Guide wire

Abstract

To shorten an operation time.SOLUTION: A guide wire includes: a flexible tube 11 extending in a front-back direction; an operation wire 12 extending in a front-back direction, which is provided inside the flexible tube 11; a fastened body 13 to which a front edge of the operation wire 12 is fastened; and a support body 14 provided behind the fastened body 13, which sandwiches the flexible tube 11 with the fastened body 13 in a front-back direction. The flexible tube 11 includes an outside coil spring 21, and an inside coil spring 22 inserted into the outside coil spring, which is wound reversely to the outside coil spring.SELECTED DRAWING: Figure 1

Description

Technical Field

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

Background Art

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like in the blood vessel, the microcatheter is left in the blood vessel, the guide wire that has been used so far is withdrawn, and then a guide wire with a higher tip load or the like than this guide wire is inserted again into the microcatheter and stabbed into the chronic total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the chronic total occlusion lesion portion or the like, the guide wire with a higher tip load or the like is withdrawn, the original guide wire with a lower tip load or the like is inserted again into the microcatheter, and after reaching the position penetrating the chronic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

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] With conventional guidewires, in order to penetrate chronic total occlusion lesions, it is necessary to insert and remove guidewires with different bending stiffness, such as tip load, into the blood vessel and use the appropriate one. Furthermore, in order to select the target blood vessel at a bifurcation before reaching the chronic total occlusion lesion, it is necessary to insert and remove the guidewire into the blood vessel and finely adjust the curvature (bending tendency called preshape) of the anterior end of the guidewire outside the body, thus reducing surgical time.

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

[0006] A guide wire according to one aspect of the present invention comprises a flexible tube extending in the front-rear direction, an operating wire extending in the front-rear direction and provided inside the flexible tube, a fixed body to which the front end edge of the operating wire is fixed, and a support provided behind the fixed body, which sandwiches the flexible tube in the front-rear direction between itself and the fixed body, wherein the flexible tube comprises an outer coil spring and an inner coil spring inserted into the outer coil spring and wound in the opposite direction to the outer coil spring.

[0007] When the manipulating wire is pulled backward, for example, if an eccentric load is applied to the flexible tube, or if the central axes of the flexible tube and the manipulating wire do not coincide, the flexible tube will compress and deform, bending in a specific direction. By manipulating the manipulating wire, the guide wire can be bent, allowing for the selection of a vessel at a vascular bifurcation and entry into the target vessel. This reduces reliance on the physician's sense of touch when guiding the guide wire along a vessel to chronic total occlusion lesions, and eliminates the need to insert and remove the guide wire from the vessel and fine-tune the curvature of the anterior end of the guide wire outside the body. Furthermore, the design that bends the flexible tube in a specific direction when the operating wire is pulled backward can be achieved, for example, by adjusting the eccentricity, direction of eccentricity, and inclination angle of the central axes of the flexible tube and the operating wire, or by adjusting the eccentricity, direction of eccentricity, etc. of the load generated on the flexible tube when a compressive load is applied. The latter adjustment can be achieved, for example, by adjusting the shape of the spring, such as the number of turns of the coil spring (relative circumferential position of both ends of the wire), the pitch angle of the coil spring, the pitch of the coil spring, the wire diameter (diameter of the wire), the gap between wires, the outer diameter of the coil, and the support configuration of both ends of the coil spring (for example, the inclination of both ends of the wire). Furthermore, by manipulating the control wire, such as by pulling it all the way backward, the fixed object moves backward, and the flexible tube undergoes compressive deformation in the anterior-posterior direction between itself and the support, thereby increasing the bending rigidity of the flexible tube. Therefore, by manipulating the control wire while the guide wire is inserted into the blood vessel, the bending rigidity of the flexible tube can be changed. This allows the flexible tube to maintain a low bending stiffness until the guidewire enters the blood vessel and reaches the chronic occluded lesion. When the guidewire penetrates the chronic occluded lesion, the bending stiffness of the flexible tube can be increased by pulling the operating wire backward. After penetration, the operating wire can be released, returning the flexible tube to its original low bending stiffness. Therefore, it eliminates the need to insert and remove guidewires with different bending stiffnesses into blood vessels to penetrate chronic occluded lesions. Therefore, the surgical time can be shortened.

[0008] Furthermore, since the flexible tube comprises an outer coil spring and an inner coil spring inserted within the outer coil spring and wound in the opposite direction to the outer coil spring, it is possible to increase the torsional rigidity in both directions along the central axis of the flexible tube and to make the difference in rigidity in the torsional direction equal. This makes it easier to transmit, for example, a torsional force applied to the support around its central axis to the fixed object via the flexible tube. It also prevents the flexible tube from twisting and rotating around its central axis when the operating wire is manipulated, thereby suppressing the fixed object from rotating around its central axis relative to the support. Furthermore, it prevents the flexible tube from deforming into unexpected shapes, such as twisting and bending simultaneously, when the operating wire is manipulated.

[0009] Multiple operating wires may be provided at intervals in the circumferential direction.

[0010] Since multiple operating wires are provided at intervals in the circumferential direction, the flexible tube can be bent precisely in the desired direction when the operating wires are manipulated.

[0011] The front ends of the outer coil spring and the inner coil spring may be fixed to the object to be fixed, and the rear ends of the outer coil spring and the inner coil spring may be fixed to the support.

[0012] Since the front ends of both the outer and inner coil springs are fixed to the object to be fixed, and the rear ends of both the outer and inner coil springs are fixed to the support, the aforementioned effects are stably achieved. [Effects of the Invention]

[0013] According to the above embodiment of the present invention, the surgical time can be shortened. [Brief explanation of the drawing]

[0014] [Figure 1] This is a longitudinal cross-sectional view of a guide wire according to one embodiment. [Figure 2] Figure 1 shows the state in which some of the operating wires are pulled backward, causing the flexible tube to be bent and deformed. [Figure 3] Figure 1 shows the state in which all of the control wires are pulled to the rear, increasing the bending rigidity of the flexible tube.

Best Mode for Carrying Out the Invention

[0015] Hereinafter, an embodiment of the guide wire will be described with reference to FIGS. 1 to 3. The guide wire 1 includes a flexible tube 11, an operating wire 12, a fixed body 13, and a support 14. The flexible tube 11, the operating wire 12, the fixed body 13, and the support 14 are formed of, for example, a metal material or the like. Note that the materials forming the flexible tube 11, the operating wire 12, the fixed body 13, and the support 14 may be changed as appropriate.

[0016] The flexible tube 11 includes an outer coil spring 21 and an inner coil spring 22. The outer coil spring 21 and the inner coil spring 22 are arranged coaxially with a common axis.

[0017] Hereinafter, this common axis is referred to as a central axis O, the side of the fixed body 13 along the central axis O is referred to as the front side, the side of the support 14 along the central axis O is referred to as the rear side, and the direction along the central axis O is referred to as the front-rear direction. When viewed from the front-rear direction, the direction intersecting the central axis O is referred to as the radial direction, and when viewed from the front-rear direction, the direction circulating around the central axis O is referred to as the circumferential direction.

[0018] The diameters of the wire rods forming the outer coil spring 21 and the inner coil spring 22 are the same over the entire length. The outer shapes and sizes of the outer coil spring 21 and the inner coil spring 22, respectively, when viewed from the front-rear direction are the same over the entire length in the front-rear direction. Note that the diameters of the wire rods forming the outer coil spring 21 and the inner coil spring 22 do not have to be the same over the entire length, and the outer shapes and sizes of the outer coil spring 21 and the inner coil spring 22, respectively, when viewed from the front-rear direction do not have to be the same over the entire length in the front-rear direction. For example, the outer diameters of the outer coil spring 21 and the inner coil spring 22 may decrease as they go forward.

[0019] The outer coil spring 21 has an outer diameter that allows for insertion into a blood vessel (for example, 0.2 mm or more and 1.0 mm or less). The inner coil spring 22 is inserted into the outer coil spring 21 and is wound in the opposite direction to the outer coil spring 21. The outer coil spring 21 and the inner coil spring 22 are sandwiched and supported in the front - rear direction by the fixed body 13 and the support body 14. The front - end portions of the outer coil spring 21 and the inner coil spring 22 are located at the same position in the front - rear direction. The rear - end portion of the outer coil spring 21 is located behind the rear - end portion of the inner coil spring 22. Note that the positional relationship in the front - rear direction of the front - end portions of the outer coil spring 21 and the inner coil spring 22, and the positional relationship in the front - rear direction of the rear - end portions of the outer coil spring 21 and the inner coil spring 22 are not limited to the illustrated example and may be changed as appropriate.

[0020] The bending rigidities of the outer coil spring 21 and the inner coil spring 22 are equal to each other at the same position in the front - rear direction. In each of the outer coil spring 21 and the inner coil spring 22, the bending rigidity of the rear - end portion is higher than the bending rigidity of the portion located in front of the rear - end portion. The spring constants in the front - rear direction of the outer coil spring 21 and the inner coil spring 22 are equal to each other. Note that the bending rigidities of the outer coil spring 21 and the inner coil spring 22 may be changed as appropriate, for example, to make them different from each other at the same position in the front - rear direction or to make them the same over the entire length in the front - rear direction. The spring constants in the front - rear direction of the outer coil spring 21 and the inner coil spring 22 may be made different from each other.

[0021] The operation wire 12 extends in the front - rear direction and is provided inside the flexible tube body 11. The operation wire 12 is formed to be elastically deformable. A plurality of operation wires 12 are provided at intervals in the circumferential direction. In the illustrated example, two operation wires 12 are provided, one on each side sandwiching the central axis O in the radial direction. Note that three or more operation wires 12 may be provided at intervals in the circumferential direction, or one operation wire 12 may be provided.

[0022] The front end of the operating wire 12 is fixed to the fixed body 13. The fixed body 13 is formed in a hemispherical shape having a spherical surface that protrudes forward and a flat rear surface that faces backward. The fixed body 13 is arranged coaxially with the central axis O. A cylindrical projection 13a that protrudes backward is formed on the rear surface of the fixed body 13. The projection 13a is arranged coaxially with the central axis O. The front end of the operating wire 12 is fixed to the rear end surface of the projection 13a, for example by brazing or crimping. The projection 13a is inserted into the front end of the inner coil spring 22. The front ends of the outer coil spring 21 and the inner coil spring 22 abut against the rear surface of the fixed body 13. The front ends of the outer coil spring 21 and the inner coil spring 22 are fixed to the fixed body 13, for example by brazing or soldering.

[0023] The external shapes and sizes of the fixed body 13 and the outer coil spring 21, as viewed from the front and rear directions, are the same. Furthermore, the external shapes and sizes of the fixed body 13 and the outer coil spring 21, as viewed from the front-rear direction, may be different from each other. In this case, it is preferable that the outer coil spring 21 does not protrude radially outward from the fixed body 13 when viewed from the front-rear direction.

[0024] The support 14 is located behind the fixed body 13 and sandwiches the flexible tube 11 between itself and the fixed body 13 in the front-rear direction. The rear ends of the outer coil spring 21 and the inner coil spring 22 are fixed to the support 14. The support 14 is formed in the shape of a rod extending in the front-rear direction. The support 14 is arranged coaxially with the central axis O. In the illustrated example, the support 14 has an insertion hole 14a through which the operating wire 12 is inserted so as to be movable in the front-rear direction. The insertion hole 14a is arranged coaxially with the central axis O. The operating wire 12 passes through the support 14 in the front-rear direction.

[0025] The support 14 is composed of a front section, a middle section, and a rear section, arranged in that order from front to rear. The front section of the support 14 has the smallest outer diameter, and the rear section has the largest outer diameter. The front section of the support 14 is fitted into the rear end of the inner coil spring 22. The rear end of the inner coil spring 22 is fixed to the outer circumferential surface of the front section of the support 14 by, for example, brazing or soldering. The middle section of the support 14 is fitted into the rear end of the outer coil spring 21. The rear end of the outer coil spring 21 is fixed to the outer circumferential surface of the middle section of the support 14 by, for example, brazing or soldering.

[0026] The rear portion of the support 14 and the outer coil spring 21, as viewed from the front-to-back direction, have the same external shape and size as viewed from the front-to-back direction. Furthermore, the external shapes and sizes of the rear portion of the support 14 and the outer coil spring 21, as viewed from the front-to-back direction, may be different from each other. In this case, it is preferable that, as viewed from the front-to-back direction, the outer coil spring 21 does not protrude radially outward from the outer circumferential surface of the rear portion of the support 14.

[0027] As described above, with the guide wire 1 according to this embodiment, when the operating wire 12 is pulled backward, for example, when an eccentric load is applied to the flexible tube 11, or when the central axes of the flexible tube 11 and the operating wire 12 do not coincide with each other, the flexible tube 11 will compress and deform, and bend in a specific direction. In the illustrated example, when a portion of the multiple manipulative wires 12 is pulled backward, as shown in Figure 2, the fixed body 13 moves backward while tilted relative to the anterior-posterior direction, causing the front end of the flexible tube 11 to bend toward the manipulative wire 12 that was pulled backward. By manipulating the manipulative wire 12, the guide wire 1 can be bent and selected at the vascular bifurcation, allowing it to enter the target vessel. This reduces reliance on the physician's sense of touch when guiding the guide wire 1 along the vessel to the chronic total occlusion lesion, and eliminates the need to insert and remove the guide wire from the vessel to fine-tune the curvature of the front end of the guide wire outside the body.

[0028] Furthermore, as shown in Figure 3, for example, if the manipulating wire 12 is pulled all the way backward, or if all of the manipulating wires 12 are pulled backward, the fixed body 13 moves backward, and the flexible tube 11 undergoes compressive deformation in the anterior-posterior direction between itself and the support 14, thereby increasing the bending rigidity of the flexible tube 11. Therefore, the bending rigidity of the flexible tube 11 can be changed by manipulating the manipulating wire 12 while the guidewire 1 is inserted into the blood vessel.

[0029] This allows the flexible tube 11 to maintain a low bending rigidity until the guidewire 1 penetrates a chronic total occlusion lesion. When the guidewire 1 is inserted into the chronic total occlusion lesion and penetrates it, the bending rigidity of the flexible tube 11 can be increased by pulling the manipulator wire 12 backward. After penetration, the manipulator wire 12 can be released, returning the bending rigidity of the flexible tube 11 to its original low state. Therefore, it is not necessary to insert and remove guidewires with different bending rigidities into blood vessels to penetrate chronic total occlusion lesions.

[0030] Therefore, the surgical time can be shortened.

[0031] Furthermore, since the flexible tube 11 is equipped with an outer coil spring 21 and an inner coil spring 22 inserted inside the outer coil spring 21 and wound in the opposite direction to the outer coil spring 21, the torsional rigidity in both directions along the central axis O of the flexible tube 11 can be increased, and the difference in rigidity in the torsional direction can be made equal. This makes it easier to transmit, for example, a torsional force applied to the support 14 around the central axis O to the fixed object 13 via the flexible tube 11. Furthermore, when the operating wire 12 is operated, the flexible tube 11 does not twist and deform around the central axis O, thereby suppressing the fixed object 13 from rotating around the central axis O relative to the support 14. Additionally, when the operating wire 12 is operated, it is possible to suppress the flexible tube 11 from deforming into unexpected shapes, such as twisting and bending simultaneously.

[0032] Since multiple operating wires 12 are provided at intervals in the circumferential direction, the flexible tube 11 can be bent precisely in the desired direction when the operating wires 12 are operated.

[0033] Since the front ends of the outer coil spring 21 and the inner coil spring 22 are fixed to the fixed body 13, and the rear ends of the outer coil spring 21 and the inner coil spring 22 are fixed to the support body 14, the aforementioned effects are stably achieved.

[0034] It should be noted that the technical scope of the present invention is not limited to the embodiments described above, and various modifications can be made without departing from the spirit of the invention.

[0035] For example, when all of the operating wires 12 are pulled backward, an eccentric load is generated on the flexible tube 11, causing the flexible tube 11 to compress and deform while being bent in a specific direction. This design can be achieved, for example, by adjusting the eccentricity and direction of the load generated on the flexible tube 11 to which a compressive load is applied. This adjustment can be achieved, for example, by adjusting the spring shape, such as the number of turns of the coil spring (relative circumferential position of both ends of the wire), the pitch angle of the coil spring, the pitch of the coil spring, the wire diameter (diameter of the wire), the gap between wires, the outer diameter of the coil, and the support configuration of both ends of the coil spring (for example, the inclination of both ends of the wire).

[0036] A single operating wire 12 is provided coaxially with the central axis O, and when this operating wire 12 is pulled backward, an eccentric load is generated on the flexible tube 11, thereby compressing and deforming the flexible tube 11 while bending it in a specific direction.

[0037] A single operating wire 12 may be provided, but one that does not align with the central axis O. In this case, the design that bends the flexible tube 11 in a specific direction when the operating wire 12 is pulled backward can be achieved, for example, by adjusting the eccentricity, eccentricity direction, and inclination angle of the central axes of the flexible tube 11 and the operating wire 12, respectively.

[0038] Furthermore, without departing from the spirit of the present invention, the components in the above embodiments may be replaced with well-known components as appropriate, and the above embodiments and modifications may be combined as appropriate. [Explanation of Symbols]

[0039] 1 Guidewire 11 Flexible tube body 12 Operating wires 13 Object to be fixed 14 Support 21 Outer coil spring 22. Inner coil spring

Claims

1. A flexible tube extending in the front-to-back direction, It extends in the front-rear direction and has an operating wire provided inside the flexible tube, The front end edge of the operating wire is fixed to the fixed body, The system includes a support provided behind the fixed object, which sandwiches the flexible tube between itself and the fixed object in the front-rear direction, The aforementioned flexible pipe body is Outer coil spring and, The system comprises an inner coil spring inserted into the outer coil spring and wound in the opposite direction to the outer coil spring, The rear ends of the outer coil spring and the inner coil spring are fixed to the support in a state where they are fitted onto it. A guide wire in which, in both the outer coil spring and the inner coil spring, the bending stiffness at the rear end is higher than the bending stiffness of the portion located forward of the rear end.

2. The guide wire according to claim 1, wherein the operating wires are provided in multiple locations spaced apart in the circumferential direction.

3. The guide wire according to claim 1 or 2, wherein the front ends of the outer coil spring and the inner coil spring are fixed to the fixed body.

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