Catheter and methods of treatment

Abstract

The present invention provides a catheter and a treatment method that easily reach the uterine artery, the prostate artery, and engage from the radial artery. A catheter (1) for uterine artery engagement has a tubular body that communicates from a base end to a front end, the tubular body (2) has a shape portion (24) that is bent on substantially the same plane (X) to impart a shape, the shape portion (24) has a base end side bend portion (25) that is bent at a prescribed first angle (θ1), a front end side bend portion (27) that is prescribed a second angle (θ2) at a position further toward the front end side than the base end side bend portion (25), and is bent toward the same side as the base end side bend portion (25), a straight line-shaped intermediate straight line portion (26) that is disposed between the base end side bend portion (25) and the front end side bend portion (27), and a straight line-shaped front end side straight line portion (28) that is disposed further toward the front end side than the front end side bend portion (27), the first minimum curvature radius (R1) at the base end side bend portion (25) is 3 times or more and 11 times or less of the second minimum curvature radius (R2) at the front end side bend portion (27).

Description

TECHNICAL FIELD

[0001] The present application relates to a catheter and a treatment method of a catheter. BACKGROUND

[0002] At present, an intervention procedure is performed in which a long catheter is inserted into a blood vessel from a hole made in the skin to treat a lesion in the body.

[0003] For example, patent document 1 describes a treatment PCI (Percutaneous Coronary Intervention) of a coronary artery by TRI (Trans Radial Intervention) in which a catheter is inserted from the radial artery of the wrist. In addition, patent document 2 describes UFE (Uterine Fibroid Embolizatrion) in which a uterine artery is embolized to treat uterine fibroids by TFI (Trans Femoral Intervention) in which a catheter is inserted from the femoral artery.

[0004] PRIOR ART DOCUMENTS

[0005] PATENT DOCUMENTS

[0006] Patent document 1: US Patent No. 6355026 specification

[0007] Patent document 2: US Patent No. 7422581 specification SUMMARY

[0008] PROBLEMS TO BE SOLVED BY THE INVENTION

[0009] Insertion of a catheter from the radial artery reduces the physical burden on the patient, but the catheter that can be inserted becomes thin. In addition, in order to reach the uterine artery or the prostatic artery from the radial artery, it is necessary to pass through the branches of a plurality of blood vessels and move in a long path. Therefore, in the case of a catheter for use instead of PCI, for example, it is difficult to reach the catheter to the target position.

[0010] The present application has been made to solve the above problems, and aims to provide a catheter and a treatment method that easily reach the uterine artery and the prostatic artery and engage from the radial artery.

[0011] MEANS FOR SOLVING THE PROBLEMS

[0012] To solve the above problems, one embodiment of the present application is a catheter for uterine artery engagement having a tubular body that communicates from a base end to a front end, characterized in that a front end portion of the tubular body has a shape portion that is bent on substantially the same plane to impart a shape, the shape portion has a base end side bent portion that is bent at a prescribed first angle, a front end side bent portion that is bent at a prescribed second angle on a more front end side than the base end side bent portion toward the same side as the base end side bent portion, a straight intermediate straight portion that is disposed between the base end side bent portion and the front end side bent portion, and a straight front end side straight portion that is disposed on a more front end side than the front end side bent portion, and a minimum radius of curvature of an axis in the base end side bent portion, which is a first minimum radius of curvature, is 3 or more to 11 or less times a minimum radius of curvature of an axis in the front end side bent portion, which is a second minimum radius of curvature.

[0013] Effects of Invention

[0014] With the catheter configured in the above-described manner, the base end side bent portion comes into contact with the internal iliac artery, and with respect to the front end side bent portion that is sharply bent at a smaller radius of curvature than the base end side bent portion toward the same direction as the base end side bent portion and / or the front end side straight portion that is on a more front end side than the front end side bent portion, it is made to face the uterine artery to easily engage with the uterine artery. Thus, the catheter easily reaches the uterine artery from the radial artery and engages with the uterine artery.

[0015] To solve the above problems, another embodiment of the present application is a catheter for prostate artery engagement having a tubular body that communicates from a base end to a front end, characterized in that a front end portion of the tubular body has a shape portion that is bent on substantially the same plane to impart a shape, the shape portion has a base end side bent portion that is bent at a prescribed first angle, a front end side bent portion that is bent at a prescribed second angle on a more front end side than the base end side bent portion toward the same side as the base end side bent portion, a straight intermediate straight portion that is disposed between the base end side bent portion and the front end side bent portion, and a straight front end side straight portion that is disposed on a more front end side than the front end side bent portion, and a minimum radius of curvature of an axis in the base end side bent portion, which is a first minimum radius of curvature, is 3 or more to 11 or less times a minimum radius of curvature of an axis in the front end side bent portion, which is a second minimum radius of curvature.

[0016] With the catheter configured in the above-described manner, the base end side bent portion comes into contact with the internal iliac artery, and with respect to the front end side bent portion that is sharply bent at a smaller radius of curvature than the base end side bent portion toward the same direction as the base end side bent portion and / or the front end side straight portion that is on a more front end side than the front end side bent portion, it is made to face the prostate artery to easily engage with the prostate artery. Thus, the catheter easily reaches the prostate artery from the radial artery and engages with the prostate artery.

[0017] Also, the first minimum curvature radius can be 25 mm, the second minimum curvature radius can be 5 mm, the first minimum curvature radius can be 5 times the second minimum curvature radius, the length of the intermediate straight portion along the axis can be 16 mm, and the length of the front end side straight portion along the axis can be 3 mm. Thus, the catheter easily reaches the uterine artery, the prostatic artery, and engages from the radial artery.

[0018] To solve the above problem, another aspect of the present application is a treatment method using a catheter having a tubular body that communicates from a base end to a front end, characterized in that a catheter described below is inserted into a blood vessel from a radial artery, wherein the front end portion of the tubular body has a shape portion that is curved on substantially the same plane to impart a shape, the shape portion has a base end side curved portion that defines a first angle, a front end side curved portion that defines a second angle at a position more toward the front end side than the base end side curved portion and is bent toward the same side as the base end side curved portion, an intermediate straight portion that is linear and is disposed between the base end side curved portion and the front end side curved portion, and a front end side straight portion that is linear and is disposed more toward the front end side than the front end side curved portion, a minimum curvature radius of an axis in the base end side curved portion, which is a first minimum curvature radius, is more than 3 times to 11 times a minimum curvature radius of an axis in the front end side curved portion, which is a second minimum curvature radius, and the shape portion is engaged in a blood vessel more distal than an internal iliac artery.

[0019] In the treatment method configured in the above manner, the base end side curved portion is brought into contact with the internal iliac artery, and the front end side curved portion that is sharply bent toward the same direction as the base end side curved portion and / or the front end side straight portion that is more toward the front end side than the front end side curved portion is brought toward and easily engaged in a blood vessel more distal than the internal iliac artery. Thus, for the operator, it is easy to bring the catheter to reach and engage in a blood vessel more distal than the internal iliac artery from the radial artery, and thus treatment is favorably performed.

[0020] In the treatment method, the radial artery into which the catheter is inserted can also be a distal radial artery. Thus, for the operator, it is easy to bring the catheter to reach and engage in a blood vessel more distal than the internal iliac artery in a less invasive manner compared to the case where the catheter is inserted from the radial artery, and thus treatment is favorably performed.

[0021] The blood vessel disposed more distal than the internal iliac artery and capable of engaging the shape portion can also be the prostatic artery. Thus, the operator is able to favorably perform treatment of the prostate using the catheter inserted into the blood vessel from the radial artery.

[0022] The blood vessel disposed more distal than the internal iliac artery and capable of engaging the shape portion can also be the uterine artery. Thus, the operator is able to favorably perform treatment of the uterus using the catheter inserted into the blood vessel from the radial artery.

[0023] The treatment target can also be an enlarged prostate caused by prostatomegaly. Thus, the operator can perform treatment of prostatomegaly using the catheter inserted into the blood vessel from the radial artery.

[0024] The treatment target can also be uterine fibroids. Thus, the operator can perform treatment of uterine fibroids using the catheter inserted into the blood vessel from the radial artery. BRIEF DESCRIPTION OF DRAWINGS

[0025] Figure 1 is a schematic view showing the configuration of the catheter inside the blood vessel.

[0026] Figure 2 is a plan view showing the front end portion of the catheter of the embodiment.

[0027] Figure 3 is a schematic view showing a state in which the catheter is inserted from the left radial artery, the base end side bent portion is abutted against the left subclavian artery, the front end side bent portion is disposed inside the aorta, and the front end straight portion and the front end opening portion are directed toward the descending aorta.

[0028] Figure 4 is a schematic view showing a state in which the catheter is inserted into the common iliac artery and the internal iliac artery.

[0029] Figure 5 is a schematic view showing a state in which the catheter is engaged with the uterine artery.

[0030] Figure 6 is a schematic view showing another example of a state in which the catheter is engaged with the uterine artery.

[0031] Figure 7 is a schematic view showing a state in which the catheter is engaged with the prostatic artery. DETAILED DESCRIPTION

[0032] Hereinafter, the embodiment of the present application will be described with reference to the drawings. Note that the dimensions of the drawings are exaggerated for the sake of explanation and can be different from the actual dimensions. Also, in the present specification and the drawings, the same reference numerals are assigned to the constituent elements having substantially the same functions to omit redundant description. In the present specification, the side to be inserted into the blood vessel is referred to as "front end side", and the side to be operated is referred to as "base end side".

[0033] The catheter 1 of the embodiment is as shown in Figure 1 and Figure 6The image shows a catheter used for engagement with the uterine artery 106 or the prostatic artery 107. Catheter 1 is inserted into the radial artery 100 of the patient's arm and engages with the uterine artery 106 or the prostatic artery 107. Catheter 1 can also be a so-called guiding catheter, angiography catheter, guidewire support catheter, or microcatheter. Alternatively, catheter 1 can be a combination of a guiding catheter and a microcatheter inserted into the guiding catheter and being longer than the guiding catheter.

[0034] like Figure 1 As shown, the catheter 1 has a tubular body 2, a hub portion 3 disposed at the base end of the tubular body 2, and an anti-torsion protection portion 4.

[0035] like Figure 1 , 2 As shown, the tubular body 2 is elongated and flexible. A lumen 21 extending from the base to the front end is formed in the approximately central part of the tubular body 2.

[0036] The hub 3 forms a passageway communicating with the lumen 21. The hub 3 can, for example, be used to carry a guidewire 6, a therapeutic catheter 5 (see reference 21). Figure 5 (e.g., insertion or removal). Additionally, the hub 3 can be used to inject various liquids such as X-ray contrast agents, pharmaceuticals, and saline solution.

[0037] The anti-torsion protection part 4 is formed of an elastic material. The anti-torsion protection part 4 covers the part where the tubular body 2 connects to the hub 3. Thus, the anti-torsion protection part 4 prevents the tubular body 2 from bending or twisting near this part.

[0038] Next, the tubular body 2 will be described in detail. The tubular body 2 has a generally straight main body portion 23 and a curved portion 24. The axis of the curved portion 24 lies in the same plane X, and the curved portion 24 is substantially curved in the same plane X. The axis refers to the line passing through the center of the tubular body 2; if the tubular body 2 is a concentric circle, it refers to the central axis. The curved portion 24 has a base-end curved portion 25, a middle straight portion 26, a front-end curved portion 27, and a front-end straight portion 28. The base-end curved portion 25 extends from the front end of the main body portion 23 toward the front end and is curved within the plane X. The middle straight portion 26 extends in a straight line from the front end of the base-end curved portion 25 toward the front end. The front-end curved portion 27 extends from the front end of the middle straight portion 26 toward the front end and is curved in the same direction as the base-end curved portion 25 within the plane X. The front-end straight portion 28 extends in a straight line from the front end of the front-end curved portion 27 toward the front end. It should be noted that the term "substantially curved within the same plane X" means that in addition to being curved within the same plane X, it may also include the case where the front end of the conduit 1 protrudes slightly from the plane X to the extent that it can practically achieve the same effect.

[0039] A straight line passing through the axis of the main body 23 is defined as a first axis A. A straight line passing through the axis of the intermediate straight line portion 26 is defined as a second axis B. A straight line passing through the axis of the front end side straight line portion 28 is defined as a third axis C.

[0040] An angle formed in the front end side with respect to the first axis A by the second axis B is defined as a first angle θ1. The first angle θ1 is an amount of change in the direction of the axis of the tubular body 2 in the base end side curved portion 25. That is, the base end side curved portion 25 defines the first angle θ1. When the first angle θ1 is 0°, the second axis B coincides with the first axis A, and when the first angle θ1 is 180°, the second axis B is folded back in the opposite direction with respect to the first axis A. The radius of curvature of the axis of the base end side curved portion 25 can be constant throughout the base end side curved portion 25, or can vary depending on the position. In the base end side curved portion 25, a first minimum radius of curvature R1 of the position where the radius of curvature of the axis is the smallest (the position where the curvature is the sharpest) is not particularly limited, and is preferably 15 mm to 50 mm, and most preferably 25 mm. The first angle θ1 is not particularly limited, and is preferably 15° to 70°, and most preferably 55°.

[0041] An angle formed in the front end side with respect to the second axis B by the third axis C is defined as a second angle θ2. The second angle θ2 is an amount of change in the direction of the axis of the tubular body 2 in the front end side curved portion 27. That is, the front end side curved portion 27 defines the second angle θ2. When the second angle θ2 is 0°, the third axis C coincides with the second axis B, and when the second angle θ2 is 180°, the third axis C is folded back in the opposite direction with respect to the second axis B. The radius of curvature of the axis of the front end side curved portion 27 can be constant throughout the front end side curved portion 27, or can vary depending on the position. In the front end side curved portion 27, a second minimum radius of curvature R2 of the position where the radius of curvature of the axis is the smallest (the position where the curvature is the sharpest) is not particularly limited, and is preferably 1 mm to 10 mm, and most preferably 5 mm. The second minimum radius of curvature R2 is smaller than the first minimum radius of curvature R1. The first minimum radius of curvature R1 is preferably more than 3 times and less than 11 times the second minimum radius of curvature R2, and most preferably 5 times. The second angle θ2 is not particularly limited, and is preferably 30° to 70°, and most preferably 50°.

[0042] The length L1 of the base end side curved portion 25 along the axis is not particularly limited, and is, for example, 1 mm to 100 mm. As an example, the length L1 of the base end side curved portion 25 along the axis is 24 mm.

[0043] The length L2 of the intermediate straight line portion 26 along the axis is not particularly limited, and is preferably 1 mm to 100 mm, and most preferably 16 mm.

[0044] The length L3 of the front end side curved portion 27 along the axis is not particularly limited, and is preferably 1 mm to 10 mm, and most preferably 4 mm.

[0045] The length L4 of the straight portion 28 on the proximal end side is not particularly limited, and is preferably 0.5 mm to 50 mm, and more preferably 3 mm.

[0046] The tubular body 2 can also have a non-illustrated reinforcing member embedded therein in a range reaching a predetermined position in the proximal end direction from the proximal end. The reinforcing member is formed by weaving a plurality of wires into a tubular shape. The position of the most proximal end of the reinforcing member is not particularly limited, and can be disposed in the shape portion 24 or the body portion 23. Further proximally from the reinforcing portion in which the reinforcing member is embedded, there is a soft portion in which no reinforcing member is disposed. The length of the soft portion is preferably 500 mm or less, and more preferably 10 to 300 mm. As an example, in the case of the 4 Fr catheter 1, the length of the soft portion is 150 mm. In the case of the 5 Fr catheter 1, the length of the soft portion is 150 mm.

[0047] The catheter 1 can also have a lubricating coating applied thereto in the proximal end direction from the proximal end opening 22 along the axis. The lubricating coating can also be applied to the entire length, for example, in a range of at least 500 mm or less, and more preferably 400 mm or less, in the proximal end direction from the proximal end opening 22 along the axis. Thus, the operator can also be able to insert the catheter 1 deeply into the uterine artery 106. The constituent material of the lubricating coating can be, for example, a copolymer of a monomer containing an epoxy group such as glycidyl acrylate, glycidyl methacrylate, 3,4-epoxycyclohexylmethyl methacrylate, 3,4-epoxycyclohexylmethyl methacrylate, β-methyl glycidyl methacrylate, and allyl glycidyl ether, and a hydrophilic monomer such as N-methyl acrylamide, N,N-dimethyl acrylamide, and acrylamide; a (co)polymer composed of the above-mentioned hydrophilic monomer; a cellulose-based high molecular substance such as hydroxypropyl cellulose and carboxymethyl cellulose; a polysaccharide, polyvinyl alcohol, methyl vinyl ether-maleic anhydride copolymer, water-soluble polyamide, poly(2-hydroxyethyl (meth)acrylate), polyethylene glycol, polyacrylamide, and polyvinylpyrrolidone.

[0048] The outer diameter of the tubular body 2 is preferably 1 mm (3 Fr) to 2.5 mm (6 Fr), more preferably 1.3 mm (4 Fr) to 1.8 mm (5 Fr). The effective length of the tubular body 2 is preferably 1300 mm to 1600 mm. The size of the tubular body 2 is preferably appropriately selected depending on the patient, the blood vessel into which the catheter 1 is to be introduced, and the like. For example, in the case where the catheter 1 is to be introduced from the usual radial artery 100 of a small female, the effective length of the tubular body 2 is preferably short. In the case where the catheter 1 is to be introduced from the distal radial artery of a large male, the effective length of the tubular body 2 is preferably long. The effective length is the length of the portion that can be inserted into the blood vessel, the sheath, or the like. In the present embodiment, the effective length is the length from the leading end of the twist-preventing protection portion 4 to the leading end of the tubular body 2, and the effective length of the catheter 1 for the uterine artery is 1350 mm, and the effective length of the catheter 1 for the prostatic artery is 1500 mm, and the length of the lubricating coating is 400 mm from the leading end in the present example.

[0049] The tubular body 2 can also be provided with a leading end tip that is softer than the base end side at the leading end portion. The leading end tip is composed of a material, such as a rubber material, that is rich in softness.

[0050] The number of layers that constitute the tubular body 2, the material that constitutes each layer, the presence or absence of a reinforcing body, and the like can also differ depending on the position in the length direction of the tubular body 2.

[0051] The material that constitutes the tubular body 2 can use, for example, various thermoplastic elastomers such as styrene-based, polyolefin-based, polyurethane-based, polyester-based, polyamide-based, polybutadiene-based, trans-polyisoprene-based, fluororubber-based, and chlorinated polyethylene-based, polyether ketone, polyimide-based, and the like, and a substance (polymer alloy, polymer blend, laminate, or the like) that is a combination of one or two or more of these can be used. A low-friction material can also be provided on the inner circumferential surface of the tubular body 2 so as to easily insert the guide wire 6, another catheter, or the like into the lumen 21. The low-friction material is, for example, a fluorine-based resin material such as polytetrafluoroethylene (PTFE). The tubular body 2 can also contain a material that is X-ray contrast.

[0052] Next, the method of using the catheter 1 of the present embodiment will be described.

[0053] As Figure 1As shown, the catheter 1 is inserted from the radial artery 100 into the blood vessel, passes through the brachial artery and the subclavian artery 101, and is inserted into the descending aorta 103. The catheter 1 further passes through the internal iliac artery 105 after being inserted into the common iliac artery 104 through the aortoiliac branch 104A of the common iliac artery 104, and engages with a blood vessel more distal than the internal iliac artery 105. The radial artery 100 into which the catheter 1 is introduced is, for example, a distal radial artery, a conventional radial artery, a snuff box radial artery, or the like. Here, a case in which a patient is a woman, the catheter 1 is inserted into an artery of the left arm, and a uterine fibroid 111 of a uterus 110 is treated is described as an example. Note that the catheter 1 can also be inserted from the radial artery 100 of the right arm.

[0054] In the surgery, the operator inserts the guide wire 6 into the radial artery 100. Next, the operator advances the catheter 1 in which the guide wire 6 is accommodated in the lumen 21 along the guide wire 6. Generally, the distal end of the guide wire 6 is ahead of the distal end of the catheter 1. Therefore, the shape portion 24 of the catheter 1 is deformed into a shape closer to a straight line than the initial shape to which the shape is given by the guide wire 6 inside the lumen 21. The shape closer to a straight line than the initial shape of the shape portion 24 is not limited to a straight line shape, and can be curved.

[0055] As shown in FIG. 2, the catheter 1 is inserted into the blood vessel from the radial artery 100, passes through the brachial artery and the subclavian artery 101, and is inserted into the descending aorta 103. The catheter 1 further passes through the internal iliac artery 105 after being inserted into the common iliac artery 104 through the aortoiliac branch 104A of the common iliac artery 104, and engages with a blood vessel more distal than the internal iliac artery 105. The radial artery 100 into which the catheter 1 is introduced is, for example, a distal radial artery, a conventional radial artery, a snuff box radial artery, or the like. Here, a case in which a patient is a woman, the catheter 1 is inserted into an artery of the left arm, and a uterine fibroid 111 of a uterus 110 is treated is described as an example. Note that the catheter 1 can also be inserted from the radial artery 100 of the right arm. Figure 3As shown, the guidewire 6 and catheter 1 pass through the subclavian artery 101 and advance towards the aortic arch 102. At the point where the subclavian artery 101 connects to the aortic arch 102, the catheter 1 must bend significantly to face the descending aorta 103. To address this, for example, the operator can temporarily retract the guidewire 6, accommodating it within the lumen 21 of the catheter 1. The shape of the portion of the catheter 1 without the guidewire 6 inserted is not restricted by the guidewire 6. Therefore, the portion of the shape 24 without the guidewire 6 inserted is intended to return to its original curved shape. If the guidewire 6 retracts towards the base side compared to the shape 24, the shape 24 as a whole returns to its original curved shape. It should be noted that the tip of the guidewire 6 can also be located inside the shape 24. In this state, the tip-side bend 27 bends sharply towards the same side as the base-side bend 25 with a smaller radius of curvature than the base-side bend 25. Furthermore, since the shaped portion 24 in this invention is smaller than the shaped portion of the coronary artery treatment catheter, the tip of the catheter 1 is more easily oriented towards the descending aorta 103 rather than the ascending aorta. The operator can use the curvature of the shaped portion 24 to advance the tip of the catheter 1 from the aortic arch 102 towards the descending aorta 103. Then, the operator allows the guidewire 6 to protrude from the catheter 1 towards the tip. This allows the guidewire 6 to easily advance towards the descending aorta 103. Next, the operator advances the catheter 1 along the guidewire 6. This allows the catheter 1 to easily advance from the aortic arch 102 towards the descending aorta 103. The catheter 1 moves towards the distal side (near the lower limb) in the descending aorta 103, reaching the vicinity of the aortoiliac branch 104A. It should be noted that the operator may also move the catheter 1 towards the distal side in the descending aorta 103 without allowing the guidewire 6 to protrude from the tip.

[0056] After catheter 1 reaches the vicinity of the aortoiliac branch 104A, the operator retracts guidewire 6 as needed, retracting it into the lumen 21 of catheter 1. This restores the original curved shape of the portion 24 where guidewire 6 was not inserted. The operator can utilize the curvature of the portion 24 to guide the tip of catheter 1 through the aortoiliac branch 104A toward the right or left common iliac artery, easily selecting and inserting it into the desired side of the common iliac artery 104.

[0057] The operator then positions the guidewire 6 so that it protrudes from the catheter 1 towards the tip. Thus, as... Figure 4 As shown, catheter 1 can be easily advanced in the common iliac artery 104. It should be noted that the operator may also move catheter 1 terminally within the common iliac artery 104 without allowing guidewire 6 to protrude from the anterior end. Catheter 1 moves terminally within the common iliac artery 104, reaching the vicinity of the entrance to the internal iliac artery 105.

[0058] After the guidewire 6 and catheter 1 reach the vicinity of the entrance to the internal iliac artery 105, the operator retracts the guidewire 6 as needed, accommodating it within the lumen 21 of the catheter 1. This restores the original curved shape of the portion 24 where the guidewire 6 was not inserted. In this state, the tip-side bend 27 bends sharply towards the same side as the base-side bend 25 with a smaller radius of curvature than the base-side bend 25. Therefore, the tip of the catheter 1 is easily oriented towards the internal iliac artery 105, which branches off from the common iliac artery 104. The operator can utilize the bend of the portion 24 to orient the tip of the catheter 1 towards the entrance to the internal iliac artery 105, and can easily insert it without damaging the internal iliac artery 105, which has a smaller internal diameter than the common iliac artery 104.

[0059] The operator then positions the guidewire 6 so that it protrudes from the anterior end of the catheter 1. This allows the catheter 1 to advance easily within the internal iliac artery 105. It should be noted that the operator may also move the catheter 1 terminally within the internal iliac artery 105 without protruding the guidewire 6 from the anterior end. The catheter 1 then moves terminally within the internal iliac artery 105, reaching the vicinity of the entrance to the uterine artery 106.

[0060] After the guidewire 6 and catheter 1 reach the vicinity of the entrance to the uterine artery 106, the operator retracts the guidewire 6 as needed, retracting it into the lumen 21 of the catheter 1. Thus, as... Figure 5 As shown, the portion of the shape 24 where the guidewire 6 is not inserted is to be restored to its original curved shape. The operator can use the curvature of the shape 24 to orient the tip of the catheter 1 toward the entrance of the uterine artery 106 and easily insert it into the uterine artery 106. In this state, the tip-side curved portion 27 bends sharply toward the same side as the base-side curved portion 25 with a smaller radius of curvature than the base-side curved portion 25. Therefore, the tip of the catheter 1 easily orients toward the uterine artery 106, which branches from the internal iliac artery 105 and is thinner than the internal iliac artery 105. Thus, the tip-side curved portion 27 and / or the tip-side straight portion 28 of the catheter 1 contact the vessel wall of the uterine artery 106, and the base-side curved portion 25 contacts and stably maintains contact with the vessel wall of the internal iliac artery 105 on the side opposite to the entrance of the uterine artery 106. Thus, the tip-side curved portion 27 and / or the tip-side straight portion 28 of the catheter 1 can engage well with the uterine artery 106 and easily maintain its position. The curved portion 27 and / or the straight portion 28 at the front end may or may not contact the vessel wall of the uterine artery 106.

[0061] Next, a treatment catheter 5, longer than catheter 1, is inserted into the lumen 21 of catheter 1 from the hub 3. The practitioner can easily insert the treatment catheter 5 into the uterine artery 106 by allowing it to protrude from the tip of catheter 1. The practitioner can then release an embolic agent and / or medication for sealing uterine fibroids 111 in the uterus 110 via the treatment catheter 5. Catheter 1 mitigates the reaction caused by releasing the embolic agent, medication, etc., from the treatment catheter 5. Furthermore, catheter 1 provides support to the treatment catheter 5 to hold it in the desired position. Therefore, by utilizing the reaction when inserting a treatment catheter 5, such as a microcatheter, into the lumen 21 of catheter 1, or when releasing the embolic agent, medication, etc., the tip of catheter 1 can be prevented from being pulled out of the entrance of the uterine artery 106. It should be noted that the medical device used to insert catheter 1 may not be a treatment catheter 5. The practitioner may also release the embolic agent and / or medication from catheter 1 without using the treatment catheter 5.

[0062] Or, such as Figure 6 As shown, when the internal iliac artery 105 is short, the operator can use the curvature of the shape portion 24 to orient the tip of the catheter 1 toward the entrance of the uterine artery 106, so that the tip-side curved portion 27 abuts against the internal iliac artery 105 and the base-side curved portion 25 abuts against the common iliac artery 104. Utilizing the reaction force when a therapeutic catheter 5, such as a microcatheter, is inserted into the lumen 21 of the catheter 1 in this state, or when an embolic agent or medication is released, the tip of the catheter 1 can be prevented from being pulled out of the entrance of the uterine artery 106.

[0063] Alternatively, the curved end 27 can be engaged with the ascending branch of the uterine artery, and the embolic agent can be injected toward the terminal artery. The operator can use catheter 1 and treatment catheter 5, or use catheter 1 alone to release the embolic agent and / or medication.

[0064] It should be noted that catheter 1 can also be used to treat benign prostatic hyperplasia (BPH) of the prostate 120 in male patients. In this case, the operation of catheter 1 until it is inserted into the internal iliac artery 105 is the same as the operation of catheter 1 in the treatment of uterine fibroids 111. Guidewire 6 and catheter 1 pass through the internal iliac artery 105 to the vicinity of the entrance of the prostatic artery 107. The prostatic artery 107 is an artery that supplies the prostate 120 and may be, for example, the inferior vesicular artery, the middle rectus artery, the internal pudendal artery, or the obturator artery. After guidewire 6 and catheter 1 reach the vicinity of the entrance of the prostatic artery 107, the operator retracts guidewire 6 as needed and houses it in the lumen 21 of catheter 1. Thus, as Figure 7As shown, the portion of the shape portion 24 that is not inserted with the guide wire 6 is to be restored to the original curved shape. The operator can use the curvature of the shape portion 24 to easily insert the catheter 1 into the prostatic artery 107 with the tip of the catheter 1 directed toward the entrance of the prostatic artery 107. In this state, the tip-side curved portion 27 is curved toward the same side as the base-end side curved portion 25. Thus, the very tip of the catheter 1 is easily directed toward the prostatic artery 107 that branches from the internal iliac artery 105 and is thinner than the internal iliac artery 105. Thus, the tip-side curved portion 27 and / or the tip-side straight portion 28 of the catheter 1 come into contact with the blood vessel wall of the prostatic artery 107, and the base-end side curved portion 25 comes into contact with the blood vessel wall of the internal iliac artery 105 on the side opposite the entrance of the prostatic artery 107 and is held stably. Thus, the tip-side curved portion 27 and / or the tip-side straight portion 28 of the catheter 1 can be securely engaged in the prostatic artery 107 and the position can be easily maintained.

[0065] After that, a therapeutic catheter 5 that is longer than the catheter 1 is inserted into the lumen 21 of the catheter 1 from the hub 3. The operator can cause the therapeutic catheter 5 to protrude from the tip of the catheter 1 and easily insert it into the prostatic artery 107. After that, the operator can release embolization agents and / or drugs that reduce blood flow to the prostate through the therapeutic catheter 5. According to the catheter 1 of the present embodiment, the tip of the catheter 1 can be prevented from being pulled out of the entrance of the prostatic artery 107 by the reaction force when the therapeutic catheter 5 such as a microcatheter is inserted into the lumen 21 of the catheter 1 or when embolization agents, drugs, or the like are released. Note that in the case where the internal iliac artery 105 is short, the operator can use the curvature of the shape portion 24 to direct the tip of the catheter 1 toward the entrance of the prostatic artery 107, bring the tip-side curved portion 27 into contact with the internal iliac artery 105, and bring the base-end side curved portion 25 into contact with the common iliac artery 104. Note that the medical device that is inserted into the catheter 1 can not be the therapeutic catheter 5. The operator can release embolization agents and / or drugs from the catheter 1, not from the therapeutic catheter 5.

[0066] As described above, the catheter 1 of the present embodiment is a catheter 1 for engaging with a uterine artery, which has a tubular body 2 that communicates from a base end to a front end, and the tubular body 2 has a shape portion 24 that is curved in a substantially same plane X and is given a shape, and the shape portion 24 has a base end side curved portion 25 that is bent at a prescribed first angle θ1, a front end side curved portion 27 that is prescribed a second angle θ2 at a position further toward the front end side than the base end side curved portion 25 and is bent toward the same side as the base end side curved portion 25, a straight intermediate straight portion 26 that is disposed between the base end side curved portion 25 and the front end side curved portion 27, and a straight front end side straight portion 28 that is disposed further toward the front end side than the front end side curved portion 27, and a minimum radius of curvature of an axis in the base end side curved portion 25, that is, a first minimum radius of curvature R1 is 3 times or more and 11 times or less than a minimum radius of curvature of an axis in the front end side curved portion 27, that is, a second minimum radius of curvature R2.

[0067] In the catheter 1 configured in the above-described manner, the base end side curved portion 25 is brought into contact with the internal iliac artery 105, and the front end side curved portion 27 and / or the front end side straight portion 28 that is more toward the front end side than the front end side curved portion 27 is sharply bent toward the same direction as the base end side curved portion 25 with a smaller radius of curvature than the base end side curved portion 25, and is brought into engagement with the uterine artery 106 toward the uterine artery 106. Thus, the catheter 1 easily reaches the uterine artery 106 from the radial artery 100 and engages with the uterine artery 106.

[0068] In addition, the catheter 1 of the present embodiment is a catheter 1 for engaging with a uterine artery, which has a tubular body 2 that communicates from a base end to a front end, and the tubular body 2 has a shape portion 24 that is curved in a substantially same plane X and is given a shape, and the shape portion 24 has a base end side curved portion 25 that is bent at a prescribed first angle θ1, a front end side curved portion 27 that is prescribed a second angle θ2 at a position further toward the front end side than the base end side curved portion 25 and is bent toward the same side as the base end side curved portion 25, a straight intermediate straight portion 26 that is disposed between the base end side curved portion 25 and the front end side curved portion 27, and a straight front end side straight portion 28 that is disposed further toward the front end side than the front end side curved portion 27, and a minimum radius of curvature of an axis in the base end side curved portion 25, that is, a first minimum radius of curvature R1 is 3 times or more and 11 times or less than a minimum radius of curvature of an axis in the front end side curved portion 27, that is, a second minimum radius of curvature R2.

[0069] In the catheter 1 configured in the above-described manner, the base end side curved portion 25 is brought into contact with the internal iliac artery 105, and the tip end side curved portion 27 which is sharply bent in the same direction as the base end side curved portion 25 with a curvature radius smaller than that of the base end side curved portion 25 and / or the tip end side linear portion 28 which is more tip end side than the tip end side curved portion 27 are caused to be easily engaged with the prostatic artery 107 by being directed toward the prostatic artery 107. Thus, the catheter 1 is easily caused to reach the prostatic artery 107 from the radial artery and to be engaged with the prostatic artery 107.

[0070] Further, it can also be that the first minimum curvature radius Rl is 25 mm, the second minimum curvature radius R2 is 5 mm, the minimum curvature radius of the axis in the base end side curved portion 25, that is, the first minimum curvature radius Rl is 5 times the minimum curvature radius of the axis in the tip end side curved portion, that is, the second minimum curvature radius R2, and the length along the axis of the intermediate linear portion 26 is 16 mm, and the length along the axis of the tip end side linear portion 28 is 3 mm. Thus, the catheter 1 is easily caused to reach and be engaged with the uterine artery 106 and the prostatic artery 107 from the radial artery 100.

[0071] Further, the present application also provides a treatment method using the catheter 1 having the tubular body 2 which is communicated from the base end to the tip end. In the treatment method, the tubular body 2 has the shape portion 24 which is curved on substantially the same plane X to impart a shape, and the shape portion 24 has the base end side curved portion 25 which is bent at a prescribed first angle θl, the tip end side curved portion 27 which is prescribed a second angle θ2 at a position more tip end side than the base end side curved portion 25 and is bent toward the same side as the base end side curved portion 25, the intermediate linear portion 26 which is linearly arranged between the base end side curved portion 25 and the tip end side curved portion 27, and the tip end side linear portion 28 which is linearly arranged more tip end side than the tip end side curved portion 27, and the catheter 1 whose minimum curvature radius Rl of the base end side curved portion 25 is more than 3 times and less than 11 times the minimum curvature radius R2 of the tip end side curved portion 27 is inserted into a blood vessel from the radial artery, and the shape portion 24 is engaged with a blood vessel more distal than the internal iliac artery 105.

[0072] In the treatment method configured in the above-described manner, the base end side curved portion 25 is brought into contact with the internal iliac artery 105 to be stably held to the blood vessel wall, and the tip end side curved portion 27 which is sharply bent in the same direction as the base end side curved portion 25 with a curvature radius smaller than that of the base end side curved portion 25 and / or the tip end side linear portion 28 which is more tip end side than the tip end side curved portion 27 are caused to be easily engaged with a blood vessel more distal than the internal iliac artery 105 by being directed toward the blood vessel. Thus, the operator causes the catheter 1 to reach and be engaged with the blood vessel more distal than the internal iliac artery 105 from the radial artery 100, and treatment is easily and favorably performed.

[0073] Further, in the aforementioned treatment method, the radial artery 100 into which the catheter 1 is inserted can also be a distal radial artery. Thereby, for the operator, it becomes easy to perform treatment well in a low-invasive manner with the catheter 1 reaching a blood vessel more distal than the internal iliac artery 105 and engaging, compared to the case where the catheter 1 is usually inserted from the radial artery.

[0074] Further, the blood vessel disposed more distal than the internal iliac artery 105 and capable of engaging with the shape portion 24 can also be the uterine artery 106. Thereby, the operator can perform treatment of the uterus 110 well using the catheter 1 inserted into the blood vessel from the radial artery 100.

[0075] The treatment target can also be the uterine fibroid 111. Thereby, the operator can perform treatment of the uterine fibroid 111 well using the catheter 1 inserted into the blood vessel from the radial artery 100.

[0076] Further, the blood vessel disposed more distal than the internal iliac artery 105 and capable of engaging with the shape portion 24 can also be the prostatic artery 107. Thereby, the operator can perform treatment of the prostate 120 (for example, treatment of prostatic hypertrophy) well using the catheter 1 inserted into the blood vessel from the radial artery 100.

[0077] The treatment target can also be the prostate 120 enlarged by prostatic hypertrophy. Thereby, the operator can perform treatment of prostatic hypertrophy well using the catheter 1 inserted into the blood vessel from the radial artery 100.

[0078] Note that the present application is not limited only to the aforementioned embodiments, and various modifications can be made by those skilled in the art within the technical idea of the present application.

[0079] Note that the present application is based on Japanese Patent Application No. 2020-95742 filed on June 1, 2020, and Japanese Patent Application No. 2020-197870 filed on November 30, 2020, the disclosures of which are incorporated herein by reference in their entirety.

[0080] Explanation of Reference Signs

[0081] 1 Catheter

[0082] 2 Tubular body

[0083] 21 Lumen

[0084] 23 Main body portion

[0085] 24 Shape portion

[0086] 25 Base end side curved portion

[0087] 26 Intermediate straight portion

[0088] 27 front end side curved portion

[0089] 28 front end side straight portion

[0090] 100 radial artery

[0091] 101 subclavian artery

[0092] 102 aortic arch

[0093] 103 descending aorta

[0094] 104 common iliac artery

[0095] 105 internal iliac artery

[0096] 106 uterine artery

[0097] 107 prostatic artery

[0098] 110 uterus

[0099] 111 uterine fibroid

[0100] 120 prostate

[0101] A first axis

[0102] B second axis

[0103] C third axis

[0104] R1 first minimum radius of curvature

[0105] R2 second minimum radius of curvature

[0106] X plane

[0107] θ1 first angle

[0108] θ2 second angle

[0109] θ3 third angle

Claims

1. A catheter for uterine artery clamping, characterized in that it is a tubular catheter for uterine artery clamping having a tubular body extending from its base to its tip, and is further characterized in that... The front end of the tubular body has a shaped portion that is bent on substantially the same plane to give it its shape. The shaped portion has: The base-end side bend is bent at a specified first angle; The front end side bend has a second angle defined at a position closer to the front end than the base end side bend, and bends toward the same side as the base end side bend. A straight, intermediate straight portion, disposed between the base-end side bend and the front-end side bend; and The straight section on the front end is positioned further forward than the curved section on the front end. The minimum radius of curvature of the axis in the base-end side bend, i.e., the first minimum radius of curvature, is more than 3 times but less than 11 times the minimum radius of curvature of the axis in the front-end side bend, i.e., the second minimum radius of curvature. The length of the curved portion along the axis is more than 1 mm and less than 10 mm, and the tubular body is covered with a lubricating coating in a range of less than 500 mm from the front opening located at the front end along the axis toward the base end.

2. The catheter for use with the uterine artery according to claim 1, characterized in that, The first minimum radius of curvature is 25mm, the second minimum radius of curvature is 5mm, the first minimum radius of curvature is 5 times the second minimum radius of curvature, the length of the middle straight section along the axis is 16mm, and the length of the front end straight section along the axis is 3mm.

3. A catheter for use with the prostate artery, characterized in that it is a tubular catheter for use with the prostate artery having a tubular body extending from its base to its tip, and is further characterized in that... The front end of the tubular body has a shaped portion that is bent on substantially the same plane to give it its shape. The shaped portion has: The base-end side bend is bent at a specified first angle; The front end side bend has a second angle defined at a position closer to the front end than the base end side bend, and bends toward the same side as the base end side bend. A straight, intermediate straight portion, disposed between the base-end side bend and the front-end side bend; and The straight section on the front end is positioned further forward than the curved section on the front end. The minimum radius of curvature of the axis in the base-end side bend, i.e., the first minimum radius of curvature, is more than 3 times but less than 11 times the minimum radius of curvature of the axis in the front-end side bend, i.e., the second minimum radius of curvature. The length of the curved portion along the axis is more than 1 mm and less than 10 mm, and the tubular body is covered with a lubricating coating in a range of less than 500 mm from the front opening located at the front end along the axis toward the base end.

4. The catheter for use with the prostate artery according to claim 3, characterized in that, The first minimum radius of curvature is 25mm, the second minimum radius of curvature is 5mm, the first minimum radius of curvature is 5 times the second minimum radius of curvature, the length of the middle straight section along the axis is 16mm, and the length of the front end straight section along the axis is 3mm.

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