical tubular body delivery device is shown. Further, the medical tubular body delivery device has a hand side as a proximal end, and a side opposite to the proximal end, that is, a side close to a lesion or the like, as a distal end.

[0009] Figure 1is a schematic view of a distal side of a medical tubular body delivery device, having an outer tube 12 in which a medical tubular body 11 is disposed, a guide wire insertion member 14 located on a proximal side of the medical tubular body 11, and an inner insertion member 13 disposed in an inner lumen of the outer tube 12. The guide wire insertion member 14 is formed with a through passage 15 in which a guide wire is inserted, and a guide wire tube 16 in which the guide wire is inserted is disposed in the through passage 15, the guide wire tube 16 being disposed extending to the proximal side at least from a proximal side opening 15a of the through passage 15. A portion of the inner insertion member 13 is fixed to the guide wire insertion member 14, and a portion of the inner insertion member 13 on the proximal side of a fixed region 14a at which the inner insertion member 13 and the guide wire insertion member 14 are fixed is disposed outwardly with a protection member 17. In addition, as shown in Figure 1 the guide wire tube 16 is disposed extending to the distal side from a distal end of the guide wire insertion member 14, and the distal end of the guide wire tube 16 reaches the inner lumen of the front end contact 18.

[0010] The inner insertion member 13 is disposed extending to the proximal end of the medical tubular body delivery device (the side of the operator's hand), and the operation of the side of the operator's hand can be transmitted to the distal side via the inner insertion member 13. In addition, the outer tube 12 is pulled to the proximal side, and thus the medical tubular body 11 is pushed out of the inner lumen of the outer tube 12 into the body lumen by the guide wire insertion member 14 and is released. In detail, if the outer tube 12 is pulled to the proximal side, the medical tubular body 11 moves to the proximal side following the movement of the outer tube 12 and compresses the guide wire insertion member 14 and the inner insertion member 13. When the reaction force generated in the guide wire insertion member 14 and the inner insertion member 13 with respect to the stress of the compression exceeds the frictional resistance of the medical tubular body 11, the medical tubular body 11 is released to the outside of the outer tube 12. However, in the case where the frictional resistance of the medical tubular body 11 is excessively large, the case where the guide wire insertion member 14 and the inner insertion member 13 are excessively soft, and the case where the members are configured to hinder the transmission of the stress in the long axis direction, the load of the outer tube 12 pulled to the proximal side increases. In addition, in the medical tubular body delivery device shown in Figure 1 In the medical tubular body delivery device shown in the drawing, the guide wire and the inner insertion member 13 are disposed in parallel, and thus at the proximal end of the guide wire insertion member 14, the transmission path of the load is offset in parallel, and a force toward the outside is generated. In particular, the proximal end of the guide wire insertion member 14 greatly changes in rigidity in its configuration, and thus the load easily escapes to the outside. If the load escapes to the outside, the load required for the deployment of the medical tubular body 11 increases.

[0011] Although such a medical tubular delivery device is inserted into the body lumen, the lumen is complexly tortuous, so the medical tubular delivery device also bends along with the lumen. If localized stress concentration occurs on the proximal side of the guidewire insertion member 14 when it is bent, the rigidity of the proximal end of the guidewire insertion member 14 easily becomes knotted, i.e., stuck and unable to move. If the outer tube 12 is pulled towards the proximal side in the knotted state, it is often impossible to push the medical tubular body 11 into the body lumen. In addition, the inner insertion member 13 is thinner than the guidewire insertion member 14, so it does not have sufficient support. Therefore, during the deployment operation of the medical tubular body 11, excessive load is sometimes applied to the inner insertion member 13. In order to strengthen the inner insertion member 13, such as Figure 1 As shown, a protective member 17 is considered to be arranged on the outside of the insertion member 13. In this case, by providing a gap between the proximal end of the guidewire insertion member 14 and the distal end of the protective member 17, interference between the members can be appropriately suppressed, thus improving operability. However, the presence of such a gap creates a rigidity discontinuity, which promotes knotting and increases the deployment load on the medical tubular body 11. Furthermore, although increasing the strength of the outer tube 12 is considered to prevent knotting of the medical tubular body delivery device, it is difficult to deform accordingly when passing through bends or branches in the lumen of the body. Therefore, it is believed that the increased contact resistance with the lumen of the body makes it difficult to insert the medical tubular body delivery device into the lumen of the body, reducing operability. Summary of the Invention

[0012] The present invention was made with regard to the above-mentioned situation, and its object is to provide a medical tubular body delivery device that does not reduce operability and is not prone to tangling.

[0013] This invention includes the following inventions.

[0014] [1] A medical tubular body delivery device is a device for delivering a medical tubular body in a body, and includes an outer tube in which the medical tubular body is disposed in an inner lumen, a guide wire insertion member disposed on a proximal side of the medical tubular body, and an inner insertion member disposed in the inner lumen of the outer tube, a through passage in which a guide wire is inserted in the inner lumen is formed in the guide wire insertion member, a guide wire tube in which the guide wire is inserted in the inner lumen is disposed in the through passage, the guide wire tube is disposed at least to extend toward the proximal side from a proximal side opening position of the through passage, a portion of the inner insertion member is fixed to the guide wire insertion member, a portion of the inner insertion member on the proximal side of a fixed region in which the inner insertion member and the guide wire insertion member are fixed has a protection member on the outer side, the protection member has an area reduction region in which a cross-sectional area of a cross section perpendicular to an axial direction of the protection member decreases toward a distal end, and the protection member of the area reduction region is biased toward a side opposite to the guide wire tube with respect to the inner insertion member.

[0015] [2] The medical tubular body delivery device according to [1], the guide wire tube has an area reduction region in which a cross-sectional area of a cross section perpendicular to an axial direction of the guide wire tube decreases toward a proximal end, and the guide wire tube of the area reduction region is biased toward the inner insertion member side.

[0016] [3] The medical tubular body delivery device according to [1] or [2], a distal end portion of the protection member is a tapered shape.

[0017] [4] The medical tubular body delivery device according to any one of [1] to [3], a distance between a most proximal position of the guide wire insertion member and a most distal position of the protection member is 0.5 mm or more and 30 mm or less.

[0018] [5] The medical tubular body delivery device according to any one of [1] to [4], the medical tubular body delivery device is a rapid exchange type in which the outer tube has a guide wire port disposed on the distal side from a proximal end of the outer tube.

[0019] [6] The medical tubular body delivery device according to any one of [1] to [5], the guide wire tube is disposed to extend toward the distal side from a distal side opening position of the through passage.

[0020] [7] The medical tubular body delivery device according to [5], an inner insertion tube in which the guide wire is inserted in the inner lumen is disposed in the inner lumen of the outer tube, and a proximal end of the inner insertion tube is fixed to the guide wire port.

[0021] [8] The medical tubular body delivery device according to [7], a portion of the inner insertion tube is disposed in the inner lumen of the guide wire tube.

[0022] [9] The medical tubular body delivery device according to any one of [1] to [8], wherein the proximal end of the guide wire tube is tapered.

[0023]

[10] The medical tubular body delivery device according to any one of [1] to [9], wherein the guide wire insertion member is colored.

[0024]

[11] The medical tubular body delivery device according to any one of [1] to

[10] , wherein the medical tubular body is a self-expandable stent.

[0025] According to the present application, the shape of the protection member disposed on the outside of the inner insertion member on the proximal side of the fixed region where the inner insertion member and the guide wire insertion member are fixed is set to the shape of an area reduction region in which the cross-sectional area of the cross section perpendicular to the axial direction of the protection member decreases toward the distal end, and the protection member of the area reduction region is biased toward the side opposite to the guide wire tube with respect to the inner insertion member, so that a medical tubular body delivery device that does not reduce the operability and is not easily knotted even when bent can be provided. BRIEF DESCRIPTION OF DRAWINGS

[0026] Figure 1 is a cross-sectional view showing one example of the distal side of the embodiment of the existing medical tubular body delivery device.

[0027] Figure 2 is a cross-sectional view showing the distal side of the first embodiment of the medical tubular body delivery device of the present application.

[0028] Figure 3 is a cross-sectional view showing a state in which the medical tubular body delivery device is bent.

[0029] Figure 4 is a cross-sectional view showing the distal side of the second embodiment of the medical tubular body delivery device of the present application.

[0030] Figure 5 is a cross-sectional view showing the distal side of the third embodiment of the medical tubular body delivery device of the present application.

[0031] Figure 6 is a cross-sectional view showing the distal side of the fourth embodiment of the medical tubular body delivery device of the present application.

[0032] Figure 7 is a cross-sectional view showing the distal side of the fifth embodiment of the medical tubular body delivery device of the present application. DETAILED DESCRIPTION

[0033] The medical tubular body delivery device of the present application has the following features, i.e., it has: an outer tube in which a medical tubular body is disposed outside a lumen, a guide wire insertion member disposed at a proximal side of the medical tubular body, and an inner insertion member disposed in the lumen of the outer tube, a through passage in which a guide wire is inserted in the lumen is formed in the guide wire insertion member, a guide wire tube in which the guide wire is inserted in the lumen is disposed in the through passage, the guide wire tube is disposed at least to extend to the proximal side beyond a proximal side opening position of the through passage, a portion of the inner insertion member is fixed to the guide wire insertion member, a portion of the inner insertion member on the proximal side of a fixed region in which the inner insertion member and the guide wire insertion member are fixed has a protection member on the outside, the protection member has an area reduction region in which a cross-sectional area of a cross section perpendicular to an axial direction of the protection member decreases toward a distal end, and the protection member of the area reduction region is biased to a side opposite to the guide wire tube with respect to the inner insertion member.

[0034] Hereinafter, one example of an embodiment of the medical tubular body delivery device of the present application will be described in detail with reference to the drawings, but the present application is not limited to the illustrated example, and can be modified to be implemented within a range in which the above and later-described objects can be achieved, and these are included in the technical scope of the present application.

[0035] Figure 2 is a cross-sectional schematic view of a first embodiment of a distal side of the medical tubular body delivery device of the present application. Figure 2 The medical tubular body delivery device illustrated has: an outer tube 22 in which a medical tubular body 21 is disposed outside a lumen, a guide wire insertion member 24 disposed at a proximal side of the medical tubular body 21, and an inner insertion member 23 disposed in the lumen of the outer tube 22.

[0036] A through passage 25 in which a guide wire is inserted in the lumen is formed in the guide wire insertion member 24, and a guide wire tube 26 in which the guide wire is inserted in the lumen is disposed in the through passage 25. The guide wire tube 26 is disposed at least to extend to the proximal side beyond a proximal side opening 25a position of the through passage 25. The proximal end of the guide wire tube 26 protrudes to the proximal side beyond the proximal end of the through passage 25, and thus the change in rigidity at the proximal end of the guide wire insertion member 24 becomes continuous, so that the operability of the medical tubular body delivery device can be improved.

[0037] A portion of the inner insertion member 23 is fixed to the guide wire insertion member 24. The inner insertion member 23 can be fixed by being pressed into the guide wire insertion member 24, or by being fixed to the guide wire insertion member 24 by heat fusion, an adhesive, or the like.

[0038] A portion of the inserting member 23 near the positioning side of the fixing region 24a where the inserting member 23 and the guidewire insertion member 24 are fixed has a protective member 27 on its outer side. By placing the protective member 27 on the outer side of the portion of the inserting member 23 in the aforementioned region, damage to the inserting member 23 can be suppressed. In addition, by placing the protective member 27, the support force and insertion permeability of the inserting member 23 in the long axis direction can be improved, thus increasing the force that can withstand the applied stress when deploying the medical tubular body, and making it easier to deploy the medical tubular body. In the axial direction of the inserting member 23, the area where the protective member 27 is placed on the outer side will sometimes be referred to as the protective member coverage area.

[0039] Furthermore, the protective member 27 has a cross-sectional area that decreases towards the distal end in a region d perpendicular to the axial direction of the protective member 27, and the protective member 27 in this region d is biased relative to the insert member 23 to the side opposite to the guidewire cannula 26. For example, when the medical tubular body delivery device passes through a curved section of the body lumen, such as... Figure 3 As shown in (a), even if the insert member 23 is subjected to stress in a way that makes it the outer side, the shape of the protective member 27 disposed on the outer side of the insert member 23 is set such that the cross-sectional area of ​​the section perpendicular to the axis of the protective member 27 decreases toward the distal end. This causes the protective member 27 in the area reduction interval to be biased relative to the insert member 23 toward the side opposite to the guidewire tube 26, thus making it difficult for the insert member 23 to escape to the side opposite to the guidewire tube 26, and therefore less prone to knotting. Furthermore, in the area reduction interval d, no protective member 27 is disposed on the guidewire tube 26 side relative to the insert member 23, thus reducing interference with the guidewire tube 26 and preventing breakage. Additionally, for example, when the medical tubular body delivery device passes through a curved section of the body lumen, such as... Figure 3 As shown in (b), even when the insert member 23 is subjected to stress in an inward manner, in the area reduction interval d, since no protective member 27 is provided on the guide wire tube 26 side relative to the insert member 23, the bending resistance is reduced, and the insert member 23 is positioned near the central axis in a cross-section perpendicular to the long side direction of the medical tubular body delivery device. As a result, the insert member 23 can withstand the compressive load when opening the medical tubular body 21 near the central axis in a cross-section perpendicular to the long side direction of the medical tubular body delivery device, so the load transfer efficiency to the insert member 23 is increased, and the medical tubular body 21 is deployed efficiently. Therefore, according to the present invention, a medical tubular body delivery device that does not reduce operability and is not easily knotted even when bent can be provided.

[0040] The shape of the distal end of the protective member 27 is preferably tapered, for example, and more preferably tapered with an inclination relative to the insert member 23 toward the side opposite to the guide wire tube 26.

[0041] The distance x between the closest position 24b of the guidewire insertion member 24 and the farthest position 27a of the protective member 27 is preferably 0.5 mm or more and 30 mm or less. By setting the distance x to 30 mm or less, the rigidity of the long axis of the medical tubular delivery device becomes continuous, thus improving its resistance to bending and reducing the likelihood of knotting. More preferably, the distance x is 20 mm or less, even more preferably 10 mm or less, and particularly preferably 5 mm or less. By setting the distance x to 5 mm or less, the support force and insertion permeability of the insertion member 23 can be improved by utilizing the protective member 27, and the stress applied from the guidewire insertion member 24 can be supported integrally with the insertion member 23 when the medical tubular body 21 is deployed. Although there is no particular limitation on the lower limit of the distance x, if it is too short, the distal end of the guide wire insertion component 24 and the protective component 27 will easily come into contact. Often, the distal part of the protective component 27 will be bent and damaged due to the stress from the guide wire insertion component 24. Therefore, the distance x is preferably 0.5 mm or more, and more preferably 1 mm or more.

[0042] like Figure 2 As shown, when the proximal protrusion length of the guidewire tube 26, which protrudes from the proximal end of the guidewire insertion member 24, is set to L, it is preferable that the proximal protrusion length L and the aforementioned distance x satisfy the relationship L > x. Because the proximal protrusion length L and the distance x satisfy the relationship L > x, the stress applied from the guidewire insertion member 24 during the deployment of the medical tubular body 21 can be continuously and seamlessly transferred from the proximal end of the guidewire tube 26 to the protective member 27, making the deployment of the medical tubular body 21 easier. Furthermore, since the rigidity change is continuous, kinking of the medical tubular body delivery device can be suppressed, allowing for safer operation.

[0043] Furthermore, it is preferable that the proximal protrusion length L, the distance x, and the area reduction interval d of the cross-sectional area perpendicular to the axis of the protective member 27 decrease towards the distal end satisfy the relationship x + d > L. The fact that the proximal protrusion length L, the distance x, and the area reduction interval d satisfy the relationship x + d > L minimizes interference between the guidewire tube 26 and the protective member 27.

[0044] The guidewire insertion member 24 has a through passage 25 for inserting the guidewire into the inner lumen, and a guidewire tube 26 for inserting the guidewire into the inner lumen is disposed within the through passage 25. By configuring the guidewire tube 26, the insertion permeability of the guidewire becomes good, so the medical tubular body delivery device can be easily inserted into the body lumen along the inserted guidewire. Preferably, the inner wall of the through passage 25 and the outer wall of the guidewire tube 26 are fixed, for example, by adhesive, heat fusion, or the like.

[0045] Alternatively, an ejection component can be configured at the distal end of the guidewire insertion component 24 to facilitate the ejection of the medical tubular body 21.

[0046] As the constituent material of the guide wire insertion member 24, the outer tube 22, and the protection member 27, for example, polyethylene, fluororesin (for example, polytetrafluoroethylene (PTFE), tetrafluoroethylene / perfluoroalkyl vinyl ether copolymer (PFA), or the like), polyamide, polyamide elastomer, polyurethane, polyester, silicone, polyether ether ketone (PEEK), or the like can be given.

[0047] As the constituent material of the inner insertion member 23, various metal materials such as stainless steel, nickel-titanium alloy, tungsten, gold, platinum, or the like can be given.

[0048] Next, the second embodiment of the medical tubular body delivery device of the present application will be described. In addition, in the following description, the same components as those of the above-described embodiments are denoted by the same reference numerals, and the overlapping description will be omitted (hereinafter the same). Figure 4 Figure 4

[0049] As shown in FIG. 1, the guide wire tube 26 preferably has an area reduction interval D in which the cross-sectional area of the cross section perpendicular to the axial direction of the guide wire tube 26 decreases toward the proximal end. The guide wire tube 26 is biased toward the inner insertion member 23 side in the area reduction interval D. The guide wire tube 26 has the area reduction interval D, whereby the load in the longitudinal direction generated when the medical tubular body 21 is released is continuously transmitted from the guide wire tube 26 to the inner insertion member 23 on which the protection member 27 is disposed on the outer side, so that the rigidity change becomes continuous, the load is difficult to escape to the outer side, and the load required for the deployment of the medical tubular body 21 can be reduced. As a result, the medical tubular body 21 can be efficiently deployed. Figure 4

[0050] The shape of the proximal end of the guide wire tube 26 is preferably a tapered shape, and more preferably a tapered shape that is inclined toward the inner insertion member 23 side. By being provided with the tapered shape, the continuity of the rigidity change is improved, and kinks are easily prevented.

[0051] The guide wire tube 26 can be disposed extending to the distal side from the distal side opening position 25b of the through path 25. The distal end of the guide wire tube 26 can be disposed extending to the lumen of the front end contact 28 as shown in FIG. 2. By disposing the guide wire tube 26 extending to the distal side from the distal side opening position 25b of the through path 25, the insertability of the guide wire can be improved. Figure 2 The guide wire tube 26 disposed extending to the distal side from the distal side opening position 25b of the through path 25 can be fixed to the distal end of the guide wire tube 26 disposed in the through path 25 by heat fusion, an adhesive, or the like, or can be a one-piece tube in which the distal end of the guide wire tube 26 disposed in the through path 25 is disposed extending.

[0052]

[0053] ​​​​The guide wire insertion member 24 is preferably colored. By coloring the guide wire insertion member 24, it is easy to recognize under an endoscope and easy to confirm the position of the medical tubular body 21 disposed on the distal side of the guide wire insertion member 24. The guide wire insertion member 24 after coloring is sometimes referred to as a visual marker. The color of the guide wire insertion member 24 is not particularly limited as long as it is a color that is easy to recognize under an endoscope, and for example, a color that is relatively conspicuous with respect to the mucosa and blood in the gastrointestinal tract is preferable, and yellow is particularly preferable.

[0054] Next, a fourth embodiment of the medical tubular body delivery device of the present application will be described with reference to FIG. 9. Figure 5 A third embodiment of the distal side of the medical tubular body delivery device of the present application will be described. As shown in FIG. 8, the medical tubular body delivery device can also be a rapid exchange type in which the outer tube 22 has a guide wire port 31 disposed on the distal side of the proximal end of the outer tube 22. The proximal end side of the guide wire tube 26 is extended and disposed to the guide wire port 31, and can also be extended and disposed to the guide wire port 31. Figure 5

[0055] Further, in the medical tubular body delivery device shown in FIG. 9, the outer tube 22 has a guide wire port 31 disposed on the distal side of the proximal end of the outer tube 22, and the proximal end side of the guide wire tube 26 is extended and disposed to the guide wire port 31. Figure 5

[0056] Next, a fourth embodiment of the medical tubular body delivery device of the present application will be described with reference to FIG. 9. Figure 6 A third embodiment of the distal side of the medical tubular body delivery device of the present application will be described. As shown in FIG. 8, the medical tubular body delivery device can also be a rapid exchange type in which the outer tube 22 has a guide wire port 31 disposed on the distal side of the proximal end of the outer tube 22. The proximal end side of the guide wire tube 26 is extended and disposed to the guide wire port 31, and can also be extended and disposed to the guide wire port 31.

[0057] As shown in FIG. 9, an inner tube 51 through which a guide wire is inserted in the lumen can also be disposed in the lumen of the outer tube 22, and the proximal end of the inner tube 51 is fixed to the guide wire port 31. Figure 6 As a mode in which the proximal end of the inner tube 51 is fixed to the guide wire port 31, for example, a mode in which a portion of the outer tube 22 is made thick, a filling member 30 is formed between the outer tube 22 and the inner tube 51, and the gap between the outer tube 22 and the proximal end of the inner tube 51 is fixed to disappear; a mode in which a filling member 30 composed of resin or the like is sandwiched between the proximal end of the inner tube 51 and the outer tube 22, and fixed by an adhesive; a mode in which an adhesive is used as the filling member 30, and the proximal end of the inner tube 51 and the outer tube 22 are adhered; and the like can be given. In addition, a mode in which the filling member 30 is not used, and the inner wall of the outer tube 22 and the outer wall of the inner tube 51 are fixed in a manner that they are tightly attached, for example, by heat fusion or crimping can also be given.

[0058] In the embodiment of the medical tubular body delivery device shown in FIG. 9, a rapid exchange type is preferable.

[0059] Figure 6 As shown in FIG. 9, an inner tube 51 through which a guide wire is inserted in the lumen can also be disposed in the lumen of the outer tube 22, and the proximal end of the inner tube 51 is fixed to the guide wire port 31.

[0060] As shown in FIG. 9, an inner tube 51 through which a guide wire is inserted in the lumen can also be disposed in the lumen of the outer tube 22, and the proximal end of the inner tube 51 is fixed to the guide wire port 31. Figure 6 ​​​As shown, a portion of the internal cannula 51 can also be disposed within the lumen of the guidewire cannula 26. With this configuration, when the outer tube 22 is pulled toward the proximal side to release and unfold the medical tubular body 21, the guidewire is always disposed within the lumen of the internal cannula 51 or the penetrating passage 25, thus preventing the guidewire from becoming entangled in, for example, the internal insertion component 23, thus preventing it from becoming inoperable and obstructing the release of the medical tubular body 21.

[0061] Next, use Figure 7 A fifth embodiment of the distal side of the medical tubular body delivery device of the present invention will be described. Figure 7 In the illustrated medical tubular delivery device, a guidewire tube 26 for inserting a guidewire through the lumen is disposed within the through passage 25. The distal end of the guidewire tube 26 extends to the distal contact 28, and the proximal end extends to the proximal opening 25a of the through passage 25. The proximal end of the guidewire tube 26 is tapered. By making it tapered, the continuity of rigidity changes is improved, thus easily preventing kinking.

[0062] Furthermore, an inner cannula 51 for inserting the guidewire is disposed within the inner lumen of the outer tube 22. The proximal end of the inner cannula 51 is fixed to the guidewire port 31. The inner cannula 51 passes through the inner lumen of the guidewire cannula 26 disposed within the through passage 25 and extends to the tip contact 28. By extending the inner cannula 51 from the guidewire port 31 to the tip contact 28, the guidewire insertion permeability can be improved. In addition, when the medical tubular body is deployed, even if the outer tube 22 is retracted, the guidewire can be maintained in either the guidewire cannula 26 or the inner cannula 51, thus preventing the guidewire from becoming entangled inside the outer tube 22 and enabling safer operation.

[0063] exist Figure 7 In this configuration, a filling member 30 is sandwiched between the inner cannula 51 and the outer cannula 22. The shape of the proximal end of the filling member 30 is consistent with the shape of the proximal end of the inner cannula 51. By making the shape of the proximal end of the filling member 30 consistent with the shape of the proximal end of the inner cannula 51, the integrity of the outer surface of the outer cannula is enhanced, and the ease of delivery is improved.

[0064] like Figure 7 As shown, a locking element 32 can also be provided on the outer surface of the guidewire tube 26. The locking element 32 engages with the inner surface of the medical tube 21. If the outer tube 22 is pulled towards the proximal side, the medical tube 21 is inhibited from retracting by the locking element 32 and unfolds to the outside of the outer tube 22.

[0065] The position of the locking member 32 is not particularly limited as long as it can suppress the retreat of the medical tubular body 21, but for example, even if the locking member 32 is provided on the distal side from the central position in the length of the medical tubular body 21 in the longitudinal direction, if the outer tube 22 is pulled toward the proximal side to deploy the medical tubular body 21, the locking member 32 is separated from the medical tubular body 21 without a gap, so it is almost impossible to obtain the retreat suppression effect by the locking member 32. Therefore, it is preferable that the locking member 32 be provided on the proximal side from the central position in the length of the medical tubular body 21 in the longitudinal direction. In addition, the proximal end of the medical tubular body 21 can be supported by the distal end of the guide wire insertion member 24 without using the locking member 32.

[0066] As the medical tubular body, for example, a stent, a stent graft, an occlusion member, an injection catheter, a prosthetic valve, or the like can be used. Among them, a stent is preferably used. As the stent, for example, a helical stent formed of one wire-shaped metal or polymer material, a stent formed by laser cutting processing of a metal tube, a stent formed by winding a metal sheet into a cylindrical shape after laser cutting and laser welding, a stent assembled by laser welding of wire-shaped members, or a stent made by braiding a plurality of wire-shaped metals can be mentioned. The stent is classified into a balloon-expandable stent which is expanded by a balloon attached thereto, and a self-expandable stent which is expanded by itself by removing an external member which suppresses expansion of the stent. In the present application, a self-expandable stent is preferably used.

[0067] This application claims the benefit of priority based on Japanese Patent Application No. 2019-228672 filed on December 18, 2019. The description of Japanese Patent Application No. 2019-228672 filed on December 18, 2019 is hereby incorporated by reference in its entirety in the present application.

[0068] Explanation of Reference Signs

[0069] 11, 21 … Medical tubular body

[0070] 12, 22 … Outer tube

[0071] 13, 23 … Interposition member

[0072] 14, 24 … Guide wire insertion member

[0073] 14a … Fixing region

[0074] 15, 25 … Through path

[0075] 15a … Proximal side opening of the through path 15

[0076] 16, 26 … Tube for guide wire

[0077] 17, 27 … Protection member

[0078] 18, 28 … leading tip contact

[0079] 24a … fixed region where the inner fitting member 23 and the guide wire insertion member 24 are fixed

[0080] 24b … most proximal position of the guide wire insertion member 24

[0081] 25a … proximal side opening of the through path 25

[0082] 25b … distal side opening of the through path 25

[0083] 27a … most distal position of the protection member

[0084] 30 … filling member

[0085] 31 … guide wire port

[0086] 32 … locking member

[0087] 51 … inner fitting tube

[0088] d … area reduction interval

[0089] D … area reduction interval.

Claims

1. A medical tubular body delivery device, which is a device for delivering medical tubular bodies within the body, characterized in that, have: The outer tube has the aforementioned medical tubular body disposed in its inner lumen; The guidewire insertion component is positioned closer to the location side than the aforementioned medical tubular body; and An insert component, which is disposed within the inner cavity of the aforementioned outer tube, The aforementioned guidewire insertion component has a through passage through which a guidewire is inserted into the inner cavity. A guide wire tube with the guide wire inserted into its inner cavity is disposed within the aforementioned through passage. The aforementioned guidewire cannula extends at least proximally beyond the proximal opening of the aforementioned through-pathway. A portion of the aforementioned insert component is fixed to the aforementioned guide wire insertion component. A portion of the aforementioned insert component, closer to the positioning side than the fixing area where the aforementioned insert component and guide wire insertion component are fixed, has a protective component on its outer side. The aforementioned protective component has a cross-sectional area that decreases towards the distal end in a region perpendicular to the axial direction of the protective component. The protective component in the area reduction zone is biased relative to the insert component on the side opposite to the guide wire cannula. The aforementioned guidewire cannula has a cross-sectional area that decreases towards the proximal end, perpendicular to the axial direction of the guidewire cannula. The guide wire tube in the area reduction zone is biased towards the insert component side.

2. The medical tubular body delivery device according to claim 1, wherein, The distal end of the aforementioned protective component is tapered.

3. The medical tubular body delivery device according to claim 1 or 2, wherein, The distance between the nearest position of the aforementioned guide wire insertion component and the farthest position of the aforementioned protective component is 0.5 mm or more and 30 mm or less.

4. The medical tubular body delivery device according to claim 1 or 2, wherein, The aforementioned medical tubular delivery device is a quick-change type with a guidewire port on the outer tube. The guidewire port is positioned distal to the proximal end of the aforementioned outer tube.

5. The medical tubular body delivery device according to claim 1 or 2, wherein, The guide wire cannula is configured to extend distally from the distal opening of the aforementioned through-pathway.

6. The medical tubular body delivery device according to claim 4, wherein, An inner cannula with the guide wire inserted through it is disposed within the inner cavity of the outer cannula. The proximal end of the cannula is fixed to the aforementioned guidewire port.

7. The medical tubular body delivery device according to claim 6, wherein, A portion of the aforementioned internal cannula is disposed within the inner cavity of the aforementioned guidewire cannula.

8. The medical tubular body delivery device according to claim 1 or 2, wherein, The proximal end of the guidewire cannula described above is tapered.

9. The medical tubular body delivery device according to claim 1 or 2, wherein, The aforementioned guide wire insertion component is colored.

10. The medical tubular body delivery device according to claim 1 or 2, wherein, The aforementioned medical tubular body is a self-expanding stent.

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