Coronary artery catheter

Abstract

[Problem] To provide a coronary artery catheter that exhibits excellent operability even when selectively accessing the left coronary artery ostium and the right coronary artery ostium from the left brachial artery in patients having various blood streams. [Solution] A coronary artery catheter 1 comprising a foremost leading end part 260 that can be introduced into both the left coronary artery ostium B8i and the right coronary artery ostium B9i from the left brachial artery, wherein: the coronary artery catheter 1 has a tubular body 10 that connects the base end with the leading end; the tubular body has a body part 100 having a generally linear shape in a natural state, and a shaped part 200 that is bent and shaped at a plurality of positions on substantially the same plane P1; in the shaped part, a fourth axis A4 intersects a first axis A1, and the angle θa between the fourth axis and a third perpendicular line H3 is more acute than the angle θb between a third axis A3 and a second perpendicular line H2 and is in a range of 1-30°; a fourth bent part 240 is bent in a protruded shape in a direction away from the fourth axis at a location between a third bending point 230a and a fifth bending point 250a; and the second perpendicular line is located at a position at which ((longitudinal width in long axis direction of shaped part) – (distance between second perpendicular line and first perpendicular line)) / (distance between second perpendicular line and first perpendicular line) is in a range of 1 / 1 to 1 / 7.

Description

Coronary artery catheter

[0001] The present invention relates to a coronary artery catheter.

[0002] In the medical field, coronary artery catheters are known for use in coronary angiography and various treatments in the coronary arteries. Coronary artery catheters come in a variety of shapes and structures, such as the Judkins type and the Amplatz type.

[0003] Patent Document 1 below proposes a coronary artery catheter for right arm access that enables the catheter tip to be introduced and engaged from an artery located in the patient's right arm (e.g., the radial artery) to the left or right coronary artery ostium. In the procedure using the coronary artery catheter for right arm access of Patent Document 1, the coronary artery catheter for right arm access is introduced from an artery located in the patient's right arm, and after passing through the brachiocephalic artery and the aorta in sequence, the tip of the coronary artery catheter for right arm access is introduced into the left or right coronary artery ostium.

[0004] In the coronary artery catheter for right arm access described in Patent Document 1, the angle (bending angle) formed by the bending portion formed between the tip end and the straight portion located on the proximal side of the tip end is set to a predetermined value so as to prevent the engagement of the tip end of the coronary artery catheter for right arm access with the left coronary artery ostium and the right coronary artery ostium from being inadvertently released. Patent Document 1 also proposes left coronary artery catheter and right coronary artery catheter that have different outer shapes and bending angles to more reliably maintain the engagement during the procedure.

[0005] Japanese Patent Application Publication No. 11-206886

[0006] Surgeons sometimes introduce coronary artery catheters through the radial artery in the left arm to preserve the radial artery in the patient's right arm. Therefore, there is currently a need for a coronary artery catheter for left arm access that can be used with both the left and right coronary artery ostia to accommodate various vascular patterns. However, existing coronary artery catheters for left arm access that can be used with both the left and right coronary artery ostia can sometimes be difficult to operate depending on the patient's vascular pattern. In such cases, surgeons prepare catheters shaped for the left coronary artery and catheters shaped for the right coronary artery in the medical field and use them appropriately. Preparing multiple types of catheters for a procedure and using them appropriately depending on the procedure can lead to issues such as increased procedure costs and increased patient exposure.

[0007] To address the above-mentioned issues, one possible solution is to use an existing coronary artery catheter for right arm access that can be used with both the left and right coronary artery openings and is compatible with various blood vessels, and can be introduced through an artery in the left arm.

[0008] However, existing coronary artery catheters for right arm access are designed to be introduced from an artery in the right arm. Therefore, due to differences in the vascular course from the arteries in the right arm to the left and right coronary artery ostia and the vascular course from the arteries in the left arm to the left and right coronary artery ostia, when an existing coronary artery catheter for right arm access is introduced from an artery in the left arm, the operability of the coronary artery catheter is significantly impaired.

[0009] The present invention has been made to solve the above-mentioned problems, and has as its object to provide a coronary artery catheter that exhibits excellent operability even when selectively accessing the left coronary artery ostium and the right coronary artery ostium from an artery in the left arm in patients with various vascular routes.

[0010] The coronary artery catheter according to the present invention is a coronary artery catheter whose most distal end can be introduced into both the left coronary artery ostium and the right coronary artery ostium from an artery in the left arm, and has a tubular body that communicates from the proximal end to the distal end, and the tubular body has a main body portion that is approximately linear in its natural state, and a shaped portion that is shaped by being bent at a plurality of points on substantially the same plane, and the shaped portion has a first bent portion that is bent at a position distal to the main body portion, a first intermediate portion that is located distal to the first bent portion, a second bent portion that is bent at a position distal to the first intermediate portion to the opposite side to the first bent portion, and a third bent portion that is bent at a position distal to the second intermediate portion. a second intermediate portion located on the most distal side of the tubular body, a third bent portion bent at a position distal to the second intermediate portion toward the same side as the second bent portion, a third intermediate portion located distal to the third bent portion, a fourth bent portion bent at a position distal to the third intermediate portion toward the same side as the third bent portion, a fourth intermediate portion located distal to the fourth bent portion, a fifth bent portion bent at a position distal to the fourth intermediate portion toward the same side as the fourth bent portion, and the most distal portion located distal to the fifth bent portion, a second axis is an axis passing through a bend start point at the boundary between the first bend portion and the tip of the main body portion and where the inclination from the first axis toward the second bend portion begins, and a second bend point having the smallest radius of curvature in the second bend portion; a third axis is an axis passing through the second bend point and a third bend point having the smallest radius of curvature in the third bend portion; a fourth axis is an axis passing through the third bend point and a fifth bend point having the smallest radius of curvature in the fifth bend portion; a line perpendicular to the first axis and passing through the bend start point is a first perpendicular line; and a line perpendicular to the first axis and passing through the second bend point is a second perpendicular line. When a line that is perpendicular to the first axis and passes through the third bending point is defined as a third perpendicular line, the fourth axis intersects the first axis, the angle formed by the fourth axis and the third perpendicular line is more acute than the angle formed by the third axis and the second perpendicular line and is in a range of 1° to 30°, the fourth bending portion is bent convexly in a direction away from the fourth axis between the third bending point and the fifth bending point, and the second perpendicular line is located at a position where (longitudinal width of the shape portion in the major axis direction - distance between the second perpendicular line and the first perpendicular line) / (distance between the second perpendicular line and the first perpendicular line) is in a range of 1 / 1 to 1 / 7.It is characterized by:

[0011] The second bending point of the coronary artery catheter bends the shaped portion in a direction opposite to the direction in which the bending initiation point, located near the distal end of the main body, bends the shaped portion. Therefore, the second bending point does not overlap with the first axis and is located on one side of the first axis in the lateral width direction of the shaped portion. When the coronary artery catheter is introduced through an artery in the left arm and introduced and engaged into the left coronary artery ostium via the left subclavian artery, a predetermined distance can be maintained between the first axis and the second bending point, located on one side of the lateral width direction of the shaped portion. This prevents the tubular body from interfering with the vascular wall on the left side of the ascending aorta when the most distal portion of the coronary artery catheter is introduced into and engaged with the left coronary artery ostium. Therefore, the coronary artery catheter has excellent operability when introducing and engaging the most distal portion of the tubular body into the left coronary artery ostium.

[0012] Furthermore, in the above-mentioned coronary artery catheter, the second bending point is located on one side of the first axis in the lateral width direction of the shaped portion. Therefore, when the above-mentioned coronary artery catheter is rotated around the first axis, the center of rotation is located near the first axis, which is located closer to the central position in the lateral width direction of the shaped portion than the second bending point. Therefore, when the above-mentioned coronary artery catheter is rotated, the operating force applied at the proximal side can be efficiently transmitted to the shaped portion located on the distal side of the main body. This results in excellent operability when introducing and engaging the most distal portion into the left coronary artery ostium and the right coronary artery ostium.

[0013] Furthermore, the coronary artery catheter has a third bend point and a fourth bend point located between the second bend point and the fifth bend point. Therefore, the coronary artery catheter has a multi-stage bend (three-stage bend) structure in which three intermediate sections, namely, a second intermediate section, a third intermediate section, and a fourth intermediate section, are formed between the second bend point and the fifth bend point. When the coronary artery catheter is introduced through an artery in the left arm and introduced and engaged into the left coronary artery ostium via the left subclavian artery, the third bend point and the fourth bend point cause the shaped section to be bent so as to be separated from the left vascular wall of the ascending aorta. Therefore, the coronary artery catheter can effectively prevent the tubular body from contacting the left vascular wall of the ascending aorta when the most distal portion is introduced into and engaged with the left coronary artery ostium. Furthermore, in the above-mentioned coronary artery catheter, because the fourth bent portion is convexly curved in a direction away from the fourth axis between the third bend point and the fifth bend point, when the most distal portion is introduced into and engaged with the left coronary artery ostium, the third intermediate portion located proximal to the fourth bend point can be effectively prevented from contacting the vascular wall on the left side of the ascending aorta, while the fourth intermediate portion located distal to the fourth bend point can be positioned toward the left coronary artery ostium, with the fourth bend point as the base point. Therefore, the above-mentioned coronary artery catheter can easily introduce and engage the most distal portion located distal to the fourth intermediate portion with the fifth bend point interposed therebetween into and engaged with the left coronary artery ostium.

[0014] Furthermore, the third bending point of the above-mentioned coronary artery catheter bends the shaped section to the same side as the second bending point at a position distal to the second bending point. Like the second bending point, the third bending point does not overlap the first axis and is located on one side of the first axis in the lateral width direction of the shaped section. Furthermore, in the above-mentioned coronary artery catheter, the second intermediate section located between the second bending point and the third bending point is also located on one side of the first axis in the lateral width direction of the shaped section. Therefore, the above-mentioned coronary artery catheter can prevent the second intermediate section from contacting the blood vessel wall on the left side of the ascending aorta when the most distal section is introduced into and engaged with the left coronary artery ostium.

[0015] Furthermore, in the above-mentioned coronary artery catheter, the angle between the fourth axis and the third perpendicular is more acute than the angle between the third axis and the second perpendicular, and is in the range of 1° to 30°. In the above-mentioned coronary artery catheter, the angle between the third axis and the second perpendicular is larger than the angle between the fourth axis and the third perpendicular. Therefore, when the tubular body is introduced through an artery in the left arm and the most distal portion is introduced and engaged with the left coronary artery ostium via the left subclavian artery, the second intermediate portion located between the second bending point and the third bending point can be positioned so as to be spaced away from the left vascular wall of the ascending aorta. Therefore, the above-mentioned coronary artery catheter can effectively prevent the tubular body from contacting the left vascular wall of the ascending aorta when the most distal portion is introduced and engaged with the left coronary artery ostium. Furthermore, in the above-mentioned coronary artery catheter, the angle between the fourth axis and the third perpendicular is more acute than the angle between the third axis and the second perpendicular and is in the range of 1° to 30°, so that when the most distal portion is engaged with the left coronary artery ostium, the tubular body is prevented from coming into contact with the left vascular wall of the ascending aorta, and the most distal portion located distal to the fifth bending point can be positioned toward the left coronary artery ostium. Therefore, the above-mentioned coronary artery catheter can more reliably maintain the state in which the most distal portion is engaged with the left coronary artery ostium.

[0016] Furthermore, in the above-mentioned coronary artery catheter, the angle between the fourth axis and the third perpendicular is in the range of 1° to 30°, so when the tubular body is introduced through an artery in the left arm and the most-extremely distal portion is introduced into the ostium of the right coronary artery via the left subclavian artery, the most-extremely distal portion located distal to the fifth bending point can be prevented from expanding excessively in the lateral width direction of the shaped portion. Therefore, with the above-mentioned coronary artery catheter, even when a relatively narrow access route from the left subclavian artery to the ostium of the right coronary artery is selected, the most-extremely distal portion can be smoothly introduced into and engaged with the ostium of the right coronary artery.

[0017] Furthermore, in the above-described coronary artery catheter, the second perpendicular line is located at a position where (the longitudinal width of the shaped portion in the longitudinal direction—the distance between the second perpendicular line and the first perpendicular line) / (the distance between the second perpendicular line and the first perpendicular line) is in the range of 1 / 1 to 1 / 7. With this structure, the second bending point of the shaped portion is located at the midpoint of the longitudinal width of the shaped portion in the longitudinal direction or at a position distal to that midpoint. Therefore, when the shaped portion is disposed in the ascending aorta and the most distal portion is engaged with the ostium of the left coronary artery, the shaped portion can be suitably prevented from contacting the curved portion of the vascular wall on the left side of the ascending aorta. Therefore, when the shaped portion is disposed in the ascending aorta and the most distal portion is engaged with the ostium of the left coronary artery, the second bending portion, the third bending portion, and the fourth bending portion can be suitably prevented from contacting the vascular wall on the left side of the ascending aorta.

[0018] 1 is a front view of a coronary artery catheter according to an embodiment; FIG. 2 is a back view of a coronary artery catheter according to an embodiment; FIG. 3 is a left side view of a coronary artery catheter according to an embodiment; FIG. 4 is a right side view of a coronary artery catheter according to an embodiment; FIG. 5 is a plan view of a coronary artery catheter according to an embodiment; FIG. 6 is a bottom view of a coronary artery catheter according to an embodiment; FIG. 7 is an enlarged front view of a coronary artery catheter according to an embodiment; FIG. 8 is an enlarged front view of a coronary artery catheter according to an embodiment; FIG. 9 is an enlarged perspective view of a coronary artery catheter according to an embodiment; FIG. 10 is a schematic view of a use example of a coronary artery catheter according to an embodiment; FIG. 11 is a schematic view of a use example of a coronary artery catheter according to an embodiment; FIG. 12 is a front view of a coronary artery catheter according to a modified example; FIG. 13 is a back view of a coronary artery catheter according to a modified example; FIG. 14 is a left side view of a coronary artery catheter according to a modified example; FIG. 15 is a right side view of a coronary artery catheter according to a modified example; FIG. 16 is a plan view of a coronary artery catheter according to a modified example; FIG. 17 is a bottom view of a coronary artery catheter according to a modified example; FIG. 18 is an enlarged front view of a coronary artery catheter according to a modified example; FIG. 19 is an enlarged front view of a coronary artery catheter according to a modified example;

[0019] The following describes preferred embodiments of the coronary artery catheter according to the present invention. The following description does not limit the technical scope or the meaning of terms described in the claims.

[0020] In this specification, the range "X to Y" means "X or more and Y or less." Furthermore, in this specification, the range "greater than X and less than Y" does not include X and Y.

[0021] 1 to 6 are six views of a coronary artery catheter 1 according to this embodiment.

[0022] FIG. 1 is a front view of the coronary artery catheter 1. FIG. 2 is a rear view of the coronary artery catheter 1. FIG. 3 is a left side view of the coronary artery catheter 1. FIG. 4 is a right side view of the coronary artery catheter 1. FIG. 5 is a plan view of the coronary artery catheter 1. FIG. 6 is a bottom view of the coronary artery catheter 1. In FIGS. 1 to 6, the areas indicated by solid lines exemplify the design features of the tubular body 10 of the coronary artery catheter 1, and the areas indicated by dashed lines exemplify other parts.

[0023] Figures 7 to 10 are enlarged views of the coronary artery catheter 1. Figures 7, 8, and 9 are enlarged views of a portion of the front view shown in Figure 1. Figures 8 and 9 are enlarged at a larger scale than Figure 7. Although Figures 8 and 9 are essentially identical, they are attached to show an example of the dimensions of each view of the coronary artery catheter 1. Figure 10 is a schematic perspective view showing a portion of the distal end of the coronary artery catheter 1.

[0024] 1 to 10 indicate the longitudinal direction of the tubular body 10. The distal end side of the tubular body 10 (the side that is introduced into the living body) is the side indicated by arrow X1, and the proximal end side of the tubular body 10 is the side indicated by arrow X2. In addition, arrow Y1-Y2 in FIGS. 1 to 10 indicate the width direction of the tubular body 10.

[0025] 11 and 12 are diagrams for explaining the effects of the coronary artery catheter 1. Fig. 11 shows an example of application of the coronary artery catheter 1 to a procedure for introducing and engaging the left coronary artery ostium B8i. Fig. 12 shows an example of application of the coronary artery catheter 1 to a procedure for introducing and engaging the right coronary artery ostium B9i.

[0026] Figures 11 and 12 show a schematic representation of a part of a patient's body together with a coronary artery catheter 1. Symbol B1 indicates the left common carotid artery. Symbol B2 indicates the left subclavian artery. Symbol B3 indicates the right common carotid artery. Symbol B4 indicates the right subclavian artery. Symbol B5 indicates the brachiocephalic trunk. Symbol B6 indicates the ascending aorta. Symbol B7 indicates the descending aorta. Symbol B8 indicates the left coronary artery ostium. Symbol B8i indicates the left coronary artery ostium. Symbol B9 indicates the right coronary artery. Symbol B9i indicates the right coronary artery ostium. Symbol Aa indicates the aortic arch. Symbol Lv indicates the left ventricle. Symbol Bw1 indicates the vascular wall on the left side of the ascending aorta B6. Symbol Bw2 indicates the vascular wall on the right side of the ascending aorta B6. Symbol Bw3 indicates the vascular wall of the left subclavian artery B2.

[0027] 11 and 12 are merely illustrative and are not intended to be limiting. For example, the coronary artery catheter 1 can be applied to any patient having a Type I, Type II, or Type III aortic arch Aa, which are classified based on the relative positions of the left common carotid artery B1, the right subclavian artery B4, and the brachiocephalic artery B5.

[0028] <Coronary Artery Catheter 1> The coronary artery catheter 1 according to this embodiment is configured so that the most distal portion 260 can be selectively introduced into both the left coronary artery ostium B8i and the right coronary artery ostium B9i from an artery in the patient's left arm (e.g., the radial artery) (see FIGS. 11 and 12). A surgeon using the coronary artery catheter 1 can selectively introduce the most distal portion 260 into the left coronary artery ostium B8i and the right coronary artery ostium B9i, for example, via the radial artery, brachial artery, axillary artery, left subclavian artery B2, and ascending aorta B6 located in the patient's left arm.

[0029] As shown in FIGS. 1 to 6 and 10, the coronary artery catheter 1 has a tubular body 10 that communicates from the proximal end to the distal end, and a hub 300 located on the proximal end side of the tubular body 10.

[0030] 10, a lumen 20 is formed inside the tubular body 10. A distal end opening 261 communicating with the lumen 20 is formed at the most distal end 260 of the tubular body 10.

[0031] 1 and 2, the hub 300 is connected to the proximal end 110 of the main body 100. The hub 300 can be configured to function as an injection port for injecting a contrast agent or the like into the lumen 20 and as an insertion port for inserting a treatment device or the like into the lumen 20.

[0032] <Tubular body 10> As shown in Figures 1 to 10, the tubular body 10 has, in its natural state, a substantially linear main body portion 100 and shaped portions 200 that are bent and shaped at multiple locations on substantially the same plane (plane P1 shown in Figure 10).

[0033] The above-mentioned "natural state" means an unloaded state in which no external force is applied to the tubular body 10. Figures 1 to 10 show the tubular body 10 in its natural state.

[0034] The tubular body 10 can be constructed, for example, as a three-layer tubular member consisting of an inner layer, a middle layer, and an outer layer. The materials that can be used for each layer include polyamide resins (e.g., nylon 11, nylon 12, nylon 6), polyester-based polyamide resins, polyether-based polyamide resins, polyurethane, ABS resin, polyester elastomer resins, polyurethane elastomer resins, and fluorine-based resins (PFA, PTFE, ETFE, etc.). In particular, using ABS resin or polyamide resin as the materials for the inner, middle, and outer layers can impart appropriate strength to each part of the tubular body 10. Furthermore, using a fluorine-based resin, preferably PTFE, for the inner layer can improve the operability of a guidewire or a therapeutic catheter inserted into the lumen 20. The tubular body 10 can also contain radiopaque materials such as barium sulfate, bismuth oxide, and tungsten. Furthermore, various reinforcing members (braid wire, etc.) can be embedded in the tubular body 10 in order to improve the strength, etc., of the tubular body 10. Furthermore, a distal tip having higher flexibility than the tubular body 10 can be attached to the most distal end portion 260.

[0035] The tubular body 10 can be formed to have an outer diameter of, for example, 1.0 mm to 3.8 mm, and an inner diameter of, for example, 0.8 mm to 3.6 mm.

[0036] The materials and specific structure of the tubular body 10 are not limited to those exemplified above, and any structure of a coronary artery catheter known in the medical field can be adopted.

[0037] As shown in FIGS. 7 to 10 , the shaped portion 200 includes a first bent portion 210 that bends at a position closer to the tip than the main body portion 100, a first intermediate portion 215 that is located closer to the tip than the first bent portion 210, a second bent portion 220 that bends at a position closer to the tip than the first intermediate portion 215 in the opposite direction to the first bent portion 210, a second intermediate portion 225 that is located closer to the tip than the second bent portion 220, and a third intermediate portion 225 that bends at a position closer to the tip than the second intermediate portion 225 in the same direction as the second bent portion 220. The distal end portion 260 has a third bend portion 230, a third intermediate portion 235 located closer to the tip than the third bend portion 230, a fourth bend portion 240 that bends toward the same side as the third bend portion 230 at a position closer to the tip than the third intermediate portion 235, a fourth intermediate portion 245 located closer to the tip than the fourth bend portion 240, a fifth bend portion 250 that bends toward the same side as the fourth bend portion 240 at a position closer to the tip than the fourth intermediate portion 245, and a most distal end portion 260 that is positioned closer to the tip than the fifth bend portion 250.

[0038] The above phrase "bent to the opposite side (same side)" means that the bent portions are bent to the opposite side (same side) when viewed from the front of the tip end side in the front view shown in Figure 7. The second bent portion 220, the third bent portion 230, the fourth bent portion 240, and the fifth bent portion 250 are each bent in the same direction so that the shaped portion 200 has a shape that draws a clockwise arc. The first bent portion 210 is bent in the opposite direction to the bent portions 220, 230, 240, and 250.

[0039] In this embodiment, the positions and portions of the tubular body 10 are defined as follows (see FIGS. 7, 8, and 9).

[0040] An axis passing through the center line of the main body 100 is defined as a first axis A1.

[0041] The first bent portion 210 has a bend start point Sa located at the boundary between the main body 100 and the tip thereof and where the inclination from the first axis A1 toward the second bent portion 220 begins, and a first bend point 210a located closer to the second bent portion 220 than the bend start point Sa and at a position where the radius of curvature is smallest in the first bent portion 210. Note that the bend start point Sa is located at a position where the first axis A1 overlaps with the outer surface of the tubular body 10 in the plan views shown in Figures 7, 8, and 9.

[0042] An axis passing through the bending start point Sa of the first bent portion 210 and the second bent point 220a of the second bent portion 220, which has the smallest radius of curvature, is defined as a second axis A2.

[0043] An axis passing through the second bending point 220a and the third bending point 230a, which has the smallest radius of curvature in the third bending portion 230, is defined as a third axis A3.

[0044] An axis passing through the third bending point 230a and the fifth bending point 250a, which has the smallest radius of curvature in the fifth bending portion 250, is defined as a fourth axis A4.

[0045] An axis passing through the third bending point 230a and the fourth bending point 240a, which has the smallest radius of curvature in the fourth bending portion 240, is defined as a fifth axis A5.

[0046] An axis passing through the fourth bending point 240a and the fifth bending point 250a is defined as a sixth axis A6.

[0047] The seventh axis A7 is an axis that is located on the same plane as the fifth bending point 250a, the bending start point Sa, the first bending point 210a, the second bending point 220a, the third bending point 230a, the fourth bending point 240a, and the fifth bending point 250a, and that passes through the end of the most distal position 260a of the most distal portion 260 on the first axis A1 side.

[0048] A line that is perpendicular to the first axis A1 and passes through the bending start point Sa is defined as a first perpendicular line H1.

[0049] A line that is perpendicular to the first axis A1 and passes through the second bending point 220a is defined as a second perpendicular line H2.

[0050] A line that is perpendicular to the first axis A1 and passes through the third bending point 230a is defined as a third perpendicular line H3.

[0051] In the front views shown in FIGS. 7 to 9, the region located to the left of the first axis A1 of the shaped portion 200 (the side indicated by the arrow Y1) is defined as "one side in the width direction."

[0052] When the positions and portions of the shaped portion 200 are defined as described above, the coronary artery catheter 1 is positioned so that the fourth axis A4 intersects the first axis A1 (see FIG. 8). Furthermore, in the coronary artery catheter 1, the angle θa between the fourth axis A4 and the third perpendicular line H3 is more acute than the angle θb between the third axis A3 and the second perpendicular line H2, and is in the range of 1° to 30° (see FIG. 8). Furthermore, in the coronary artery catheter 1, the second perpendicular line H2 is positioned such that (the longitudinal width L1 of the shaped portion 200 in the major axis direction minus the distance L3 between the second perpendicular line H2 and the first perpendicular line H1 (hereinafter referred to as "distance L2") / (the distance L3 between the second perpendicular line H2 and the first perpendicular line H1 (hereinafter referred to as "distance L3")) is in the range of 1 / 1 to 1 / 7 (see FIG. 7). It is more preferable that the distance L2 / distance L3 be in the range of 1 / 1.5 to 1 / 4.

[0053] The angle θa is more preferably 5° to 25°. The coronary artery catheter 1 of this embodiment has an angle θa of 16°.

[0054] The angle θb is preferably 60° to 85°. The coronary artery catheter 1 of this embodiment has an angle θb of 75°. The magnitude of the angle θb is not particularly limited as long as the angle θa is more acute than the angle θb.

[0055] In the coronary artery catheter 1, the longitudinal width L1 of the shaped portion 200 in the longitudinal direction is preferably in the range of 70 mm to 160 mm (see FIG. 7). The longitudinal width L1 is more preferably 80 mm to 122 mm. The distance L2 is preferably 24 mm to 53 mm, provided that the ratio of distance L2 / distance L3 is in the range of 1 / 1 to 1 / 7. Furthermore, when the distance L2 is 24 mm to 53 mm, the distance L3 is preferably 45 mm to 98 mm. In the coronary artery catheter 1 of this embodiment, the longitudinal width L1 is 113 mm, the distance L2 is 36 mm, and the distance L3 is 77 mm.

[0056] The third bending point 230a and the fourth bending point 240a are located between the second bending point 220a and the fifth bending point 250a in the longitudinal direction of the tubular body 10. Therefore, the coronary artery catheter 1 has a multi-stage bent (three-stage bent) structure in which three intermediate portions, namely, the second intermediate portion 225, the third intermediate portion 235, and the fourth intermediate portion 245, are formed between the second bending point 220a and the fifth bending point 250a.

[0057] 7 is preferably 41 mm to 58 mm. In addition, in the coronary artery catheter 1, the ratio (W2 / W1) of the maximum width W2 from the first axis A1 on the second perpendicular line H2 to the second bent portion 220 to the width W1 of the shaped portion 200 is preferably 1 / 2 to 1 / 4.

[0058] The width W1 is more preferably 41 mm to 58 mm. The width W1 of the coronary artery catheter 1 of this embodiment is 49 mm. The width W1 refers to the maximum width of the shaped portion 200 in the front view shown in FIG. 7. In this embodiment, the width W1 is the distance of a straight line connecting the end of the second bent portion 220 opposite to the first axis A1, which is located on the second perpendicular line H2, and the position of the end of the most distal position 260a of the most distal portion 260 opposite to the first axis A1, projected onto the second perpendicular line H2.

[0059] When the width W1 is 41 mm to 58 mm, the maximum width W2 is preferably 12 mm to 26 mm, assuming that the ratio (W2 / W1) is 1 / 2 to 1 / 4. The maximum width W2 of the coronary artery catheter 1 of this embodiment is 22 mm.

[0060] As shown in FIG. 9, in the coronary artery catheter 1, the angle formed between the first axis A1 and the second axis A2 is defined as a first angle θ1.

[0061] In addition, in the coronary artery catheter 1, the angle formed by the second axis A2 and the third axis A3 is defined as a second angle θ2.

[0062] In addition, in the coronary artery catheter 1, the angle formed by the third axis A3 and the fifth axis A5 is defined as a third angle θ3.

[0063] In addition, in the coronary artery catheter 1, the angle formed by the fifth axis A5 and the sixth axis A6 is defined as a fourth angle θ4.

[0064] In addition, in the coronary artery catheter 1, the angle formed between the sixth axis A6 and the seventh axis A7 is defined as a fifth angle θ5.

[0065] The coronary artery catheter 1 can be configured so that the fifth angle θ5 is smaller than the fourth angle θ4, the fourth angle θ4 is smaller than the third angle θ3, the third angle θ3 is smaller than the second angle θ2, and the second angle θ2 is smaller than the first angle θ1. Furthermore, when the magnitude relationships among the first angle θ1, the second angle θ2, the third angle θ3, the fourth angle θ4, and the fifth angle θ5 are defined as above, the coronary artery catheter 1 can be configured so that the linear distance L4 between the third bending point 230a and the fifth bending point 250a along the fourth axis A4 shown in Figure 8 is equal to or greater than 1 time and less than 2 times the linear distance L5 between the second bending point 220a and the third bending point 230a along the third axis A3.

[0066] The first angle θ1 is preferably greater than 155° and less than 175°. The first angle θ1 is more preferably equal to or greater than 160° and less than 173°. The coronary artery catheter 1 of this embodiment has a first angle θ1 of 167°.

[0067] When the first angle θ1 is 175° or greater, the second intermediate section 225 of the coronary artery catheter 1 is likely to come into contact with the left vascular wall Bw1 of the ascending aorta B6 when the most-distal section 260 is introduced into and engaged with the left coronary artery ostium B8i. On the other hand, when the first angle θ1 is 155° or less, the first bending section 210 bends too sharply, making it difficult to bring the most-distal section 260 into the left coronary artery ostium B8i.

[0068] The second angle θ2 is preferably greater than 130° and less than 170°. The second angle θ2 is more preferably equal to or greater than 140° and less than 160°. The coronary artery catheter 1 of this embodiment has a second angle θ2 of 153°.

[0069] In the coronary artery catheter 1, when the second angle θ2 is 170° or greater, the third angle θ3 formed by the third bent portion 230, which is located distally of the second bent portion 220, becomes acute, and the degree of bending at the third bent portion 230 becomes too large. Therefore, when the most-distal portion 260 of the coronary artery catheter 1 engages with the right coronary artery orifice B9i, the range over which the most-distal portion 260 engages with the right coronary artery orifice B9i becomes narrower, making it more likely for the most-distal portion 260 to slip out of the right coronary artery orifice B9i. Furthermore, when the second angle θ2 is 130° or less, the second intermediate portion 225 of the coronary artery catheter 1 is more likely to come into contact with the left vascular wall Bw1 of the ascending aorta B6 when the most-distal portion 260 engages with the left coronary artery orifice B8i. As a result, the range in which the most distal portion 260 of the coronary artery catheter 1 engages with the left coronary artery orifice B8i is narrowed, making it easier for the most distal portion 260 to come out of the left coronary artery orifice B8i.

[0070] The third angle θ3 is preferably greater than 120° and less than 165°. The third angle θ3 is more preferably equal to or greater than 130° and less than 155°. The coronary artery catheter 1 of this embodiment has a third angle θ3 of 143°.

[0071] When the third angle θ3 is 165° or greater, the third intermediate section 235 of the coronary artery catheter 1 is positioned so as to be significantly separated from the left vascular wall Bw1 of the ascending aorta B6 when the most-distal section 260 is introduced into the right coronary artery ostium B9i. Therefore, when the third angle θ3 is 165° or greater, it becomes difficult to introduce the most-distal section 260 into the left coronary artery ostium B8i. Furthermore, when the third angle θ3 is 120° or less, the angle of the third bent section 230 becomes too small. Therefore, when the most-distal section 260 of the coronary artery catheter 1 is engaged with the right coronary artery ostium B9i, the range over which the most-distal section 260 engages with the right coronary artery ostium B9i becomes narrow, making it easier for the most-distal section 260 to slip out of the right coronary artery ostium B9i.

[0072] The fourth angle θ4 is preferably greater than 70° and less than 160°. Furthermore, the fourth angle θ4 is more preferably equal to or greater than 80° and less than 150°. In the coronary artery catheter 1 of this embodiment, the fourth angle θ4 is 140°.

[0073] When the fourth angle θ4 is 70° or less, the fourth intermediate portion 245, the fifth bent portion 250, and the most-distal portion 260, which are located distally of the fourth bent portion 240, move closer to the first axis A1, and therefore, when the most-distal portion 260 is introduced into the left coronary artery orifice B8i, the most-distal portion 260 approaches a shape that moves parallel to the opening direction of the left coronary artery orifice B8i, making insertion difficult. Therefore, when the most-distal portion 260 is introduced into the left coronary artery orifice B8i, the range over which the most-distal portion 260 engages with the left coronary artery orifice B8i is narrowed, making it easier for the most-distal portion 260 to slip out of the left coronary artery orifice B8i. Furthermore, when the fourth angle θ4 is 160° or greater, the fourth intermediate portion 245, which is located distal to the fourth bent portion 240, is positioned so as to run parallel to the left vascular wall Bw1 of the ascending aorta B6 when the most-distal portion 260 engages with the left coronary artery ostium B8i, making it difficult to move the most-distal portion 260 closer to the left coronary artery ostium B8i and to position the most-distal portion 260 toward the left coronary artery ostium B8i. As a result, the most-distal portion 260 of the coronary artery catheter 1 cannot be smoothly introduced into the left coronary artery ostium B8i.

[0074] The fifth angle θ5 is preferably greater than 50° and less than 130°. The fifth angle θ5 is more preferably equal to or greater than 60° and less than 120°. The coronary artery catheter 1 of this embodiment has a fifth angle θ5 of 110°.

[0075] When the fifth angle θ5 is 130° or greater, the most-distal portion 260 of the coronary artery catheter 1 is positioned away from the left coronary artery ostium B8i when the most-distal portion 260 is introduced into the left coronary artery ostium B8i. Therefore, when the fifth angle θ5 is 130° or greater, it becomes difficult to introduce the most-distal portion 260 into the left coronary artery ostium B8i. Furthermore, when the fifth angle θ5 is 50° or less, the angle of the fifth bent portion 250 of the coronary artery catheter 1 becomes too small. Therefore, when the most-distal portion 260 of the coronary artery catheter 1 is engaged with the right coronary artery ostium B9i, the range over which the most-distal portion 260 engages with the right coronary artery ostium B9i becomes narrow, making it easier for the most-distal portion 260 to slip out of the right coronary artery ostium B9i.

[0076] 8 is preferably 20 mm to 50 mm, provided that it is equal to or greater than 1 time and less than 2 times the linear distance L5. The linear distance L4 of the coronary artery catheter 1 of this embodiment is 38 mm.

[0077] 8 is preferably 11 mm to 35 mm. In the coronary artery catheter 1 of this embodiment, the linear distance L5 is 23 mm.

[0078] 7 and 8 , the most distal portion 260 can be disposed so as to be located closer to the fifth bent portion 250 than the third perpendicular line H3 in the long axis direction of the shaped portion 200. In other words, the most distal portion 260 can be disposed closer to the tip side in the long axis direction than the third perpendicular line H3.

[0079] 7 and 8 , the first intermediate portion 215 is curved away from the first axis A1 (the side indicated by the arrow Y1). The second intermediate portion 225 is curved closer to the first axis A1 (the side indicated by the arrow Y2). The second intermediate portion 225 may extend substantially linearly between the second bent portion 220 and the third bent portion 230.

[0080] As shown in FIGS. 8 and 9 , the third intermediate portion 235 is curved toward the fourth bent portion 240, which is located closer to the distal end than the third bent portion 230. The fourth intermediate portion 245 is curved toward the fifth bent portion 250, which is located closer to the distal end than the fourth bent portion 240. The most distal portion 260 is curved so as to be folded back toward the proximal end at the fifth bent point 250 a. The third intermediate portion 235 may extend substantially linearly between the third bent portion 230 and the fourth bent portion 240. The fourth intermediate portion 245 may also extend substantially linearly between the fourth bent portion 240 and the fifth bent portion 250. The most distal portion 260 may also extend substantially linearly between the fifth bent portion 250 and the most distal position 260 a of the most distal portion 260.

[0081] 8 and 9, the first intermediate portion 215 intersects with the second axis A2, which is a line connecting the bending start point Sa and the second bending point 220a. Furthermore, a part of the first intermediate portion 215 on the bending start point Sa side is located closer to the first axis A1 than the second axis A2.

[0082] 8 and 9 , the first bending point 210 a of the first bending portion 210 is located between the first axis A1 and the second axis A2. Therefore, the shaped portion 200 is configured such that the first bending portion 210 and a portion of the first intermediate portion 215 are located between the first axis A1 and the second axis A2 in the region between the bending start point Sa and the second bending point 220 a. Therefore, in the coronary artery catheter 1, as shown in FIG. 11 , when the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2 and the most distal portion 260 is introduced into the left coronary artery ostium B8i, the shaped portion 200 can be oriented toward the ascending aorta B6. In the coronary artery catheter 1, with the shaped portion 200 oriented toward the ascending aorta B6 as described above, the second bent portion 220, the third bent portion 230, and the fourth bent portion 240 can be positioned so that a predetermined distance is maintained between the second bent portion 220, the third bent portion 230, and the fourth bent portion 240 and the vascular walls Bw1, Bw2 of the ascending aorta B6. Therefore, when the distal end portion 260 is introduced into the left coronary artery ostium B8i, the coronary artery catheter 1 can prevent the second bent portion 220, the third bent portion 230, and the fourth bent portion 240 from coming into contact with the ascending aorta B6, thereby preventing a decrease in operability.

[0083] Next, the function and effect of the coronary artery catheter 1 will be described with reference to FIGS.

[0084] Fig. 11 shows the state when the most distal portion 260 of the coronary artery catheter 1 is introduced into and engaged with the left coronary artery opening B8i. Fig. 12 shows the state when the most distal portion 260 of the coronary artery catheter 1 is introduced into and engaged with the right coronary artery opening B9i.

[0085] The second bending point 220a of the coronary artery catheter 1 bends the shaped portion 200 in a direction opposite to the direction in which the bending start point Sa, located near the distal end of the main body 100, bends the shaped portion 200 (see FIGS. 7 and 8 ). Therefore, the second bending point 220a does not overlap with the first axis A1 and is located on one side of the first axis A1 in the lateral width direction of the shaped portion 200 (to the left of the first axis A1 in FIGS. 7 , 8 , and 9 ). As shown in FIG. 11 , when the coronary artery catheter 1 is introduced through an artery in the left arm and introduced and engaged into the left coronary artery ostium B8i via the left subclavian artery B2, a predetermined distance can be maintained between the first axis A1 and the second bending point 220a located on one side of the lateral width direction of the shaped portion 200. This prevents the tubular body 10 from coming into contact with the blood vessel walls Bw1, Bw2 of the ascending aorta B6 when the most-distal portion 260 of the coronary artery catheter 1 is introduced into and engaged with the left coronary artery ostium B8i, thereby providing the coronary artery catheter 1 with excellent operability when the most-distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i.

[0086] Furthermore, in the coronary artery catheter 1, the second bending point 220a is located on one side of the first axis A1 in the lateral width direction of the shaped portion 200 (see FIGS. 7 and 8 ). Therefore, when the coronary artery catheter 1 is rotated around the first axis A1, the center of rotation is located near the first axis A1, which is located closer to the central position in the lateral width direction of the shaped portion 200 than the second bending point 220a. Therefore, when the coronary artery catheter 1 is rotated, the operating force applied at the proximal side can be efficiently transmitted to the shaped portion 200 located at the distal end of the main body 100. This provides the coronary artery catheter 1 with excellent operability when introducing and engaging the most distal portion 260 into the left coronary artery orifice B8i and the right coronary artery orifice B9i.

[0087] Furthermore, the coronary artery catheter 1 has a third bending point 230a and a fourth bending point 240a located between the second bending point 220a and the fifth bending point 250a (see FIGS. 7 and 8 ). Therefore, the coronary artery catheter 1 has a multi-stage bending (three-stage bending) structure in which three intermediate sections, namely, the second intermediate section 225, the third intermediate section 235, and the fourth intermediate section 245, are formed between the second bending point 220a and the fifth bending point 250a. Therefore, as shown in FIG. 11 , when the coronary artery catheter 1 is introduced from an artery in the left arm and introduced and engaged into the left coronary artery ostium B8i via the left subclavian artery B2, the shaped section 200 is positioned in a bent state by the third bending point 230a and the fourth bending point 240a so as to be separated from the left vascular wall Bw1 of the ascending aorta B6. Therefore, the coronary artery catheter 1 can effectively prevent the tubular body 10 from coming into contact with the blood vessel wall Bw1 on the left side of the ascending aorta B6 when the most-distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i. Furthermore, in the coronary artery catheter 1, the fourth bending portion 240 is convexly curved in a direction away from the fourth axis A4 between the third bending point 230a and the fifth bending point 250a. Therefore, when the most-distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i, the third intermediate portion 235 located proximal to the fourth bending point 240a can be effectively prevented from coming into contact with the blood vessel wall Bw1 on the left side of the ascending aorta B6, and the fourth intermediate portion 245 located distal to the fourth bending point 240a can be positioned toward the left coronary artery ostium B8i. Therefore, the coronary artery catheter 1 can easily introduce and engage the most distal portion 260, which is located more distal than the fourth intermediate portion 245, with the fifth bending point 250a in between, into the left coronary artery opening B8i.

[0088] Furthermore, the third bending point 230a of the coronary artery catheter 1 bends the shaped portion 200 to the same side as the second bending point 220a at a position distal to the second bending point 220a. Like the second bending point 220a, the third bending point 230a does not overlap the first axis A1 and is located on one side of the first axis A1 in the lateral width direction of the shaped portion 200. Furthermore, in the coronary artery catheter 1, the second intermediate portion 225 located between the second bending point 220a and the third bending point 230a is also located on one side of the first axis A1 in the lateral width direction of the shaped portion 200. Therefore, as shown in FIG. 11 , the coronary artery catheter 1 can prevent the second intermediate portion 225 from coming into contact with the left vascular wall Bw1 of the ascending aorta B6 when the most distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i.

[0089] Furthermore, in the coronary artery catheter 1, the angle θa formed by the fourth axis A4 and the third perpendicular line H3 is more acute than the angle θb formed by the third axis A3 and the second perpendicular line H2 and is in the range of 1° to 30° (see FIG. 8 ). Because the angle θa formed by the third axis A3 and the second perpendicular line H2 is larger than the angle θb formed by the fourth axis A4 and the third perpendicular line H3, the coronary artery catheter 1 can be positioned so that the second intermediate section 225 located between the second bending point 220a and the third bending point 230a is spaced apart from the left vascular wall Bw1 of the ascending aorta B6 when introduced from an artery in the left arm and introduced into the left coronary artery ostium B8i via the left subclavian artery B2, as shown in FIG. Therefore, the coronary artery catheter 1 can effectively prevent the tubular body 10 from coming into contact with the left vascular wall Bw1 of the ascending aorta B6 when the most-distal portion 260 is introduced into the left coronary artery ostium B8i. Furthermore, in the coronary artery catheter 1, the angle θa between the fourth axis A4 and the third perpendicular H3 is more acute than the angle θb between the third axis A3 and the second perpendicular H2 and is in the range of 1° to 30°. Therefore, as shown in FIG. 11 , when the most-distal portion 260 is engaged with the left coronary artery ostium B8i, the most-distal portion 260 located distal to the fifth bending point 250a can be positioned toward the left coronary artery ostium B8i while preventing the tubular body 10 from coming into contact with the left vascular wall Bw1 of the ascending aorta B6. Therefore, the coronary artery catheter 1 can more reliably maintain the state in which the most-distal portion 260 is engaged with the left coronary artery ostium B8i.

[0090] Furthermore, because the angle θa between the fourth axis A4 and the third perpendicular line H3 of the coronary artery catheter 1 is in the range of 1° to 30°, when the coronary artery catheter 1 is introduced through an artery in the left arm and the most-distal portion 260 is introduced into the right coronary artery ostium B9i via the left subclavian artery B2, the most-distal portion 260 located distal to the fifth bending point 250a is prevented from excessively expanding in the lateral width direction of the shaped portion 200. In other words, the lateral width W' formed during the approach to the right coronary artery ostium B9i shown in FIG. 12 can be kept within a predetermined range. Therefore, even when a relatively narrow access route from the left subclavian artery B2 to the right coronary artery ostium B9i is selected, the coronary artery catheter 1 allows the most-distal portion 260 to be smoothly introduced into and engaged with the right coronary artery ostium B9i.

[0091] Furthermore, in the coronary artery catheter 1, the second perpendicular line H2 is located at a position where the ratio of the distance L2 to the distance L3 is in the range of 1 / 1 to 1 / 7 (see FIG. 7 ). With this structure, the second bending point 220a of the shaped portion 200 is located at the midpoint of the longitudinal width of the shaped portion 200 in the longitudinal direction, or at a position distal to the midpoint. This effectively prevents the shaped portion 200 from contacting the curved portion of the left vascular wall Bw1 of the ascending aorta B6 when the shaped portion 200 is positioned in the ascending aorta B6 and the most distal portion 260 is engaged with the left coronary artery ostium B8i. Therefore, the coronary artery catheter 1 effectively prevents the second bending portion 220, the third bending portion 230, and the fourth bending portion 240 from contacting the left vascular wall Bw1 of the ascending aorta B6 when the shaped portion 200 is positioned in the ascending aorta B6 and the most distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i.

[0092] As described above, the coronary artery catheter 1 according to this embodiment is configured as a coronary artery catheter whose most distal portion 260 can be introduced into both the left coronary artery orifice B8i and the right coronary artery orifice B9i from an artery in the left arm. The coronary artery catheter 1 has a tubular body 10 that communicates from the base end to the tip. The tubular body 10 has a main body portion 100 that is substantially linear in its natural state and shaped portions 200 that are bent at multiple locations on substantially the same plane P1. The shaped portion 200 includes a first bent portion 210 that bends at a position closer to the tip than the main body portion 100, a first intermediate portion 215 that is located closer to the tip than the first bent portion 210, a second bent portion 220 that bends at a position closer to the tip than the first intermediate portion 215 in the opposite direction to the first bent portion 210, a second intermediate portion 225 that is located closer to the tip than the second bent portion 220, and a third bent portion 230 that bends at a position closer to the tip than the second intermediate portion 225 in the same direction as the second bent portion 220. a third intermediate portion 235 located closer to the tip than the third bend portion 230; a fourth bend portion 240 that bends toward the same side as the third bend portion 230 at a position closer to the tip than the third intermediate portion 235; a fourth intermediate portion 245 located closer to the tip than the fourth bend portion 240; a fifth bend portion 250 that bends toward the same side as the fourth bend portion 240 at a position closer to the tip than the fourth intermediate portion 245; and a most distal portion 260 that is positioned closer to the tip than the fifth bend portion 250.In the tubular body 10, an axis passing through the center line of the main body portion 100 is defined as a first axis A1, an axis passing through a bending start point Sa, which is located at the boundary between the first bent portion 210 and the tip of the main body portion 100 and where the inclination from the first axis A1 toward the second bent portion 220 begins, and a second bent point 220a, which has the smallest radius of curvature, in the second bent portion 220 is defined as a second axis A2, an axis passing through the second bent point 220a and a third bent point 230a, which has the smallest radius of curvature, in the third bent portion 230 is defined as a third axis A3, and an axis passing through the third bent point 230a and a fifth bent point 250a, which has the smallest radius of curvature, in the fifth bent portion 250 is defined as a fourth axis A4. If a line passing through starting point Sa is defined as a first perpendicular line H1, a line perpendicular to first axis A1 and passing through second bending point 220a is defined as a second perpendicular line H2, and a line perpendicular to first axis A1 and passing through third bending point 230a is defined as a third perpendicular line H3, then fourth axis A4 intersects first axis A1, angle θa formed between fourth axis A4 and third perpendicular line H3 is more acute than angle θb formed between third axis A3 and second perpendicular line H2 and is in the range of 1° to 30°, fourth bend portion 240 is bent convexly in a direction away from fourth axis A4 between third bending point 230a and fifth bending point 250a, and second perpendicular line H2 is located at a position where distance L2 / distance L3 is in the range of 1 / 1 to 1 / 7.

[0093] The coronary artery catheter 1 configured as described above has excellent operability in a procedure in which the catheter is introduced through an artery in the left arm and the most distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i and the right coronary artery ostium B9i via the left subclavian artery B2 and the ascending aorta B6. Here, "excellent operability" means that the most distal portion 260 can be smoothly introduced into and engaged with the left coronary artery ostium B8i and the right coronary artery ostium B9i by a simple operation such as pushing and pulling the tubular body 10, and that torque transmission to the most distal portion 260 is high when the surgeon rotates the hub 300 and the proximal end portion 110 of the tubular body 10. "High torque transmission to the most distal portion 260" means that the following effects are achieved. For example, after engaging the most distal portion 260 of the tubular body 10 with the left coronary artery ostium B8i and performing angiography by injecting a contrast medium from the most distal portion 260, the surgeon may then engage the most distal portion 260 of the tubular body 10 with the other right coronary artery ostium B9i and perform angiography by injecting a contrast medium from the most distal portion 260. In such a case, in order to move the most distal portion 260 from the left coronary artery ostium B8i to the right coronary artery ostium B9i, the surgeon grasps the hub 300 and rotates the proximal end portion 110 of the main body portion 100 with the shaping portion 200 positioned in the ascending aorta B6 and the descending aorta B7, thereby rotating the shaping portion 200 and moving the most distal portion 260. In this case, when the shaped portion 200 of the coronary artery catheter 1 configured as described above is rotated, there is little contact (friction) between the shaped portion 200 and the left vascular wall Bw1 of the ascending aorta B6 and the right vascular wall Bw2 of the ascending aorta B6, and the rotation of the hub 300 can be efficiently transmitted to the most distal portion 260. The coronary artery catheter 1 has excellent operability, which shortens the procedure time and reduces the patient's exposure and stress. For example, when an existing coronary artery catheter (hereinafter referred to as a "dual-purpose catheter") configured to be introduced into the left coronary artery ostium B8i and the right coronary artery ostium B9i via access from the right arm is introduced through an artery in the left arm and engaged with the left coronary artery ostium B8i and the right coronary artery ostium B9i, a portion of the dual-purpose catheter may unintentionally interfere with the vascular wall or the like. Unintentional interference of a portion of the dual-purpose catheter with the vascular wall or the like increases frictional resistance during operation of the dual-purpose catheter.As a result, with a dual-purpose catheter, a large difference occurs between the operation at the proximal end and the operation of the distal end of the dual-purpose catheter. This makes it difficult for the surgeon to smoothly introduce and engage the most distal portion 260 into the left coronary artery ostium B8i and the right coronary artery ostium B9i. As a result, when introducing and engaging the distal end of the dual-purpose catheter into the left coronary artery ostium B8i and the right coronary artery ostium B9i, the surgeon must employ skilled techniques, such as pressing a part of the dual-purpose catheter against the blood vessel wall near the left coronary artery ostium B8i and the right coronary artery ostium B9i to change the angle.

[0094] Next, the effects based on the additional configuration of the coronary artery catheter 1 will be described.

[0095] In the coronary artery catheter 1, when the axis passing through the third bending point 230a and the fourth bending point 240a, which has the smallest radius of curvature in the fourth bending portion 240, is defined as a fifth axis A5, and the axis passing through the fourth bending point 240a and the fifth bending point 250a is defined as a sixth axis A6, the fourth angle θ4 formed by the fifth axis A5 and the sixth axis A6 is greater than 70° and less than 160°.

[0096] In the coronary artery catheter 1 configured as described above, the fourth angle θ4 is greater than 70° and less than 160°. Therefore, as shown in FIG. 11 , when the most-distal portion 260 located distal to the fourth bend 240 is introduced into and engaged with the left coronary artery ostium B8i, the most-distal portion 260 can be positioned so as to be hooked onto the left coronary artery ostium B8i, and this positioned state can be suitably maintained. Furthermore, when the most-distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i, the coronary artery catheter 1 can be positioned so that the most-distal portion 260 is in contact with the left coronary artery ostium B8i and parallel to the opening direction of the left coronary artery ostium B8i. Therefore, the coronary artery catheter 1 can effectively prevent the most-distal portion 260 from slipping out of the left coronary artery ostium B8i when contrast medium is discharged with the most-distal portion 260 introduced into and engaged with the left coronary artery ostium B8i. In addition, because the fourth angle θ4 of the coronary artery catheter 1 is greater than 70°, when the most-distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i, the fourth bent portion 240 is easily deformed into a substantially linear shape, allowing for smooth rotation of the shaping portion 200 within the ascending aorta B6. Furthermore, because the fourth angle θ4 of the coronary artery catheter 1 is greater than 70° and less than 160°, when the most-distal portion 260 is introduced into and engaged with the right coronary artery ostium B9i, as shown in Fig. 12 , the third bent portion 230 and the fourth bent portion 240 are located between the left vascular wall Bw1 and the right vascular wall Bw2 of the ascending aorta, and the catheter is bent in multiple stages between the vascular walls of the ascending aorta B6. Therefore, when the coronary artery catheter 1 introduces and engages the most distal portion 260 into the right coronary artery orifice B9i, the multi-stage bending portions (third bending portion 230 and fourth bending portion 240) of the shaped portion 200 can distribute the force applied from the vascular wall of the ascending aorta B6 to the shaped portion 200 located between the vascular walls of the ascending aorta B6, thereby effectively preventing kinking of the shaped portion 200 located between the vascular walls of the ascending aorta B6.

[0097] Furthermore, in the coronary artery catheter 1, the angle formed by the first axis A1 and the second axis A2 is a first angle θ1, the angle formed by the second axis A2 and the third axis A3 is a second angle θ2, the angle formed by the third axis A3 and the fifth axis A5 is a third angle θ3, and the angle formed by the sixth axis A6 and the bending start point Sa, the first bending point 210a, the second bending point 220a, the third bending point 230a, the fourth bending point 240a, and the fifth bending point A5 is a sixth axis A6. When the angle formed by the third bending point 230a and a seventh axis A7, which is located on the same plane P1 as the first bending point 250a and passes through the end of the most distal position 260a of the most distal portion 260 on the first axis A1 side, is defined as a fifth angle θ5, the fifth angle θ5 is smaller than the fourth angle θ4, the fourth angle θ4 is smaller than the third angle θ3, the third angle θ3 is smaller than the second angle θ2, and the second angle θ2 is smaller than the first angle θ1. Furthermore, in the coronary artery catheter 1, the linear distance L4 between the third bending point 230a and the fifth bending point 250a along the fourth axis A4 is greater than or equal to but less than twice the linear distance L5 between the second bending point 220a and the third bending point 230a along the third axis A3.

[0098] In the coronary artery catheter 1 configured as described above, the magnitude relationship between the angles θ1, θ2, θ3, θ4, and θ5 is defined so that the outer shape of the shaped portion 200 bends more sharply toward the most-distal portion 260. Therefore, when the most-distal portion 260 of the coronary artery catheter 1 is introduced into and engaged with the left coronary artery ostium B8i, the first bending portion 210, the first intermediate portion 215, the second bending portion 220, the second intermediate portion 225, the third bending portion 230, the third intermediate portion 235, the fourth bending portion 240, and the fourth intermediate portion 245 can be positioned so that the most-distal portion 260, which bends at the sharpest angle compared to the other bending portions, is hooked onto the left coronary artery ostium B8i while preventing contact of the first bending portion 210, the first intermediate portion 215, the second bending portion 220, the second intermediate portion 225, the third bending portion 230, the third intermediate portion 235, the fourth bending portion 240, and the fourth intermediate portion 245 with the left vascular wall Bw1 of the ascending aorta B6. Furthermore, since the shaped portion 200 is more tightly bent toward the most-distal portion 260, the return stress (stress that attempts to restore the shape to its natural state) when the shaped portion 200 is stretched into a substantially straight shape increases toward the most-distal portion 260. Therefore, the coronary artery catheter 1 has an improved backup force that keeps the most-distal portion 260 engaged with the left coronary artery ostium B8i. Furthermore, in the coronary artery catheter 1, the linear distance L4 between the third bending point 230a and the fifth bending point 250a along the fourth axis A4 is equal to or greater than one time and less than two times the linear distance L5 between the second bending point 220a and the third bending point 230a along the third axis A3. Therefore, while the second intermediate portion 225 located between the second bending point 220a and the third bending point 230a is prevented from contacting the left vascular wall Bw1 of the ascending aorta B6, the third intermediate portion 235, the fourth bending portion 240, and the fourth intermediate portion 245 located distally of the third bending point 230a can be moved closer to the left coronary artery ostium B8i using the third bending point 230a as a base point, and the most distal portion 260 located distally of the fourth intermediate portion 245 can be engaged at a deeper position in the left coronary artery ostium B8i. As a result, the most distal portion 260 of the coronary artery catheter 1 comes into contact with the left coronary artery ostium B8i over a wider area, thereby improving the backup force for the left coronary artery ostium B8i.

[0099] In addition, the coronary artery catheter 1 has a width W1 of the shaped portion 200 in the range of 41 mm to 58 mm, and the ratio (W2 / W1) of the maximum width W2 from the first axis A1 to the second bend portion 220 on the second perpendicular line H2 to the width W1 of the shaped portion 200 is 1 / 2 to 1 / 4.

[0100] The coronary artery catheter 1 configured as described above has a width W1 in the range of 41 mm to 58 mm. Therefore, as shown in FIG. 11 , when the most distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i, the shaped portion 200 curves to move away from the ascending aorta B6. Furthermore, because the ratio (W2 / W1) is ½ to ¼, the expansion of the shaped portion 200 in the width direction can be limited within a predetermined range based on the first axis A1. Therefore, as shown in FIG. 11 , when the most distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i, the most distal portion 260 can be oriented toward the left coronary artery ostium B8i near the left coronary artery ostium B8i while preventing contact between the ascending aorta B6 and the tubular body 10. This allows the most distal portion 260 of the coronary artery catheter 1 to be introduced into and engaged with the left coronary artery ostium B8i more smoothly.

[0101] Furthermore, the coronary artery catheter 1 is formed so that the longitudinal width L1 of the shaped portion 200 in the long axis direction is in the range of 70 mm to 160 mm.

[0102] 11 , when a part of the shaped portion 200 is positioned in the ascending aorta B6 and the most distal portion 260 is introduced into and engaged with the left coronary artery ostium B8i, the coronary artery catheter 1 can ensure a predetermined vertical distance L' of the shaped portion 200 located between the left subclavian artery B2 and the left coronary artery ostium B8i. This makes it possible for the coronary artery catheter 1 to effectively prevent the shaped portion 200 from contacting the left vascular wall Bw1 of the ascending aorta B6.

[0103] In addition, the coronary artery catheter 1 has a first intermediate portion 215 that intersects with a second axis A2 connecting the bending start point Sa and the second bending point 220a, and a portion of the first intermediate portion 215 on the bending start point Sa side is located closer to the first axis A1 than the second axis A2.

[0104] 11 , when the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2 and the most distal portion 260 is introduced into the left coronary artery ostium B8i, the coronary artery catheter 1 can orient the shaped portion 200, which is located distal to the main body portion 100, toward the ascending aorta B6. With the shaped portion 200 oriented toward the ascending aorta B6 as described above, the coronary artery catheter 1 can position the second bent portion 220, the third bent portion 230, and the fourth bent portion 240 so that a predetermined distance is maintained between the second bent portion 220, the third bent portion 230, and the fourth bent portion 240 and the vascular walls Bw1, Bw2 of the ascending aorta B6. Therefore, when the most distal portion 260 is introduced into the left coronary artery ostium B8i, the coronary artery catheter 1 can prevent the second bent portion 220, the third bent portion 230, and the fourth bent portion 240 from coming into contact with the ascending aorta B6, thereby preventing a decrease in operability.

[0105] Furthermore, in the coronary artery catheter 1, the most distal portion 260 is located closer to the fifth bent portion 250 than the third perpendicular line H3 in the longitudinal direction of the shaped portion 200.

[0106] As shown in FIG. 11 , when the coronary artery catheter 1 configured as described above introduces the tubular body 10 from the left subclavian artery B2 into the ascending aorta B6, the most distal portion 260 is moved downward along the ascending aorta B6 while preventing contact between the tubular body 10 and the vascular walls Bw1, Bw2 of the ascending aorta B6, and then the most distal portion 260 is moved upward so as to be pulled up, thereby enabling the most distal portion 260 to be introduced into and engaged with the left coronary artery ostium B8i by a simple operation.

[0107] 11 , the coronary artery catheter 1 can be configured so that when the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2 and the most-distal portion 260 is introduced into the left coronary artery ostium B8i, the second bent portion 220, the third bent portion 230, and the fourth bent portion 240 do not come into contact with the vascular walls Bw1, Bw2 of the ascending aorta B6. With this configuration, the coronary artery catheter 1 can be prevented from reducing operability due to the second bent portion 220, the third bent portion 230, and the fourth bent portion 240 coming into contact with the ascending aorta B6 when the most-distal portion 260 is introduced into the left coronary artery ostium B8i. 12 , the coronary artery catheter 1 can be configured so that when the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2 and the most-distal portion 260 is introduced into the right coronary artery ostium B9i, the second bent portion 220 comes into contact with the left vascular wall Bw1 of the ascending aorta B6. In this configuration, when the most-distal portion 260 is introduced into and engaged with the right coronary artery ostium B9i, the second bent portion 220 is supported by the left vascular wall Bw1 of the ascending aorta B6, thereby increasing the backup force of the most-distal portion 260 against the right coronary artery ostium B9i.

[0108] 11 and 12 , the coronary artery catheter 1 can be configured so that, when the tubular body 10 is inserted into the aortic arch Aa via the left subclavian artery B2 and the most-distal portion 260 is introduced into the left coronary artery ostium B8i or the right coronary artery ostium B9i, the first bent portion 210 is positioned in contact with the vascular wall Bw3 of the left subclavian artery B2 or in the aortic arch Aa. When the coronary artery catheter 1 is configured so that the first bent portion 210 is in contact with the vascular wall Bw3 of the left subclavian artery B2 when the most-distal portion 260 is introduced into the left coronary artery ostium B8i or the right coronary artery ostium B9i, the first bent portion 210 is supported by the vascular wall Bw3 of the left subclavian artery B2, and therefore, an operating force applied from the proximal side (e.g., a rotational force during a rotational operation) can be effectively transmitted to the shaped portion 200 located at the distal end of the main body portion 100. Furthermore, when the coronary artery catheter 1 is configured so that the first bending portion 210 is located in the aortic arch Aa when the most-distal portion 260 is introduced into the left coronary artery ostium B8i or the right coronary artery ostium B9i, the first bending portion 210 can be prevented from coming into contact with the vascular walls Bw1, Bw2 of the left subclavian artery B2. Therefore, the coronary artery catheter 1 can smoothly introduce and engage the most-distal portion 260 into the left coronary artery ostium B8i or the right coronary artery ostium B9i.

[0109] <Modifications> Modifications of the above-described embodiment will now be described.

[0110] The coronary artery catheter 1A according to the modified example differs from the coronary artery catheter 1 according to the previously described embodiment in the shape of the shaped portion 200. In other respects, it is substantially the same as the coronary artery catheter 1. Therefore, in the modified example, explanations other than the differences in shape will be omitted as appropriate.

[0111] The coronary artery catheter 1A according to the modified example has the same structure as the coronary artery catheter 1 according to the above-described embodiment, in that "the fourth axis A4 intersects with the first axis A1, the angle θa formed between the fourth axis A4 and the third perpendicular line H3 is more acute than the angle θb formed between the third axis A3 and the second perpendicular line H2 and is in the range of 1° to 30°, the fourth bent portion 240 is bent in a convex shape in a direction away from the fourth axis A4 between the third bend point 230a and the fifth bend point 250a, and the second perpendicular line H2 is located at a position where the ratio of the distance L2 to the distance L3 is in the range of 1 / 1 to 1 / 7."

[0112] The coronary artery catheter 1A according to the modified example has the above-described structure, and thus the most-advanced portion 260 can be introduced into and engaged with both the left coronary artery orifice B8i and the right coronary artery orifice B9i from an artery in the left arm. Furthermore, the coronary artery catheter 1 has the above-described structure, and thus can exhibit the excellent operability described in the above-described embodiment when introducing and engaging the most-advanced portion 260 into the left coronary artery orifice B8i and the right coronary artery orifice B9i from an artery in the left arm.

[0113] Fig. 13 is a front view of a coronary artery catheter 1A according to a modified example. Fig. 14 is a back view of a coronary artery catheter 1A according to a modified example. Fig. 15 is a left side view of a coronary artery catheter 1A according to a modified example. Fig. 16 is a right side view of a coronary artery catheter 1A according to a modified example. Fig. 17 is a plan view of a coronary artery catheter 1A according to a modified example. Fig. 18 is a bottom view of a coronary artery catheter 1A according to a modified example. In Figs. 13 to 18, the areas indicated by solid lines exemplify the design features of the tubular body 10 of the coronary artery catheter 1A according to the modified example, and the areas indicated by dashed lines exemplify other parts.

[0114] Figures 19, 20, and 21 are enlarged views of the coronary artery catheter 1A. Figures 19, 20, and 21 are enlarged views of a portion of the front view shown in Figure 13, and correspond to Figures 7, 8, and 9 shown in the above-mentioned embodiment.

[0115] 19, 20 and 21, examples of suitable dimensions of each part of the coronary artery catheter 1A will be described.

[0116] The definitions of the axes and perpendicular lines, etc., which are the basis for measuring the dimensions of each part of the coronary artery catheter 1A of Modified Example 1 described below, are substantially the same as those of the coronary artery catheter 1 of the above-described embodiment. However, in the coronary artery catheter 1A of Modified Example 1, as shown in Figures 19, 20, and 21, the most distal portion 260 located on the distal side of the fifth bent portion 250 extends toward the first axis A1 from the fifth bent portion 250 as a base point. Therefore, in the plan view shown in Figure 19, the width W1, which is the maximum width of the shaped portion 200, is defined as the distance of a straight line connecting the end of the second bent portion 220 opposite the first axis A1, which is located on the second perpendicular line H2, and the position of the end 250b of the fifth bent portion 250 opposite the first axis A1, projected onto the second perpendicular line H2.

[0117] The coronary artery catheter 1A has an angle θa of 6°, an angle θb of 72°, a vertical width L1 of 102 mm, a distance L2 of 35 mm, a distance L3 of 67 mm, a horizontal width W1 of 50 mm, a maximum horizontal width W2 of 16 mm, a first angle θ1 of 168°, a second angle θ2 of 150°, a third angle θ3 of 143°, a fourth angle θ4 of 127°, a fifth angle θ5 of 108°, a linear distance L4 of 41 mm, and a linear distance L5 of 22 mm.

[0118] The coronary artery catheter according to the present invention has been described above through embodiments and modifications. However, the present invention is not limited to the described contents and can be modified as appropriate based on the claims.

[0119] This application is based on Japanese Patent Application No. 2022-100202, filed on June 22, 2022, the disclosure of which is incorporated herein by reference in its entirety.

[0120] 1 Coronary artery catheter 1A Coronary artery catheter 10 Tubular body 20 Lumen 100 Main body 110 Base end 200 Shaped portion 210 First bent portion 210a First bent point 215 First intermediate portion 220 Second bent portion 220a Second bent point 225 Second intermediate portion 230 Third bent portion 230a Third bent point 235 Third intermediate portion 240 Fourth bent portion 240a Fourth bent point 250 Fifth bent portion 250a Fifth bent point 260 Most distal portion 260a Most distal position 261 Tip opening 300 Hub Sa Bending start point P1 Plane A1 First axis A2 Second axis A3 Third axis A4 Fourth axis A5 Fifth axis A6 Sixth axis A7 Seventh axis H1 First perpendicular line H2 Second perpendicular line H3 Third perpendicular line L1 Vertical width of shaped portion L2 Vertical width of shaped portion in the long axis direction - distance between the second perpendicular line and the first perpendicular line L3 Distance between the second perpendicular line and the first perpendicular line L4 Straight-line distance between the third bending point and the fourth bending point L5 Straight-line distance between the second bending point and the third bending point W1 Horizontal width of shaped portion W2 Maximum horizontal width from the first axis to the second bending point on the second perpendicular line θa Angle between the fourth axis and the third perpendicular line θb Angle between the third axis and the second perpendicular line θ1 First angle θ2 Second angle θ3 Third angle θ4 Fourth angle θ5 Fifth angle B1 Left common carotid artery B2 Left subclavian artery B3 Right common carotid artery B4 Right subclavian artery B5 Brachiocephalic artery B6 Ascending aorta B7 Descending aorta B8 Left coronary artery B8i Left coronary artery ostium B9 Right coronary artery B9i Right coronary artery ostium Bw1 Left vascular wall of the ascending aorta Bw2 Right vascular wall of the ascending aorta Bw3 Vascular wall of the left subclavian artery Aa Aortic arch Lv Left ventricle

Claims

1. A coronary artery catheter capable of introducing a distal end portion into both a left coronary artery opening and a right coronary artery opening from an artery in a left arm, A tubular body that communicates from the base end to the tip end, The tubular body has, in a natural state, a substantially straight main body portion and a shaped portion that is bent and shaped at a plurality of points on substantially the same plane, The shape portion is A first bent portion bent at a position closer to the tip end than the main body portion; A first intermediate portion located on a tip side of the first bent portion; a second bent portion bent toward an opposite side to the first bent portion at a position closer to the tip end than the first intermediate portion; A second intermediate portion located on a tip side of the second bent portion; a third bent portion bent toward the same side as the second bent portion at a position closer to the tip end than the second intermediate portion; a third intermediate portion located on a tip side of the third bent portion; a fourth bent portion bent toward the same side as the third bent portion at a position on the tip side of the third intermediate portion; a fourth intermediate portion located on a tip side of the fourth bent portion; a fifth bent portion bent toward the same side as the fourth bent portion at a position on the tip side of the fourth intermediate portion; the most distal portion is disposed on the distal side of the fifth bent portion, In the tubular body, An axis passing through a center line of the main body portion is defined as a first axis, a second axis is an axis passing through a bending start point, which is located at the boundary between the first bent portion and the tip of the main body portion and starts to incline from the first axis toward the second bent portion, and a second bent point, which has the smallest radius of curvature in the second bent portion; a third axis is an axis passing through the second bending point and a third bending point having the smallest radius of curvature in the third bending portion; an axis passing through the third bending point and a fifth bending point having the smallest radius of curvature in the fifth bending portion is defined as a fourth axis; A line perpendicular to the first axis and passing through the bending start point is defined as a first perpendicular line; A line perpendicular to the first axis and passing through the second bending point is defined as a second perpendicular line; When a line perpendicular to the first axis and passing through the third bending point is defined as a third perpendicular line, the fourth axis intersects with the first axis, an angle between the fourth axis and the third perpendicular line is more acute than an angle between the third axis and the second perpendicular line and is in a range of 1° to 30°; the fourth bent portion is bent convexly in a direction away from the fourth axis between the third bend point and the fifth bend point, the second perpendicular line is located at a position such that (longitudinal width of the shaped portion in the major axis direction--distance between the second perpendicular line and the first perpendicular line) / (distance between the second perpendicular line and the first perpendicular line) is in the range of 1 / 1 to 1 / 7.

2. an axis passing through the third bending point and the fourth bending point having the smallest radius of curvature in the fourth bending portion is defined as a fifth axis; When an axis passing through the fourth bending point and the fifth bending point is defined as a sixth axis, 2. The coronary artery catheter according to claim 1, wherein a fourth angle between the fifth axis and the sixth axis is greater than 70 degrees and less than 160 degrees.

3. In the shape portion, an angle between the first axis and the second axis is defined as a first angle; an angle between the second axis and the third axis is a second angle; an angle between the third axis and the fifth axis is a third angle; When an angle formed by the sixth axis and a seventh axis which is located on the same plane as the bending start point, the first bending point having the smallest radius of curvature in the first bending portion, the second bending point, the third bending point, the fourth bending point, and the fifth bending point, and which passes through an end portion of the most distal position of the most distal portion on the first axis side, is defined as a fifth angle, the fifth angle is less than the fourth angle; the fourth angle is less than the third angle; the third angle is less than the second angle; The second angle is configured to be smaller than the first angle, 3. The coronary artery catheter according to claim 2, wherein a linear distance between the third bend point and the fifth bend point along the fourth axis is equal to or greater than one time and less than two times a linear distance between the second bend point and the third bend point along the third axis.

4. The width of the shape is in the range of 41 mm to 58 mm, 4. The coronary artery catheter according to claim 1, wherein a ratio of a maximum lateral width on the second perpendicular line from the first axis to the second bent portion to a lateral width of the shaped portion is 1 / 2 to 1 / 4.

5. 4. The coronary artery catheter according to claim 1, wherein the longitudinal width of said shaped portion in the longitudinal direction is in the range of 70 to 160 mm.

6. the first intermediate portion intersects with the second axis connecting the bending start point and the second bending point, The coronary artery catheter according to any one of claims 1 to 3, characterized in that a part of the first intermediate section on the side of the bending start point is located closer to the first axis than the second axis.

7. 4. The coronary artery catheter according to claim 1, wherein the most distal portion is located on the fifth bent portion side relative to the third perpendicular line in the longitudinal direction of the shaped portion.

8. when the tubular body is inserted into the aortic arch via the left subclavian artery and the most distal portion is introduced into the left coronary artery ostium, the second bent portion, the third bent portion, and the fourth bent portion do not come into contact with a vascular wall of the ascending aorta, 4. The coronary artery catheter according to claim 1, wherein when the tubular body is inserted into the aortic arch via the left subclavian artery and the most distal portion is introduced into the orifice of the right coronary artery, the second bent portion comes into contact with the vascular wall on the left side of the ascending aorta.

9. 4. The coronary artery catheter according to claim 1, wherein when the tubular body is inserted into the aortic arch via the left subclavian artery and the most distal portion is introduced into the left coronary artery or right coronary artery orifice, the first bent portion is located at a position contacting a blood vessel wall of the left subclavian artery or in the aortic arch.