Medical devices

Abstract

To easily determine the position of wires in medical devices. [Solution] The medical device comprises a long main body and a leading part connected to the tip of the main body and entering the lesion. The main body includes a first part which is a part of a wire and a second part which is a part of the wire different from the first part and has a part that faces the first part in a first direction intersecting the axial direction of the main body. The leading part includes a third part which is a part of the wire different from the first and second parts and is located between the first and second parts of the wire. The surface of the first part facing the second part is curved. The surface of the second part facing the first part is flat.

Description

Technical Field

[0006] , , ,

[0007] , ,

[0001] The technology disclosed in this specification relates to medical devices.

Background Art

[0002] Known medical devices have a main body portion and a leading portion. The main body portion includes a first wire (first portion) that is a part of a wire, and a second wire (second portion) that is another part of the wire and faces the first wire in a direction intersecting the axial direction of the main body portion. The leading portion is another part of the wire and includes a loop located between the first wire and the second wire in the wire (see, for example, Patent Document 1).

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

[0008] [Figure 1] This diagram schematically shows the configuration of the guide wire in the first embodiment. [Figure 2] This diagram schematically shows the configuration of the guide wire in the first embodiment. [Figure 3] This diagram schematically shows the configuration of the guide wire in the first embodiment. [Figure 4] This diagram schematically shows the configuration of the guide wire in the first embodiment. [Figure 5] This diagram schematically shows the configuration of the guide wire in the first embodiment. [Figure 6] A flowchart illustrating an example of a treatment method using a guidewire. [Figure 7] An explanatory diagram showing an example of a treatment method using a guidewire. [Figure 8] An explanatory diagram showing an example of a treatment method using a guidewire. [Figure 9] An explanatory diagram showing an example of a treatment method using a guidewire. [Figure 10] This is an explanatory diagram illustrating the configuration of the guide wire in the second embodiment. [Figure 11] This is an explanatory diagram illustrating the configuration of the guide wire in the second embodiment. [Figure 12]This is an explanatory diagram illustrating the configuration of the guide wire in the third embodiment. [Figure 13] This is an explanatory diagram illustrating the configuration of the guide wire in the third embodiment. [Figure 14] This is an explanatory diagram illustrating the configuration of the guide wire in the fourth embodiment. [Figure 15] This is an explanatory diagram illustrating the configuration of the guide wire in the fourth embodiment. [Figure 16] This is an explanatory diagram illustrating the configuration of the guide wire in the fifth embodiment. [Figure 17] This is an explanatory diagram illustrating the configuration of the guide wire in the fifth embodiment. [Figure 18] A schematic diagram showing the configuration of the guide wires in a modified example. [Figure 19] A schematic diagram showing the configuration of the guide wires in a modified example. [Modes for carrying out the invention]

[0009] A. First Embodiment: (Basic configuration of guidewire 100) Figures 1 to 5 are explanatory diagrams schematically showing the configuration of the guide wire 100 in the first embodiment. In each figure, XYZ axes orthogonal to each other for specifying directions are shown. Figure 1 shows the appearance of the guide wire 100 viewed in the X-axis direction. Figure 2 shows the appearance of the guide wire 100 viewed in the Y-axis direction. Figure 3 shows the YZ longitudinal section of the guide wire 100. Figure 4 shows the XY cross section of the guide wire 100 at the position IV-IV in Figure 3. Figure 5 shows the XZ cross section of the guide wire 100 at the position V-V in Figure 3. In the guide wire 100, the positive Z-axis side is the tip side (distal side) to be inserted into the body. In the guide wire 100, the negative Z-axis side is the proximal side (proximal side) to be operated by the operator. In each figure, illustration of a part of the guide wire 100 may be omitted. In Figures 1 to 3, a state where the guide wire 100 is in a straight line parallel to the Z-axis is shown. The guide wire 100 has flexibility enough to be curved. These points are the same in the subsequent figures. The Y-axis direction is an example of the first direction.

[0010] In this specification, for the guide wire 100 and each of its constituent members, the end on the tip side is referred to as the "tip", the tip and its vicinity are referred to as the "tip portion", the end on the proximal side is referred to as the "proximal end", and the proximal end and its vicinity are referred to as the "proximal end portion". The cross section of the guide wire 100 and each of its constituent members means a section orthogonal to the longitudinal direction. The longitudinal section of the guide wire 100 and each of its constituent members means a section parallel to the central axis in the longitudinal direction. For the guide wire 100 and each of its constituent members, the direction orthogonal to the longitudinal direction is referred to as the "radial direction". The outer diameter of the guide wire 100 and each of its constituent members means the width along the radial direction. In this specification, for the guide wire 100 and each of its constituent members, the length along the Y-axis direction may be particularly referred to as the "width", and the length along the X-axis direction may be particularly referred to as the "thickness".

[0011] [[ID=]7] The guide wire 100 is a long medical device inserted into a living body lumen such as a blood vessel. The total length of the guide wire 100 is, for example, 1000 mm or more and 3000 mm or less. The guide wire 100 is an example of a medical device.

[0012] The guide wire 100 includes a main body portion 10 and a leading portion 20.

[0013] The main body portion 10 is a long portion extending along the central axis Ax. In the present embodiment, the central axis Ax of the main body portion 10 coincides with the central axis of the guide wire 100. The proximal end 15 of the main body portion 10 coincides with the proximal end of the guide wire 100. A spiral groove 18 is formed on the outer peripheral surface 17 of the distal end portion of the main body portion 10.

[0014] The leading portion 20 is connected to the tip 16 of the main body 10. The base end 27 of the leading portion 20 is connected to the tip 16 of the main body 10. The leading portion 20 can be described as a leading section, drill section, crushing section, peeling section, entry section, peeler, shaver, etc. The tip 23 of the leading portion 20 coincides with the tip of the guide wire 100. The leading portion 20 is loop-shaped and surrounds a through hole 24 extending in the X-axis direction. The surface of the leading portion 20 may or may not have an edge. An edge is the boundary (ridge) between two surfaces. The leading portion 20 rotates around the central axis Ax and enters the lesion. The entry of the leading portion 20 into the lesion can be described as crossing through the lesion, drilling through the lesion, crushing the lesion, peeling away the lesion, digging into the lesion, entering the lesion, etc. The length L20 of the leading portion 20 along the central axis Ax is, for example, 0.2 mm or more and 2.0 mm or less. The length L20 of the leading portion 20 may also be 0.3 mm or more and 1.5 mm or less, or 0.4 mm or more and 1.0 mm or less. In the view along the X axis, the end of the leading portion 20 on the positive Y axis side at the base end 27 is called the first end 27E1, and the end of the leading portion 20 on the negative Y axis side at the base end 27 is called the second end 27E2.

[0015] The maximum outer diameter Dx of the leading portion 20 is greater than the thickness T2 of the leading portion 20 at the maximum outer diameter position Px. That is, the leading portion 20 is flattened overall. The thickness T2 of the leading portion 20 at the maximum outer diameter position Px is smaller than the maximum outer diameter D1 of the tip 16 of the main body portion 10. The thickness T2 of the leading portion 20 at the maximum outer diameter position Px is, for example, 0.02 mm or more and 0.3 mm or less. The thickness T2 of the leading portion 20 at the maximum outer diameter position Px may be 0.04 mm or more and 0.2 mm or less, or 0.06 mm or more and 0.1 mm or less. The maximum outer diameter Dx of the leading portion 20 is, for example, 1.2 times or more the thickness T2 of the leading portion 20 at the maximum outer diameter position Px. The maximum outer diameter Dx of the leading portion 20 may be 1.5 times or more the thickness T2 of the leading portion 20 at the maximum outer diameter position Px, or it may be 1.8 times or more.

[0016] The maximum outer diameter Dx of the leading portion 20 is measured as follows. The measurer observes the guide wire 100 from the side. In this embodiment, the side is the Y-axis direction. The measurer searches for an angle in which the front portion and the back portion of the leading portion 20 overlap, and the back portion is not visible. For example, the measurer searches for an angle in which the portion between the second end 27E2 and the tip 23 is not visible if both of the following two conditions are met. The first condition is that the portion between the first end 27E1 and the tip 23 is located on the front side. The second condition is that the portion between the second end 27E2 and the tip 23 is located on the back side. The invisibility of the portion between the second end 27E2 and the tip 23 is caused by the overlap between the portion between the first end 27E1 and the tip 23 and the portion between the second end 27E2 and the tip 23. Next, the measurer photographs the guide wire 100 using a microscope along a viewpoint rotated 90 degrees around the central axis Ax from this viewpoint. The operator sets the microscope's magnification to 200x or higher. The operator measures the outer diameter of the leading section 20 at three measurement positions on the captured image where the leading section 20 is thought to have its maximum outer diameter Dx. Specifically, at each measurement position, the operator draws a pair of parallel lines that pass through a pair of ends in the outer diameter direction of the leading section 20 and are perpendicular to the outer diameter direction, and measures the distance between these pairs of lines. The operator adopts the maximum value among the measurement results at the three measurement positions as the maximum outer diameter Dx of the leading section 20.

[0017] (Treatment method using guidewire 100) Figure 6 is a flowchart showing an example of a treatment method using a guidewire 100. Figures 7 to 9 are explanatory diagrams showing an example of a treatment method using a guidewire 100. As shown in Figures 8 and 9, in the treatment method using a guidewire 100, the operator inserts the leading portion 20 of the guidewire 100 into the lesion 220 within the blood vessel 200. The lesion 220 is, for example, a highly calcified lesion. The lesion 220 is, for example, a chronic total occlusion lesion. The length L0 of the lesion 220 along the extension direction of the blood vessel 200 is, for example, 100 mm or more and 500 mm or less. The length of the lesion 220 may be 150 mm or more and 450 mm or less, or 200 mm or more and 400 mm or less.

[0018] As shown in Figure 7, the lesion 220 to be treated is located, for example, in a blood vessel 200 in the lower limb of a human. Figure 7 shows a lesion 220 occurring in the lower leg region. In this treatment method, a technique called a crossover is used, in which, for example, the blood vessel 200 is accessed from the groin of the opposite leg 251, which is the leg opposite to the target leg 252, which is the leg in which the lesion 220 is located, and then the lesion 220 on the target leg 252 is approached. The method of inserting the guidewire 100 into the blood vessel 200 to approach the lesion 220 occurring in the lower leg region does not have to be a crossover. The approach method may also be an antegrade approach in which the guidewire 100 is inserted from the blood vessel 200 in the groin of the target leg 252 where the lesion 220 is located and the guidewire 100 is advanced along the blood flow. The approach method may also be an antegrade approach in which the guidewire 100 is inserted from the blood vessel 200 in the arm and the guidewire 100 is advanced along the blood flow. This approach may also be a retrograde approach in which the guidewire 100 is inserted into either a blood vessel 200 in the ankle or in the top of the foot of the target leg 252 where the lesion 220 is located, and the guidewire 100 is advanced against the flow of blood. The location for inserting the guidewire 100 into the blood vessel 200 is not limited to the aforementioned locations. When inserting the guidewire 100 from a blood vessel 200 in the arm, the surgeon may select a blood vessel 200 in the wrist as the insertion site for the guidewire 100. When inserting the guidewire 100 from a blood vessel 200 in the leg, the surgeon may select the superficial aorta or popliteal artery as the insertion site for the guidewire 100. The guidewire 100 is not limited to treating lesions 220 occurring in the subknee region, but can also be used to treat lesions 220 occurring in other locations, such as the iliac artery.

[0019] First, the surgeon inserts a lead guidewire into the blood vessel 200 (S110). Unlike the guidewire 100 in this embodiment, the lead guidewire is a known guidewire that does not have a leading portion 20. The lead guidewire is also called a workhorse guidewire or first-choice guidewire. The surgeon inserts the lead guidewire into the blood vessel 200 through a sheath (not shown) placed at the puncture site 230 (see Figure 7) of the opposite leg 251. The surgeon advances the lead guidewire to just before the lesion 220 in the blood vessel 200 of the target leg 252.

[0020] Next, the surgeon inserts the catheter 120 into the blood vessel 200 along the lead guidewire (S120). The surgeon then advances the catheter 120 (see Figure 8) to just before the lesion 220 in the blood vessel 200.

[0021] Next, the surgeon withdraws the lead guidewire from the blood vessel 200 (S130). Then, the surgeon inserts the guidewire 100 into the catheter 120 inserted into the blood vessel 200, with the leading portion 20 at the front (S140, Figure 8). The surgeon advances the guidewire 100 to just before the lesion 220 in the blood vessel 200. When advancing the guidewire 100, the surgeon may or may not rotate the guidewire 100 around the central axis Ax.

[0022] Next, the surgeon rotates the guidewire 100 and advances it toward the tip, thereby entering the leading portion 20 of the guidewire 100 into the lesion 220 (S150, Figure 9). When the surgeon grasps the proximal end of the guidewire 100 and rotates the guidewire 100 around the central axis Ax, the leading portion 20 located at the tip of the guidewire 100 also rotates around the central axis Ax. The leading portion 20, rotating within the lesion 220, excavates by cutting through the lesion 220. In this embodiment, during the guidewire advancement step (S150), the surgeon advances the leading portion 20 until it has passed through the lesion 220. If the leading portion 20 has an edge, when the leading portion 20 rotates around the central axis Ax with the edge in contact with the lesion 220, the edge scrapes the lesion 220. As the edge scrapes away the lesion 220, the leading portion 20 enters the space created, forming a through-hole in the lesion 220. As described above, a spiral groove 18 is formed on the outer circumferential surface 17 of the main body 10. Due to the presence of this groove 18, the main body 10 has a function (referred to as the "lesion discharge function") to discharge small pieces of the lesion 220 generated by the contact between the rotating leading portion 20 and the lesion 220 from the tip side to the proximal end side of the main body 10. The guidewire 100 advancement step (S150) is performed while no other medical devices have passed over the lesion 220.

[0023] After the leading portion 20 of the guidewire 100 has passed the lesion 220, the operator advances a catheter (not shown) along the guidewire 100 to the position of the lesion 220. Then the operator withdraws the guidewire 100. When withdrawing the guidewire 100, the operator may or may not rotate the guidewire 100 around its central axis Ax.

[0024] Subsequently, the surgeon inserts a guidewire for an adjunct device (not shown) into the blood vessel 200 and advances it until the tip of the guidewire passes the lesion 220. The surgeon then advances the adjunct device to the location of the lesion 220, following the guidewire. The adjunct device may be, for example, an atherectomy device, a balloon catheter, or a stent.

[0025] (Detailed configuration of guide wire 100) As shown in Figure 3, the guide wire 100 has a wire 40 and a coil 50.

[0026] The coil 50 is a cylindrical member in which one or more wires are wound in a spiral shape. The main body 10 includes the coil 50. The outer diameter of the coil 50 is, for example, 0.1 mm or more and 0.6 mm or less. The outer diameter of the coil 50 may be 0.2 mm or more and 0.5 mm or less, or 0.3 mm or more and 0.4 mm or less. The outer diameter of the coil 50 may be 1.00 mm or more and 2.00 mm or less, or 1.10 mm or more and 1.65 mm or less, or 1.20 mm or more and 1.35 mm or less. In this embodiment, the outer diameter of the coil 50 is constant over the entire length of the coil 50. The coil 50 may have a tapered shape in which the outer diameter of the coil 50 gradually decreases from the base end to the tip, or a tapered shape in which the outer diameter of the coil 50 gradually decreases from the tip to the base end. A spiral groove 53 is formed on the outer circumferential surface 52 of the coil 50. In this embodiment, the coil 50 is Z-wound, and the direction of travel of the groove 53 is also the direction of the Z-wound. Due to the presence of the helical groove 53, a helical groove 18 is formed on the outer circumferential surface 17 of the main body 10. The tip of the coil 50 coincides with the tip 16 of the main body 10. The coil 50 is an example of a cylindrical body.

[0027] The wire forming the coil 50 may be a single strand or a stranded wire made by twisting multiple strands together. In this embodiment, the coil 50 is a multi-strand coil in which multiple wires are wound together. In this embodiment, each wire forming the coil 50 is a stranded wire.

[0028] For example, metal can be used as the material for forming the coil 50. More specifically, radiotransparent materials such as stainless steel (SUS302, SUS304, SUS316, etc.), Ni-Ti alloys, and piano wire, or radiopaque materials such as platinum, gold, tungsten, and any of these alloys can be used. The coil 50 may be formed entirely from the same material, or each part may be formed from different materials.

[0029] The wire 40 is a linear member. The wire 40 has a base portion 40A, a folded portion 40B, and a loop portion 40C. In the wire 40, the base portion 40A, the loop portion 40C, and the folded portion 40B are arranged in this order from the first end 40E1 to the second end 40E2 of the wire 40. The base portion 40A and the loop portion 40C are continuous in the longitudinal direction of the wire 40. The loop portion 40C and the folded portion 40B are continuous in the longitudinal direction of the wire 40. The main body portion 10 includes the base portion 40A and the folded portion 40B of the wire 40. The leading portion 20 includes the loop portion 40C of the wire 40. The base portion 40A is an example of a first part. The folded portion 40B is an example of a second part. The loop portion 40C is an example of a third part.

[0030] The base portion 40A is a part of the wire 40. The proximal end of the base portion 40A is located at the proximal end of the main body portion 10. The proximal end of the base portion 40A is the part that is grasped by the operator. The tip of the base portion 40A is located at the tip of the main body portion 10.

[0031] The base portion 40A has a large diameter portion 41, a first tapered portion 42, an intermediate diameter portion 43, a second tapered portion 44, and a small diameter portion 47. In the base portion 40A, the large diameter portion 41, the first tapered portion 42, the intermediate diameter portion 43, the second tapered portion 44, and the small diameter portion 47 are arranged in this order from the base end to the tip end of the guide wire 100.

[0032] The large diameter portion 41 is a rod-shaped portion having a substantially constant outer diameter. The outer diameter (maximum width) of the large diameter portion 41 is, for example, approximately 0.2 mm or more and 3.0 mm or less. The first tapered portion 42 is a portion in which the diameter gradually decreases from the boundary with the large diameter portion 41 toward the boundary with the intermediate diameter portion 43. The intermediate diameter portion 43 is a rod-shaped portion having a substantially constant outer diameter smaller than the outer diameter of the large diameter portion 41. The second tapered portion 44 is a portion in which the diameter gradually decreases from the boundary with the intermediate diameter portion 43 toward the boundary with the small diameter portion 47. In this embodiment, the second tapered portion 44 includes a base-end second tapered portion 45 and a tip-end second tapered portion 46 located toward the tip than the base-end second tapered portion 45. The small diameter portion 47 is a rod-shaped portion having a substantially constant outer diameter smaller than the outer diameter of the intermediate diameter portion 43.

[0033] In this embodiment, the rate of change of the outer diameter along the longitudinal direction (hereinafter referred to as "gradient") in the base end second tapered portion 45 and the tip end second tapered portion 46 are different from each other. For example, the gradient of the base end second tapered portion 45 is steeper than the gradient of the tip end second tapered portion 46. The gradient of the base end second tapered portion 45 may be gentler than the gradient of the tip end second tapered portion 46, or it may be the same as the gradient of the tip end second tapered portion 46. In this embodiment, the gradients in the first tapered portion 42 and the second tapered portion 44 are different from each other. For example, the gradient of the first tapered portion 42 is steeper than the gradient of the second tapered portion 44. The gradient of the first tapered portion 42 may be gentler than the gradient of the second tapered portion 44, or it may be the same as the gradient of the second tapered portion 44.

[0034] The folded portion 40B is a part of the wire 40 that is different from the base portion 40A. The folded portion 40B has a portion that faces the base portion 40A in the Y-axis direction, which intersects the axial direction of the main body portion 10. In this embodiment, the base portion 40A and the folded portion 40B are in contact with each other. The base end of the folded portion 40B is located closer to the tip than the base end of the base portion 40A. In other words, the base end of the base portion 40A is located closer to the base than the base end of the folded portion 40B. The tip of the folded portion 40B is located at the tip of the main body portion 10.

[0035] The loop portion 40C is a part of the wire 40 that is distinct from the base portion 40A and the folded portion 40B. The loop portion 40C is located between the base portion 40A and the folded portion 40B in the longitudinal direction of the wire 40. The loop portion 40C is loop-shaped when viewed in the X-axis direction. The loop portion 40C surrounds the through hole 24 in the leading portion 20. The loop portion 40C extends from boundary position 40P1, which is the boundary position with the base portion 40A, toward the tip, folds back toward the base end at the tip 23 of the leading portion 20, and extends toward the base end to boundary position 40P2, which is the boundary position with the folded portion 40B. Boundary positions 40P1 and 40P2 are the base ends of the loop portion 40C. The base end of the loop portion 40C is located at the base end of the leading portion 20. The tip of the loop portion 40C is located at the tip of the leading portion 20.

[0036] For example, metal can be used as the material for forming the wire 40. More specifically, stainless steel (SUS302, SUS304, SUS316, etc.), Ni-Ti alloy, piano wire, etc., can be used. The wire 40 may be formed entirely from the same material, or each part may be formed from different materials.

[0037] The wire 40 is inserted into the hollow of the coil 50. The coil 50 covers at least a portion of the tip side of the base portion 40A and the folded portion 40B.

[0038] The coil 50 is joined to the wire 40 via a tip-side joining member 61 formed at the tip of the coil 50 and a base-side joining member 62 formed at the base end of the coil 50. The base portion 40A and the folded portion 40B are connected to the coil 50 via the tip-side joining member 61. The tip-side joining member 61 protrudes from the tip 51 of the coil 50 toward the tip side. The loop portion 40C is connected to the coil 50 via the portion of the tip-side joining member 61 that protrudes from the tip 51 of the coil 50. The coil 50 may also be joined to the wire 40 via joining members formed at other locations. Examples of materials used to form the tip-side joining member 61 and the base-side joining member 62 include metal solder (Au-Sn alloy, Sn-Ag alloy, Sn-Pb alloy, Pb-Ag alloy, etc.), brazing material (aluminum alloy brazing, silver brazing, gold brazing, etc.), and adhesive (epoxy adhesive, etc.).

[0039] The leading portion 20 has a reinforcing portion 28 located at the connection point with the main body portion 10. The reinforcing portion 28 reinforces the connection point between the leading portion 20 and the main body portion 10. In this embodiment, the reinforcing portion 28 is formed from the portion of the tip-side joining material 61 that protrudes toward the tip side from the tip 51 of the coil 50. The reinforcing portion 28 may also be formed by the welded joint between the leading portion 20 and the main body portion 10. A constriction 29 is formed on the outer circumferential surface of the reinforcing portion 28. That is, in a part of the reinforcing portion 28 (for example, the base end), the width in the direction perpendicular to the axis Ax of the reinforcing portion 28 decreases toward the tip of the reinforcing portion 28, and in another part of the reinforcing portion 28 (for example, the tip), the width in the direction perpendicular to the axis Ax of the reinforcing portion 28 increases toward the tip of the reinforcing portion 28. For this reason, the outer circumferential surface of the reinforcing portion 28 has a curved surface that is recessed toward the radially inward side of the reinforcing portion 28.

[0040] As shown in Figure 1, the guide wire 100 comprises a first coating 31 and a second coating 32. The first coating 31 covers at least a portion of the leading portion 20. The first coating 31 may also cover a portion of the main body portion 10. In this embodiment, the first coating 31 covers a region R31 formed by the entire leading portion 20 and the tip portion of the main body portion 10. The second coating 32 covers at least a portion of the main body portion 10. In this embodiment, the second coating 32 covers a region R32 which is the intermediate portion of the main body portion 10 excluding the tip and base portions. Region R32 is located on the base end side of region R31. The slipperiness of the first coating 31 is different from that of the second coating 32. For example, the slipperiness of the first coating 31 is lower than that of the second coating 32. The first coating 31 is, for example, hydrophobic and is formed of silicone. The second coating 32 is, for example, hydrophilic and is formed from polyvinylpyrrolidone, polyacrylic acid, polyacrylamide, polyvinyl alcohol, maleic anhydride copolymer, hyaluronic acid, etc.

[0041] The guide wire 100 further comprises a third coating 33. The third coating 33 covers at least a portion of the main body 10. In this embodiment, the third coating 33 covers region R33, which is the base end of the main body 10. Region R33 is located on the base end side of region R32. The third coating 33 is formed of, for example, PTFE.

[0042] As shown in Figure 4, the cross-sectional shape of the base portion 40A and the cross-sectional shape of the folded portion 40B are different from each other. The surface of the base portion 40A facing the folded portion 40B is a curved surface. In this specification, "curved surface" includes not only strictly curved surfaces but also shapes that deviate from a curved surface due to unavoidable circumstances such as manufacturing errors. In this embodiment, the cross-section of the base portion 40A is circular. More specifically, the cross-section of the base portion 40A is a perfect circle. The cross-section of the base portion 40A may be a circle other than a perfect circle, such as an ellipse. The surface of the folded portion 40B facing the base portion 40A is a flat surface. In this specification, "flat surface" includes not only strictly flat surfaces but also shapes that deviate from a flat surface due to unavoidable circumstances such as manufacturing errors. In this embodiment, the cross-section of the folded portion 40B is rectangular. More specifically, the cross-section of the folded portion 40B is rectangular. The cross-section of the folded portion 40B may be a rectangle other than a rectangle, such as a square, trapezoid, or parallelogram.

[0043] In this specification, the region in the base portion 40A where the surface facing the folded portion 40B is curved, and the region in the folded portion 40B where the surface facing the base portion 40A is flat, is referred to as the specific region SA. The distance d1 from the tip 16 of the main body portion 10 to the tip of the specific region SA is, for example, 2 mm or less. The distance d1 may be 1.6 mm or less, or 1.2 mm or less.

[0044] In this embodiment, as shown in FIG. 4, in the Y-axis direction in which the base portion 40A and the folded-back portion 40B face each other, when the width of the base portion 40A is width w1 and the width of the folded-back portion 40B is width w2, w1 > w2 holds. That is, the width w1 in the Y-axis direction at the tip of the base portion 40A is smaller than the width w2 in the Y-axis direction at the tip of the folded-back portion 40B. The ratio w1 / w2 of the width w1 to the width w2 is, for example, 1.1 or more and 2.0 or less. w1 / w2 may be 1.2 or more and 1.8 or less, or may be 1.25 or more and 1.5 or less. The width w1 and the width w2 may be w1 < w2, or may be w1 = w2. In this embodiment, in the X-axis direction, when the thickness of the base portion 40A is thickness t1 and the thickness of the folded-back portion 40B is thickness t2, t1 < t2 holds. The thickness t1 and the thickness t2 may be t1 > t2, or may be t1 = t2.

[0045] As shown in FIG. 5, in this embodiment, the cross-section of the loop portion 40C is circular. More specifically, the cross-section of the loop portion 40C is a perfect circle. That is, the shape of the cross-section in the base portion 40A and the shape of the cross-section in the loop portion 40C are similar to each other. The cross-section of the loop portion 40C may be a non-perfect circle such as an ellipse.

[0046] (Method for manufacturing the guide wire 100) The guide wire 100 of this embodiment can be manufactured by, for example, the following manufacturing method. First, the worker prepares the wire 40. The worker makes at least a part of the surface of the portion corresponding to the folded portion 40B flat by, for example, pressing or polishing the wire 40. In other words, the worker makes the cross-section of the portion corresponding to the folded portion 40B rectangular by, for example, pressing or polishing the wire 40. Next, the worker inserts the wire 40 into the hollow part of the coil 50. At this time, the worker positions the wire 40 in the hollow part of the coil 50 such that a part of the tip of the wire 40 protrudes from the tip of the coil 50. Next, the worker bends the portion of the wire 40 that protrudes from the tip of the coil 50 into a loop shape. This forms the base portion 40A, the folded portion 40B, and the loop portion 40C of the wire 40, respectively. Next, the worker inserts the portion of the wire 40 corresponding to the folded portion 40B into the hollow part of the coil 50.

[0047] Next, the worker joins the wire 40 and the coil 50. Specifically, in order to join the wire 40 to the coil 50, the worker forms a tip-side joining member 61 and a base-side joining member 62 using a joining material such as solder. The joining material is supplied, for example, from between the strands of the coil 50 to the inside of the coil 50. The tip-side joining member 61 that protrudes from the tip of the coil 50 towards the tip side forms a reinforcing portion 28. Through the joining process, a guide wire 100 having a leading portion 20 with a reinforcing portion 28 and a main body portion 10 is manufactured.

[0048] (Effects of this embodiment) As described above, the guide wire 100 of this embodiment comprises a long main body portion 10 and a leading portion 20 connected to the tip 16 of the main body portion 10 and entering the lesion portion 220. The main body portion 10 includes a base portion 40A, which is a part of the wire 40, and a folded portion 40B, which is a part of the wire 40 different from the base portion 40A and has a portion facing the base portion 40A in the Y-axis direction intersecting the axial direction of the main body portion 10. The leading portion 20 is a part of the wire 40 different from the base portion 40A and the folded portion 40B and includes a loop portion 40C located between the base portion 40A and the folded portion 40B of the wire 40. The surface of the base portion 40A facing the folded portion 40B is a curved surface. The surface of the folded portion 40B facing the base portion 40A is a flat surface. According to the guide wire 100 of this embodiment, the position of the base portion 40A and the position of the folded portion 40B can be easily determined. When the wire 40 is folded back to form the folded portion 40B so as to overlap the base portion 40A, the fact that either the base portion 40A or the folded portion 40B is a plane prevents the base portion 40A and the folded portion 40B from shifting relative to each other in the direction perpendicular to the axial direction of the main body portion 10 (X-axis direction). This prevents the base portion 40A and the folded portion 40B from shifting and intersecting. In other words, since the base portion 40A and the folded portion 40B are provided at the same position in the direction perpendicular to the axial direction of the main body portion 10 (X-axis direction), the base portion 40A and the folded portion 40B extend parallel to the axial direction of the main body portion 10 (Z-axis direction).

[0049] In the guide wire 100 of this embodiment, the cross-section of the base portion 40A is circular. With the guide wire 100 of this embodiment, the position of the base portion 40A and the position of the folded portion 40B can be easily determined.

[0050] In the guide wire 100 of this embodiment, the cross-section of the folded portion 40B is rectangular. With the guide wire 100 of this embodiment, the positions of the base portion 40A and the folded portion 40B can be easily determined.

[0051] In the guide wire 100 of this embodiment, the cross-section of the loop portion 40C is circular. With the guide wire 100 of this embodiment, the position of the base portion 40A and the position of the folded portion 40B can be easily determined.

[0052] In the guide wire 100 of this embodiment, the cross-sectional shape of the base portion 40A and the cross-sectional shape of the loop portion 40C are similar to each other. With the guide wire 100 of this embodiment, the positions of the base portion 40A and the folded portion 40B can be easily determined.

[0053] In the guide wire 100 of this embodiment, the base end of the base portion 40A is located at the base end of the main body portion 10. With the guide wire 100 of this embodiment, the position of the base portion 40A and the position of the folded portion 40B can be easily determined.

[0054] In the guide wire 100 of this embodiment, the width in the Y-axis direction at the tip of the base portion 40A is greater than the width in the Y-axis direction at the tip of the folded portion 40B. According to the guide wire 100 of this embodiment, since the width of the base portion 40A located at the base end of the main body portion 10 is greater than the width of the folded portion 40B, the torque transmission performance of the guide wire 100 is improved.

[0055] In the guide wire 100 of this embodiment, the main body 10 further includes a coil 50 that covers the base portion 40A and the folded portion 40B, and the base portion 40A and the folded portion 40B are joined to the coil 50. According to the guide wire 100 of this embodiment, the positions of the base portion 40A and the folded portion 40B can be easily determined.

[0056] In the guide wire 100 of this embodiment, the base end of the base portion 40A is located closer to the base end than the base end of the folded portion 40B. With the guide wire 100 of this embodiment, the positions of the base portion 40A and the folded portion 40B can be easily determined.

[0057] In this embodiment of the guide wire 100, since the cross-section of the base portion 40A located at the base end of the main body portion 10 is circular, the wire 40 is less likely to twist when the guide wire 100 rotates, and the torque transmission performance of the guide wire 100 is improved.

[0058] B. Second Embodiment: Figures 10 and 11 are schematic diagrams illustrating the configuration of the guide wire 100a in the second embodiment. Figure 10 shows the XY cross-section of the guide wire 100a at the same position as the XY cross-section of the guide wire 100 shown in Figure 4. Figure 11 shows the XZ cross-section of the guide wire 100a at the same position as the XZ cross-section of the guide wire 100 shown in Figure 5. In the following, for components of the guide wire 100a in the second embodiment that are the same as those of the guide wire 100 in the first embodiment, the same reference numerals are used, and their descriptions will be omitted as appropriate.

[0059] In the guide wire 100a of the second embodiment, the shape of the cross-section of the wire 40a differs from the shape of the cross-section of the wire 40 in the guide wire 100 of the first embodiment. More specifically, as shown in Figure 10, the surface of the base portion 40Aa facing the folded portion 40Ba is a curved surface. In this embodiment, the cross-section of the base portion 40Aa is circular. More specifically, the cross-section of the base portion 40Aa is a perfect circle, similar to the base portion 40A of the first embodiment. The cross-section of the base portion 40Aa may be a circle other than a perfect circle, such as an ellipse. The surface of the folded portion 40Ba facing the base portion 40Aa is a flat surface. In this embodiment, the outer edge of the cross-section of the folded portion 40Ba includes an arc-shaped portion AP and a straight portion SP. The straight portion SP is located on the outer edge of the folded portion 40Ba facing the base portion 40Aa. The arc-shaped portion AP is connected to both ends of the straight portion SP. In other words, in this embodiment, the cross-section of the folded portion 40Ba is a partial circle. More specifically, the cross-section of the folded portion 40Ba is a semicircle. The cross-section of the folded portion 40Ba may be a partial circle other than a semicircle, such as a segmented circle or a bow shape. In this specification, a partial circle is one of the shapes obtained by dividing a circle in two with a chord. A semicircle is one of the shapes obtained by dividing a circle in two with a chord passing through the center of the circle. A segmented circle is the larger of the two shapes obtained by dividing a circle in two with a chord that does not pass through the center of the circle. A bow shape is the smaller of the two shapes obtained by dividing a circle in two with a chord that does not pass through the center of the circle. The base portion 40Aa is an example of a first part. The folded portion 40Ba is an example of a second part.

[0060] As shown in Figure 11, the cross-section of the loop portion 40Ca is circular. More specifically, the cross-section of the loop portion 40Ca is perfectly circular. The cross-section of the loop portion 40Ca may be an ellipse or other circular shape. The loop portion 40Ca is an example of the third part.

[0061] As described above, in the guide wire 100a of this embodiment, the outer edge of the cross-section of the folded portion 40Ba includes an arc-shaped portion AP and a straight portion SP, and the straight portion SP faces the base portion 40Aa. With the guide wire 100a of this embodiment, for example, compared to a guide wire in which the cross-section of the folded portion is circular and the width of the folded portion in the first direction is equal to that of the folded portion 40Ba of the guide wire 100a, it is possible to increase the area of ​​the cross-section of the folded portion 40Ba. In other words, with the guide wire 100a of this embodiment, it is easy to increase the size of the folded portion 40Ba.

[0062] In the guide wire 100a of this embodiment, the cross-section of the folded portion 40Ba is partially circular. With the guide wire 100a of this embodiment, for example, compared to a guide wire in which the cross-section of the folded portion is circular and the width of the folded portion in the first direction is equal to that of the folded portion 40Ba of the guide wire 100a, it is possible to increase the area of ​​the cross-section of the folded portion 40Ba. In other words, with the guide wire 100a of this embodiment, it is easy to increase the size of the folded portion 40Ba.

[0063] C. Third Embodiment: Figures 12 and 13 are schematic diagrams illustrating the configuration of the guide wire 100b of the third embodiment. Figure 12 shows the XY cross-section of the guide wire 100b at the same position as the XY cross-section of the guide wire 100 shown in Figure 4. Figure 13 shows the XZ cross-section of the guide wire 100b at the same position as the XZ cross-section of the guide wire 100 shown in Figure 5. In the following, for the configuration of the guide wire 100b of the third embodiment, components that are the same as those of the guide wire 100 of the first embodiment will be denoted by the same reference numerals, and their descriptions will be omitted as appropriate.

[0064] In the guide wire 100b of the third embodiment, the shape of the cross-section of the wire 40b differs from the shape of the cross-section of the wire 40 in the guide wire 100 of the first embodiment. More specifically, as shown in Figure 12, the surface of the base portion 40Ab facing the folded portion 40Bb is a plane. In this embodiment, the cross-section of the base portion 40Ab is rectangular. More specifically, the cross-section of the base portion 40Ab is rectangular. The cross-section of the base portion 40Ab may be a rectangle other than a rectangle, such as a square, trapezoid, or parallelogram. The surface of the folded portion 40Bb facing the base portion 40Ab is a curved surface. In this embodiment, the cross-section of the folded portion 40Bb is circular. More specifically, the cross-section of the folded portion 40Bb is a perfect circle. The cross-section of the folded portion 40Bb may be a circle other than a perfect circle, such as an ellipse. The folded portion 40Bb is an example of the first part. The base section 40Ab is an example of the second part.

[0065] As shown in Figure 13, the cross-section of the loop portion 40Cb is rectangular. More specifically, the cross-section of the loop portion 40Cb is rectangular. The cross-section of the loop portion 40Cb may be a rectangle other than a rectangle, such as a square or trapezoid. The loop portion 40Cb is an example of the third part.

[0066] As described above, in the guide wire 100b of this embodiment, the cross-section of the loop portion 40Cb is rectangular. With the guide wire 100b of this embodiment, because the cross-section of the loop portion 40Cb is rectangular, the flexibility of the loop portion 40Cb is improved compared to a guide wire in which, for example, the cross-section of the loop portion is circular and the area of ​​the cross-section of the loop portion is the same as that of the guide wire 100b.

[0067] D. Fourth Embodiment: Figures 14 and 15 are schematic diagrams illustrating the configuration of the guide wire 100c in the fourth embodiment. Figure 14 shows the XY cross-section of the guide wire 100c at the same position as the XY cross-section of the guide wire 100 shown in Figure 4. Figure 15 shows the XZ cross-section of the guide wire 100c at the same position as the XZ cross-section of the guide wire 100 shown in Figure 5. In the following, for components of the guide wire 100c in the fourth embodiment that are the same as those of the guide wire 100 in the first embodiment, the same reference numerals are used, and their descriptions will be omitted as appropriate.

[0068] In the guide wire 100c of the fourth embodiment, the shape of the cross-section of the wire 40c differs from the shape of the cross-section of the wire 40 in the guide wire 100 of the first embodiment. More specifically, as shown in Figure 14, the surface of the base portion 40Ac facing the folded portion 40Bc is a curved surface. In this embodiment, the outer edge of the cross-section of the base portion 40Ac includes an arc-shaped portion APc and a straight portion SPc. The arc-shaped portion APc is located on the outer edge of the base portion 40Ac facing the folded portion 40Bc. The straight portion SPc is connected to both ends of the arc-shaped portion APc. That is, in this embodiment, the cross-section of the base portion 40Ac is a partial circle. More specifically, the cross-section of the base portion 40Ac is a semicircle. The cross-section of the base portion 40Ac may be a partial circle other than a semicircle, such as a segmented circle or an arc shape. The surface of the folded portion 40Bc facing the base portion 40Ac is a plane. In this embodiment, the cross-section of the folded portion 40Bc is rectangular. More specifically, the cross-section of the folded portion 40Bc is rectangular. The cross-section of the folded portion 40Bc may be a rectangle other than a rectangle, such as a square or trapezoid. The base portion 40Ac is an example of a first part. The folded portion 40Bc is an example of a second part.

[0069] As shown in Figure 15, the cross-section of the loop portion 40Cc is rectangular. More specifically, the cross-section of the loop portion 40Cc is rectangular. That is, the shape of the cross-section of the folded portion 40Bc and the shape of the cross-section of the loop portion 40Cc are similar to each other. The cross-section of the loop portion 40Cc may be a rectangle other than a rectangle, such as a square or trapezoid. The loop portion 40Cc is an example of the third part.

[0070] As described above, in the guide wire 100c of this embodiment, the outer edge of the cross-section of the base portion 40Ac includes an arc-shaped portion APc and a straight portion SPc, and the arc-shaped portion APc faces the folded portion 40Bc. With the guide wire 100c of this embodiment, the positions of the base portion 40Ac and the folded portion 40Bc can be easily determined.

[0071] In the guide wire 100c of this embodiment, the cross-section of the base portion 40Ac is partially circular. With the guide wire 100c of this embodiment, the position of the base portion 40Ac and the position of the folded portion 40Bc can be easily determined.

[0072] In the guide wire 100c of this embodiment, the cross-sectional shape of the folded portion 40Bc and the cross-sectional shape of the loop portion 40Cc are similar to each other. With the guide wire 100c of this embodiment, the positions of the base portion 40Ac and the folded portion 40Bc can be easily determined.

[0073] E. Fifth Embodiment: Figures 16 and 17 are schematic diagrams illustrating the configuration of the guide wire 100d in the fifth embodiment. Figure 16 shows the XY cross-section of the guide wire 100d at the same position as the XY cross-section of the guide wire 100 shown in Figure 4. Figure 17 shows the XZ cross-section of the guide wire 100d at the same position as the XZ cross-section of the guide wire 100 shown in Figure 5. In the following, for components of the guide wire 100d in the fifth embodiment that are the same as those of the guide wire 100 in the first embodiment, the same reference numerals are used, and their descriptions will be omitted as appropriate.

[0074] In the fifth embodiment of the guide wire 100d, the shape of the cross-section of the wire 40d differs from the shape of the cross-section of the wire 40 in the first embodiment of the guide wire 100. More specifically, as shown in Figure 16, the surface of the base portion 40Ad facing the folded portion 40Bd is a curved surface. In this embodiment, the cross-section of the base portion 40Ad is circular. More specifically, the cross-section of the base portion 40Ad is a perfect circle, similar to the base portion 40A in the first embodiment. The cross-section of the base portion 40Ad may be a circle other than a perfect circle, such as an ellipse. The surface of the folded portion 40Bd facing the base portion 40Ad is a flat surface. In this embodiment, the outer edge of the cross-section of the folded portion 40Bd includes an arc-shaped portion APd and a straight portion SPd. The straight portion SPd is located at the outer edge of the folded portion 40Bd facing the base portion 40Ad. The arc-shaped portion APd is connected to both ends of the straight portion SPd. In other words, in this embodiment, the cross-section of the folded portion 40Bd is a partial circle. More specifically, the cross-section of the folded portion 40Bd is a semicircle. The cross-section of the folded portion 40Bd may also be a partial circle other than a semicircle, such as a segmented circle or an arc shape. The base portion 40Ad is an example of a first portion. The folded portion 40Bd is an example of a second portion.

[0075] As shown in Figure 17, the cross-section of the loop portion 40Cd is rectangular. More specifically, the cross-section of the loop portion 40Cd is rectangular. That is, the cross-sectional shapes of the base portion 40Ad, the folded portion 40Bd, and the loop portion 40Cd are not similar to each other. The cross-section of the loop portion 40Cd may be a rectangle other than a rectangle, such as a square or trapezoid. The loop portion 40Cd is an example of the third part.

[0076] As described above, in the guide wire 100d of this embodiment, the cross-sectional shape of the base portion 40Ad, the cross-sectional shape of the folded portion 40Bd, and the cross-sectional shape of the loop portion 40Cd are not similar to each other. With the guide wire 100d of this embodiment, the positions of the base portion 40Ad and the folded portion 40Bd can be easily determined.

[0077] F. Variations: The technologies disclosed herein are not limited to the embodiments described above and can be modified in various forms without departing from their essence, for example, the following modifications are possible.

[0078] Figures 18 and 19 are schematic diagrams illustrating the configuration of a modified guide wire 100e. Figure 18 shows the XY cross-section of guide wire 100e at the same position as the XY cross-section of guide wire 100 shown in Figure 4. Figure 19 shows the XZ cross-section of guide wire 100e at the same position as the XZ cross-section of guide wire 100 shown in Figure 5. In the following, for components of the modified guide wire 100e that are the same as those of guide wire 100 in the first embodiment, the same reference numerals are used, and their descriptions will be omitted as appropriate.

[0079] In the modified guide wire 100e, the shape of the cross-section of the wire 40e differs from the shape of the cross-section of the wire 40 in the guide wire 100 of the first embodiment. Specifically, as shown in Figure 18, the cross-section of the base portion 40Ae is circular, similar to the base portion 40e of the first embodiment. The surface of the folded portion 40Be facing the base portion 40Ae is flat. In this modified example, the outer edge of the cross-section of the folded portion 40Be includes an arc-shaped portion APe and a straight portion SPe. The straight portion SPe is located on the outer edge of the folded portion 40Be facing the base portion 40Ae. The arc-shaped portion APe is connected to both ends of the straight portion SPe. That is, in this modified example, the cross-section of the folded portion 40Be is partially circular. More specifically, the cross-section of the folded portion 40Be is a segmented circle. The cross-section of the folded portion 40Be is a flattened segmented circle. As shown in Figure 19, the cross-section of the loop portion 40Ce includes an arc-shaped portion APe and a straight portion SPe. That is, in this modified example, the cross-section of the loop portion 40Ce is a partial circle. More specifically, the cross-section of the loop portion 40Ce is a segmented circle. The cross-section of the folded portion 40Be is a flattened segmented circle. As in this modified example, the cross-section of the second portion may also be a partial circle.

[0080] The configuration of the guide wire 100 in the above embodiment is merely an example and can be modified in various ways. For example, the guide wire does not necessarily have to have at least one of the first coating 31, the second coating 32, and the third coating 33.

[0081] The materials of each component in the above embodiment are merely examples and can be modified in various ways. The method for manufacturing the guide wire 100 in the above embodiment is merely an example and can be modified in various ways. The treatment method using the guide wire 100 in the above embodiment is merely an example and can be modified in various ways.

[0082] In the above embodiment, a guidewire 100 for treating lesions within blood vessels was used as an example. The techniques disclosed herein are similarly applicable to medical devices in general for treating lesions in biological tubular lumenes.

[0083] Each of the features described in each of the embodiments described above may be appropriately combined with other embodiments or modifications. Each of the features described in each of the modifications described above may be appropriately combined with embodiments or modifications. Each of the features described in each of the embodiments described above may be appropriately omitted. Each of the features described in each of the modifications described above may be appropriately omitted.

Claims

1. A medical device (100), A long main body (10) and A reading unit (20) is connected to the tip (16) of the main body (10) and enters the lesion (220), Equipped with, The main body (10) is A first part (40A) is a portion of the wire (40), The wire (40) includes a second portion (40B) which is a portion different from the first portion (40A) and has a portion that faces the first portion (40A) in a first direction that intersects the axial direction of the main body (10), The leading portion (20) is a part of the wire (40) that is different from the first portion (40A) and the second portion (40B), and includes a third portion (40C) located between the first portion (40A) and the second portion (40B) of the wire (40). The surface of the first part (40A) facing the second part (40B) is a curved surface. A medical device (100) in which the surface of the second part (40B) facing the first part (40A) is planar.

2. A medical device (100) according to claim 1, The cross-section of the first portion (40A) is circular, medical device (100).

3. A medical device (100c) according to claim 1, The outer edge of the cross-section of the first portion (40Ac) includes an arc-shaped portion (APc) and a straight portion (SPc), The curved portion (APc) is a medical device (100c) facing the second portion (40Bc).

4. A medical device (100c) according to claim 3, The cross-section of the first portion (40Ac) is partially circular, medical device (100c).

5. A medical device (100) according to any one of claims 1 to 4, The cross-section of the second part (40B) of the medical device (100) is rectangular.

6. A medical device (100a) according to any one of claims 1 to 4, The outer edge of the cross-section of the second portion (40Ba) includes an arc-shaped portion (AP) and a straight portion (SP), The linear portion (SP) is a medical device (100a) facing the first portion (40Aa).

7. A medical device (100a) according to claim 6, The cross-section of the second portion (40Ba) is partially circular, medical device (100a).

8. A medical device (100) according to any one of claims 1 to 7, The cross-section of the third portion (40C) is circular, medical device (100).

9. A medical device (100b) according to any one of claims 1 to 7, The cross-section of the third portion (40Cb) of the medical device (100b) is rectangular.

10. A medical device (100d) according to any one of claims 1 to 4, A medical device (100d) in which the cross-sectional shapes of the first part (40Ad), the second part (40Bd), and the third part (40Cd) are not similar to each other.

11. A medical device (100) according to any one of claims 1 to 4, A medical device (100) in which the cross-sectional shape of the first part (40A) and the cross-sectional shape of the third part (40C) are similar to each other.

12. A medical device (100c) according to any one of claims 1 to 4, A medical device (100c) in which the cross-sectional shape of the second part (40Bc) and the cross-sectional shape of the third part (40Cc) are similar to each other.

13. A medical device (100) according to any one of claims 1 to 12, The base end of the first portion (40A) is located at the base end of the main body portion (10) of the medical device (100).

14. A medical device (100) according to claim 13, A medical device (100) in which the width (w1) in the first direction at the tip of the first portion (40A) is greater than the width (w2) in the first direction at the tip of the second portion (40B).

15. A medical device (100) according to any one of claims 1 to 14, The main body (10) further includes a cylindrical body (50) that covers the first portion (40A) and the second portion (40B), The first part (40A) and the second part (40B) are a medical device (100) joined to the cylindrical body (50).

16. A medical device (100) according to any one of claims 1 to 15, A medical device (100) wherein the proximal end of the first portion (40A) is located proximal to the proximal end of the second portion (40B).

Images