Operation member for guide wire

Abstract

The present invention comprises a first cylindrical member which extends in the longitudinal direction, a second cylindrical member which extends in the longitudinal direction, and an outer cylinder which is externally mounted to the first cylindrical member and the second cylindrical member so as to be rotatable around an axis extending in the longitudinal direction and which extends in the longitudinal direction. The first cylindrical member and the second cylindrical member are provided in a state in which relative movement in the longitudinal direction is possible and relative rotation around the axis is restricted. The outer cylinder is provided to one cylindrical member among the first cylindrical member and the second cylindrical member in a state in which movement in the longitudinal direction is restricted. A first guiding part is formed on the inner circumferential surface of the outer cylinder and on the outer circumferential surface of the other cylindrical member of the first cylindrical member and the second cylindrical member, said first guiding part allowing the other cylindrical member to move longitudinally relative to the one cylindrical member such that the distance between a fastened body and the front end of a supporting tube of a guide wire changes with the relative rotation of the outer cylinder and the other cylindrical member around the axis.

Description

Guidewire operating member

[0001] The present invention relates to a guidewire operating member. This application claims priority to Japanese Patent Application No. 2023-169659, filed on September 29, 2023, the contents of which are incorporated herein by reference.

[0002] Conventionally, operating members for deforming the front end of a guidewire have been known, as shown in, for example, Patent Document 1 below. Generally, a guidewire is inserted into a blood vessel and used to guide an angiography catheter to a chronic total occlusion lesion or the like while penetrating the blood vessel. The guidewire operating member shown in Patent Document 1 below includes first and second tubular members extending in the front-rear direction, and an outer tube rotatably mounted on the first and second tubular members and extending in the front-rear direction. The first and second tubular members are arranged to be relatively movable in the front-rear direction but with their relative rotation restricted. Guide portions are formed on the inner peripheral surface of the outer tube and the outer peripheral surface of the second tubular member, allowing the second tubular member to move back and forth relative to the first tubular member as the outer tube and the second tubular member rotate relative to each other.

[0003] Japanese Patent No. 7188847

[0004] In conventional guidewire operating members, the relative positions of the outer tube and the first tubular member in the front-to-rear direction are unstable, and when the outer tube is rotated relative to the first tubular member and the second tubular member, for example, the outer tube may move back and forth relative to the first tubular member, or the second tubular member may not move back and forth relative to the first tubular member, etc. In this case, it is not possible to accurately deform the front end of the guidewire into a desired shape.

[0005] The present invention provides a guidewire manipulation member that can accurately deform the front end portion of a guidewire into a desired shape.

[0006] A guidewire according to one aspect of the present invention is a guidewire operating member attached to a guidewire including: a flexible tubular body extending in a front-rear direction; an operating wire extending in the front-rear direction and provided inside the flexible tubular body; a fixed body to which a front end edge of the operating wire is fixed; and a support tubular body provided behind the fixed body, sandwiching the flexible tubular body in the front-rear direction between the fixed body and the flexible tubular body and having the operating wire inserted therein; the guidewire operating member includes a first tubular member fixed to a rear end of the support tubular body and extending in the front-rear direction; a second tubular member connected to a portion of the operating wire protruding rearward from the support tubular body and extending in the front-rear direction; and a guidewire operating member attached to the first tubular member and the second tubular member, the first tubular member being rotatable about an axis extending in the front-rear direction. and an outer tube fitted to the outer tube and extending in the front-to-rear direction, wherein the first and second tube members are movable relative to each other in the front-to-rear direction while their relative rotation about the axis is restricted, and the outer tube is mounted on either one of the first and second tube members in a state where its movement in the front-to-rear direction is restricted, and a first guide portion is formed on the inner peripheral surface of the outer tube and the outer peripheral surface of the other of the first and second tube members, which moves the other tube member back and forth relative to the one tube member such that the front-to-rear distance between the object to be fixed and the front end of the support pipe changes as the outer tube and the other tube member rotate relative to each other about the axis.

[0007] When the outer tube, which is attached to either the first or second tubular member in a state where its movement in the forward / backward direction is restricted, is rotated about its axis, the other tubular member moves forward / backward relative to the first tubular member due to a first guide portion formed on the inner peripheral surface of the outer tube and the outer peripheral surface of the other tubular member. During this rotation, the distance in the forward / backward direction between the object to be fixed and the front end of the support tubular member is shortened, causing the flexible tubular member to undergo compressive deformation. As a result, for example, when an eccentric load is generated on the flexible tubular member in a coil spring, or when the central axes of the flexible tubular member and the operating wire do not coincide with each other, the flexible tubular member undergoes compressive deformation and bends in a specific direction. By manipulating the outer tube outside the body and bending the front end of the guidewire inside the body, a blood vessel can be selected at a vascular bifurcation and advanced into the target blood vessel. This reduces the physician's dependency on operational sense when guiding the guidewire along a blood vessel to reach a chronic total occlusion lesion or the like. This also eliminates the need to insert and remove the guidewire from the blood vessel to fine-tune the curvature of the front end of the guidewire outside the body. Furthermore, when the outer tube is rotated about its axis, the distance in the front-to-rear direction between the object to be fixed and the front end of the support tube becomes shorter, and the flexible tube is compressed and deformed in the front-to-rear direction, thereby increasing the bending rigidity of the flexible tube. Therefore, the bending rigidity of the flexible tube can be changed by manipulating the outer tube outside the body while the guidewire is inserted into the blood vessel. As a result, when penetrating a chronic total occlusion or the like with the guidewire, the bending rigidity of the flexible tubular body can be reduced until the guidewire enters the blood vessel and reaches the chronic total occlusion or the like within the blood vessel. Then, when the guidewire penetrates the chronic total occlusion or the like and penetrates the chronic total occlusion or the like with the guidewire, the bending rigidity of the flexible tubular body can be increased by rotating the outer tube about its axis. After penetrating the chronic total occlusion or the like, the bending rigidity of the flexible tubular body can be restored to its original, low state by rotating the outer tube in the opposite direction. Therefore, it is possible to eliminate the need to use different guide wires with different bending stiffness by inserting and removing them into and from blood vessels, etc., to penetrate a chronic total occlusion lesion, etc. As a result, the surgical time can be shortened.

[0008] In the above process, the forward and backward movement of the outer tube relative to one tubular member is restricted, and the first guide portion is formed on the inner peripheral surface of the outer tube and the outer peripheral surface of the other tubular member. Therefore, when the outer tube is rotated about the axis, the forward and backward movement of the outer tube relative to one tubular member is restricted, and the other tubular member can be reliably moved forward and backward relative to the one tubular member, allowing the front end of the guidewire to be accurately deformed into a desired shape.

[0009] Note that the design to bend the flexible tubing in a specific direction when the outer cylinder is rotated about its axis can be achieved, for example, by adjusting the amount of eccentricity, direction of eccentricity, angle of inclination, etc. of the central axes of the flexible tubing and the operating wire, or, if the flexible tubing is a coil spring, by adjusting the amount of eccentricity, direction of eccentricity, etc. of the load generated in the flexible tubing when a compressive load is applied. The latter adjustment can be achieved, for example, by adjusting the spring shape, such as the number of turns of the coil spring (relative circumferential positions of both ends of the wire), pitch angle of the coil spring, pitch of the coil spring, wire diameter (diameter of the wire), inter-wire gap, coil outer diameter, and support mode of both ends of the coil spring (for example, inclination of both ends of the wire).

[0010] The first guide portion is composed of a first engaging protrusion and a first guide groove that extends about the axis and accommodates the first engaging protrusion so that it can move about the axis, and the first and second cylindrical members are formed with second guide portions that allow relative movement in the front-to-rear direction while restricting relative rotation of the first and second cylindrical members about the axis, and the second guide portion is composed of a second engaging protrusion and a second guide groove that extends in the front-to-rear direction and accommodates the second engaging protrusion so that it can move in the front-to-rear direction, and the first guide portion and the second guide portion may be separated in the front-to-rear direction.

[0011] The first guide portion and the second guide portion are spaced apart in the front-rear direction, and the first engaging protrusion and the second engaging protrusion are housed separately in the first guide groove and the second guide groove, respectively, rather than integrally housed in the first guide groove and the second guide groove. Therefore, the protrusion length of each of the first engaging protrusion and the second engaging protrusion can be kept short. Furthermore, compared to a configuration in which the first engaging protrusion or the second engaging protrusion is housed integrally in the first guide groove and the second guide groove, during assembly, the first engaging protrusion and the second engaging protrusion can be easily housed separately in the first guide groove and the second guide groove, respectively, without excessively large radial elastic deformation of the first cylindrical member or the second cylindrical member, and the rigidity of each of the first cylindrical member or the second cylindrical member can be easily ensured.

[0012] According to the above aspect of the present invention, the front end portion of the guidewire can be deformed into a desired shape with high precision.

[0013] Fig. 1 is a longitudinal sectional view showing a state in which a guidewire manipulation member of one embodiment is attached to a guidewire. Fig. 2 is a view showing a state in which an outer tube of the guidewire manipulation member of Fig. 1 is rotated relative to a second tubular member and the second tubular member is moved rearward relative to a first tubular member. Fig. 3 is a longitudinal sectional view showing a guidewire manipulation member of a modified example attached to a guidewire. Fig. 4 is a longitudinal sectional view showing a guidewire manipulation member of a modified example attached to a guidewire.

[0014] A first embodiment of a guidewire manipulation member will be described below with reference to Figures 1 and 2. First, a guidewire 100 to which the guidewire manipulation member is attached will be described. Note that the shape of the guidewire is not limited to this embodiment and may be modified as appropriate.

[0015] The guidewire 100 includes a flexible tubular body 111, an operating wire 112, a front fixable body 113 (fixable body), a support tubular body 114, and a rear fixable body 115. The flexible tubular body 111, the operating wire 112, the front fixable body 113, the support tubular body 114, and the rear fixable body 115 are formed of, for example, a metal material. Note that this material may be changed as appropriate.

[0016] The flexible tubular body 111, the operating wire 112, and the support tubular body 114 are arranged coaxially with a common axis. Hereinafter, this common axis will be referred to as the central axis O (axis), the side of the front-side fixed body 113 along the central axis O will be referred to as the front side, the side of the support tubular body 114 along the central axis O will be referred to as the rear side, and the direction along the central axis O will be referred to as the front-rear direction. A direction intersecting the central axis O as viewed from the front-rear direction will be referred to as the radial direction, and a direction going around the central axis O as viewed from the front-rear direction will be referred to as the circumferential direction. Note that the central axes of the flexible tubular body 111, the operating wire 112, and the support tubular body 114 do not have to coincide with each other by, for example, tilting, intersecting, or being separated from each other.

[0017] The outer diameter of the flexible tubular body 111 is large enough to be inserted into a blood vessel (for example, 0.2 mm or more and 1.0 mm or less). The diameter of the wire material forming the flexible tubular body 111 is constant along its entire length. The outer shape and size of the flexible tubular body 111 as viewed from the front-rear direction are constant along its entire length in the front-rear direction. Note that the diameter of the wire material forming the flexible tubular body 111 does not have to be constant along its entire length, and the outer shape and size of the flexible tubular body 111 as viewed from the front-rear direction do not have to be constant along its entire length in the front-rear direction. For example, the outer diameter of the flexible tubular body 111 may decrease toward the front.

[0018] The flexible tubular body 111 extends in the front-rear direction and is formed to be bendable. The flexible tubular body 111 is formed as a coil spring extending in the front-rear direction. The bending rigidity of the front and rear portions of the flexible tubular body 111 is smaller than the bending rigidity of the middle portion. When a compressive load in the front-rear direction is applied to the flexible tubular body 111, the front and rear portions contract more in the front-rear direction than the middle portion. Note that the flexible tubular body 111 may be a tubular body having a peripheral wall that extends continuously over its entire length in both the front-rear direction and the circumferential direction. Furthermore, the bending rigidity of the flexible tubular body 111 may be the same over its entire length in the front-rear direction.

[0019] The operation wire 112 extends in the front-rear direction and is provided inside the flexible tubular body 111. The operation wire 112 is formed to be elastically deformable. Note that multiple operation wires 112 may be provided at positions radially spaced apart from the central axis O and spaced apart in the circumferential direction.

[0020] The front end edge of the operation wire 112 is fixed to the front-side fixed body 113. The front-side fixed body 113 is formed in a hemispherical shape with a protruding spherical surface facing forward and a flat rear surface facing rearward. The front-side fixed body 113 is disposed coaxially with the central axis O. The front end edge of the operation wire 112 is fixed to the rear surface of the front-side fixed body 113 by, for example, brazing or crimping. The front end of the flexible tubular body 111 abuts against the rear surface of the front-side fixed body 113. The front end of the flexible tubular body 111 may be fixed to the rear surface of the front-side fixed body 113 by, for example, brazing or soldering.

[0021] The front adherend body 113 and the flexible tubular body 111 have the same outer shape and size as viewed from the front-rear direction. However, the front adherend body 113 and the flexible tubular body 111 may have different outer shapes and sizes as viewed from the front-rear direction. In this case, it is preferable that the flexible tubular body 111 does not protrude radially outward from the front adherend body 113 as viewed from the front-rear direction.

[0022] The support tube 114 is provided behind the front fixed body 113. The flexible tube 111 is sandwiched in the front-rear direction between the support tube 114 and the front fixed body 113. The support tube 114 extends in the front-rear direction. The operation wire 112 is inserted inside the support tube 114. The operation wire 112 passes through the support tube 114 in the front-rear direction.

[0023] The diameter of the front portion of the support tube 114 decreases toward the front. The front end of the front portion of the support tube 114 is inserted into the rear end of the flexible tube 111. The outer peripheral surface of the front portion of the support tube 114 abuts against the rear end of the flexible tube 111 in the front-to-rear direction and supports the rear end of the flexible tube 111. The rear portion of the support tube 114, which is located rearward of the front portion, and the flexible tube 111 have the same outer shape and size as viewed in the front-to-rear direction. Note that the outer shapes and sizes of the rear portion of the support tube 114 and the flexible tube 111 as viewed in the front-to-rear direction may be different from each other. In this case, it is preferable that the flexible tube 111 does not protrude radially outward from the outer peripheral surface of the rear portion of the support tube 114 as viewed in the front-to-rear direction.

[0024] The rear-side fixed body 115 is provided rearward of the support pipe 114. The rear end edge of the operation wire 112 is fixed to the rear-side fixed body 115. The rear-side fixed body 115 includes an end wall portion 115a and a peripheral wall portion 115b extending forward from the outer peripheral edge of the end wall portion 115a. The end wall portion 115a has the same shape as the front-side fixed body 113 and is oriented in the opposite direction to the front-side fixed body 113 in the front-to-rear direction. The rear-side fixed body 115 is disposed coaxially with the central axis O. The rear end edge of the operation wire 112 is fixed to the front surface of the end wall portion 115a by, for example, brazing or crimping. The peripheral wall portion 115b surrounds the rear end of the operation wire 112 from the radially outer side.

[0025] Next, the guidewire operating member 1 will be described.

[0026] The guidewire operating member 1 includes a first cylindrical member 11, a second cylindrical member 12, and an outer cylinder 13. The first cylindrical member 11, the second cylindrical member 12, and the outer cylinder 13 are arranged coaxially with a central axis O.

[0027] The first cylindrical member 11 is fixed to the rear end of the support pipe 114 and extends in the front-rear direction. The rear end of the support pipe 114 is fitted into the front-end opening of the first cylindrical member 11. In the illustrated example, the first cylindrical member 11 includes an outer cylindrical member 21, an inner cylindrical member 22, and a first main cylindrical member 23. Note that the inner cylindrical member 22 and the first main cylindrical member 23 may be integrally formed. The front portion of the inner cylindrical member 22 is fitted into the front portion of the outer cylindrical member 21. The inner diameter of the front portion of the outer cylindrical member 21 and the outer diameter of the front portion of the inner cylindrical member 22 each decrease toward the front. The inner cylindrical member 22 has multiple radially penetrating slits (not shown) formed at intervals in the circumferential direction along its entire length in the front-rear direction, excluding the rear end. The front end of the first main cylindrical member 23 is inserted between the inner peripheral surface of the rear portion of the outer cylindrical member 21 and the outer peripheral surface of the rear portion of the inner cylindrical member 22. The first main body tube 23 protrudes rearward from the outer tube 21 and the inner tube 22. A male thread (not shown) is formed on the outer peripheral surface of the front end of the first main body tube 23, and a female thread (not shown) that screws onto the male thread of the first main body tube 23 is formed on the inner peripheral surface of the rear end of the outer tube 21. The rear end of the support pipe 114 is fitted into and fixed in the inner tube 22 through the front end opening of the outer tube 21. By tightening the outer tube 21 onto the first main body tube 23, the diameter of the inner tube 22, excluding the rear end, is reduced and the inner peripheral surface of the inner tube 22 tightens against the outer peripheral surface of the rear end of the support pipe 114.

[0028] The second tubular member 12 is connected to a portion of the operation wire 112 that protrudes rearward from the support tube 114, and extends in the front-to-rear direction. In the example shown, the peripheral wall portion 115b of the rear-side fixed body 115 is fitted into and fixed to the rear end opening of the second tubular member 12. In this way, the second tubular member 12 is connected to the operation wire 112 via the rear-side fixed body 115. Note that the operation wire 112 may also be directly connected to the second tubular member 12.

[0029] The second cylindrical member 12 includes an outer cylindrical member 31, an inner cylindrical member 32, and a second main cylindrical member 33. The inner cylindrical member 32 and the second main cylindrical member 33 may be integrally formed. The rear portion of the inner cylindrical member 32 is fitted within the rear portion of the outer cylindrical member 31. The inner diameter of the rear portion of the outer cylindrical member 31 and the outer diameter of the rear portion of the inner cylindrical member 32 each decrease toward the rear. The inner cylindrical member 32 has multiple radially penetrating slits (not shown) spaced apart circumferentially along its entire length in the front-to-rear direction, excluding the front end portion. The rear end portion of the second main cylindrical member 33 is inserted between the inner peripheral surface of the front portion of the outer cylindrical member 31 and the outer peripheral surface of the front portion of the inner cylindrical member 32. The second main cylindrical member 33 protrudes forward from the outer cylindrical member 31 and the inner cylindrical member 32. A male thread (not shown) is formed on the outer peripheral surface of the rear end of the second main body tube 33, and a female thread (not shown) that screws onto the male thread of the second main body tube 33 is formed on the inner peripheral surface of the front portion of the outer tube 31. The front portion of the peripheral wall portion 115b of the rear fixed body 115 is fitted and fixed into the inner tube 32 through the rear end opening of the outer tube 31. By tightening the outer tube 31 onto the second main body tube 33, the inner tube 32, excluding the front end, is deformed by reducing its diameter, and the inner peripheral surface of the inner tube 32 tightens against the outer peripheral surface of the front portion of the peripheral wall portion 115b of the rear fixed body 115. The front portion of the second main body tube 33 is inserted into the first main body tube 23 so as to be movable back and forth. The rear portion of the second main body tube 33 protrudes rearward from the first main body tube 23. The outer diameter of the rear portion of the second main body tube 33 is larger than the outer diameter of the front portion of the second main body tube 33 and is the same as the outer diameter of the first main body tube 23. The outer diameter of the rear portion of the second main body cylinder 33 is not limited to this embodiment and may be changed as appropriate.

[0030] The outer cylinder 13 extends in the front-rear direction and is fitted to the first cylindrical member 11 and the second cylindrical member 12 so as to be rotatable about the central axis O. In the illustrated example, the outer cylinder 13 is fitted to the first main body cylinder 23 and the second main body cylinder 33.

[0031] The outer tube 13 is mounted on either the first cylindrical member 11 or the second cylindrical member 12 in a state where its movement in the front-rear direction is restricted. A first guide portion 25 is formed on the inner peripheral surface of the outer tube 13 and on the outer peripheral surface of the other cylindrical member of the first cylindrical member 11 or the second cylindrical member 12. The first guide portion 25 moves the other cylindrical member back and forth relative to the one cylindrical member as the outer tube 13 and the other cylindrical member rotate relative to each other about the central axis O so as to shorten the front-rear distance between the front-side fixed body 113 and the front end of the support pipe 114. In the illustrated example, the outer tube 13 is mounted on the first cylindrical member 11 in a state where its movement in the front-rear direction is restricted, and the first guide portion 25 is formed on the inner peripheral surface of the outer tube 13 and the outer peripheral surface of the second cylindrical member 12.

[0032] The first guide portion 25 is composed of a first engagement protrusion 26 and a first guide groove 27 that extends about the central axis O and accommodates the first engagement protrusion 26 so that the first engagement protrusion 26 is movably accommodated about the central axis O. In the illustrated example, two first engagement protrusions 26 are formed circumferentially spaced apart on the inner peripheral surface of the outer tube 13. The two first engagement protrusions 26 face each other radially. The first engagement protrusions 26 are provided at the rear end of the outer tube 13. Two first guide grooves 27 are formed on the outer peripheral surface of the second main body tube 33 of the second tubular member 12. The first guide groove 27 extends spirally about the central axis O. The first guide groove 27 is formed on the outer peripheral surface of a rear portion of the second main body tube 33 that protrudes rearward from the first main body tube 23. Each of the first engagement protrusions 26 is accommodated in one of the two first guide grooves 27. When the guide wire 100 is in standby mode before being operated, the first engaging protrusion 26 is positioned within the rear end of the first guide groove 27. The front end of the first guide groove 27 may be open toward the front.

[0033] Here, the first cylindrical member 11 and the second cylindrical member 12 are formed with second guide portions 35 that allow relative movement in the front-to-rear direction while restricting relative rotation of the first cylindrical member 11 and the second cylindrical member 12 about the central axis O. The second guide portion 35 is composed of a second engaging protrusion 36 and a second guide groove 37 that extends in the front-to-rear direction and accommodates the second engaging protrusion 36 so that it can move in the front-to-rear direction. The first guide portion 25 and the second guide portion 35 are spaced apart in the front-to-rear direction.

[0034] In the illustrated example, two second engagement protrusions 36 are formed circumferentially spaced apart on the outer peripheral surface of the front portion of the second main body tube 33 located within the first main body tube 23. However, a single second engagement protrusion 36 may be provided. The second engagement protrusion 36 is provided at the front end of the second main body tube 33. The two second engagement protrusions 36 are provided at positions facing each other in the radial direction. The radial outer ends of the second engagement protrusions 36 are located at the same radial position relative to the outer peripheral surface of the first main body tube 23 or at the radial inner side. At the front end of the second main body tube 33, a notch 33a is formed in each portion located between adjacent second engagement protrusions 36 in the circumferential direction, penetrating radially and opening to the front end opening edge of the second main body tube 33. As a result, the front end of the second main body tube 33 is configured to be elastically deformable in the radial direction so that the two second engagement protrusions 36 approach each other.

[0035] The second guide groove 37 is formed on the inner circumferential surface of the first main body tube 23 of the first tubular member 11 and extends in the front-rear direction. The second guide groove 37 penetrates the first main body tube 23 in the radial direction. Note that the second guide groove 37 does not have to penetrate the first main body tube 23 in the radial direction. Two second guide grooves 37 are formed in the first main body tube 23 with a gap between them in the circumferential direction. The two second guide grooves 37 face each other in the radial direction. A second engaging protrusion 36 is housed in each of the two second guide grooves 37. The second engaging protrusion 36 is located within the front end of the second guide groove 37 when the guidewire 100 is in standby mode before being operated.

[0036] The rear end of the first main body tube 23 of the first cylindrical member 11 is inserted into the front end of the outer tube 13. Two third engagement protrusions 38 protruding radially inward are formed on the inner peripheral surface of the front end of the outer tube 13 at a circumferentially spaced interval. The two third engagement protrusions 38 face each other radially. The third engagement protrusions 38 are formed as ridges extending circumferentially. In the front portion of the outer tube 13, each portion located between adjacent third engagement protrusions 38 in the circumferential direction is formed with a notch 13a that penetrates radially and opens to the front end opening edge of the outer tube 13. This allows the front portion of the outer tube 13 to elastically deform in the radial direction such that the two third engagement protrusions 38 move away from each other. A circumferential groove 39 extending continuously throughout the entire circumferential length is formed on the outer peripheral surface of the rear end of the first main body tube 23. The third engagement protrusion 38 is housed in the circumferential groove 39 so as to be rotatable about the central axis O while its movement in the front-to-rear direction is restricted. By engaging the third engagement protrusion 38 with the circumferential groove 39, the outer cylinder 13 is provided so as to be rotatable about the central axis O while its movement in the front-to-rear direction is restricted relative to the first cylindrical member 11. The third engagement protrusion 38 and the circumferential groove 39 are provided between the first guide portion 25 and the second guide portion 35 along the front-to-rear direction.

[0037] As described above, according to the guide wire operating member 1 of this embodiment, when the outer tube 13, which is provided on the first cylindrical member 11 in a state where its movement in the front-to-rear direction is restricted, is rotated around the central axis O, the first guide portions 25 formed on the inner peripheral surface of the outer tube 13 and the outer peripheral surface of the second cylindrical member 12 cause the second cylindrical member 12 to move rearward relative to the first cylindrical member 11, as shown in Fig. 2. At this time, the operating wire 112 is pulled rearward, thereby shortening the distance in the front-to-rear direction between the front fixed body 113 and the front end of the support tube 114, and the flexible tube 111 is compressed and deformed.

[0038] As a result, for example, when an eccentric load is generated in the flexible tubular body 111 when the flexible tubular body 111 is a coil spring, or when the central axes of the flexible tubular body 111 and the operating wire 112 do not coincide with each other, the flexible tubular body 111 undergoes compressive deformation and bends in a specific direction, as shown by the two-dot chain line in Fig. 2 , for example. This allows the surgeon to select a blood vessel at a vascular bifurcation and advance the guidewire 100 into the target blood vessel by operating the outer tube 13 outside the body and bending the front end of the guidewire 100 inside the body. This reduces the physician's dependency on operational sense when guiding the guidewire 100 along the blood vessel to reach a chronic total occlusion lesion or the like. This also eliminates the need to insert and remove the guidewire from the blood vessel to fine-tune the curvature of the front end of the guidewire outside the body.

[0039] Furthermore, when the outer tube 13 is rotated around the central axis O, the distance in the front-to-rear direction between the front fixation member 113 and the front end of the support tube 114 becomes shorter, and the flexible tube 111 is compressed and deformed in the front-to-rear direction, increasing the bending rigidity of the flexible tube 111. Therefore, with the guidewire 100 inserted into a blood vessel, the bending rigidity of the flexible tube 111 can be changed by manipulating the outer tube 13 outside the body. As a result, when the guidewire 100 is to penetrate a chronic total occlusion lesion or the like, the bending stiffness of the flexible tubular body 111 is kept low until the guidewire 100 is advanced into a blood vessel and reaches the chronic total occlusion lesion or the like within the blood vessel. Then, when the guidewire 100 is thrust into the chronic total occlusion lesion or the like and penetrates the chronic total occlusion lesion or the like with the guidewire 100, the outer tube 13 is rotated about the central axis O to increase the bending stiffness of the flexible tubular body 111. After penetrating the chronic total occlusion lesion or the like, the outer tube 13 is rotated in the opposite direction to return the bending stiffness of the flexible tubular body 111 to its original low state. This eliminates the need to insert and remove guidewires with different bending stiffnesses into and from blood vessels or the like to selectively penetrate a chronic total occlusion lesion or the like. As a result, the surgical time can be shortened.

[0040] In the above process, forward and backward movement of the outer tube 13 relative to the first cylindrical member 11 is restricted, and the first guide portion 25 is formed on the inner peripheral surface of the outer tube 13 and the outer peripheral surface of the second cylindrical member 12. Therefore, when the outer tube 13 is rotated around the central axis O, the forward and backward movement of the outer tube 13 relative to the first cylindrical member 11 is restricted, which makes it possible to reliably move the second cylindrical member 12 back and forth relative to the first cylindrical member 11, and the front end of the guidewire 100 can be deformed accurately into a desired shape.

[0041] The design of bending the flexible tubular body 111 in a specific direction when the outer tube 13 is rotated about the central axis O can be achieved, for example, by adjusting the amount of eccentricity, direction of eccentricity, angle of inclination, etc. of the central axes of the flexible tubular body 111 and the operating wire 112, or, if the flexible tubular body 111 is a coil spring, by adjusting the amount of eccentricity, direction of eccentricity, etc. of the load generated in the flexible tubular body 111 when a compressive load is applied. The latter adjustment can be achieved, for example, by adjusting the spring shape, such as the number of turns of the coil spring (relative circumferential positions of both ends of the wire), pitch angle of the coil spring, pitch of the coil spring, wire diameter (diameter of the wire), wire gap, coil outer diameter, and support mode of both ends of the coil spring (for example, inclination of both ends of the wire).

[0042] The first guide portion 25 and the second guide portion 35 are spaced apart in the front-rear direction, and the first engaging protrusion 26 and the second engaging protrusion 36 are housed separately in the first guide groove 27 and the second guide groove 37, respectively, rather than integrally housed in the first guide groove 27 and the second guide groove 37. This makes it possible to keep the protrusion length of each of the first engaging protrusion 26 and the second engaging protrusion 36 short. Furthermore, compared to a configuration in which the first engaging protrusion 26 or the second engaging protrusion 36 is housed integrally in the first guide groove 27 and the second guide groove 37, during assembly, the first engaging protrusion 26 and the second engaging protrusion 36 can be easily housed separately in the first guide groove 27 and the second guide groove 37 without excessively large radial elastic deformation of the first main body tube 23 or the second main body tube 33, and the rigidity of each of the first main body tube 23 or the second main body tube 33 can be easily ensured.

[0043] The technical scope of the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the spirit of the present invention.

[0044] For example, as in the guide wire operating member 1a shown in Figure 3, a configuration may be adopted in which the first guide portion 25 has the first engagement protrusion 26 formed not on the outer tube 13 but on the outer peripheral surface of the rear portion of the second main body tube 33 of the second tube member 12 that protrudes rearward from the first main body tube 23, and the first guide groove 27 formed not on the rear portion of the second main body tube 33 but on the inner peripheral surface of the outer tube 13.

[0045] As shown in FIG. 4 , the guidewire operating member 1b may include an outer tube 13 mounted on the second tubular member 12 with its movement in the forward / backward direction restricted, and a first guide portion 25 formed on the inner peripheral surface of the outer tube 13 and the outer peripheral surface of the first tubular member 11. A specific description will be given below with reference to FIG. 4 . The first engagement protrusion 26 of the first guide portion 25 is provided on the front end of the outer tube 13, and the first guide groove 27 of the first guide portion 25 is formed on the outer peripheral surface of the first main body tube 23 of the first tubular member 11. The first guide groove 27 is formed on the outer peripheral surface of the rear portion of the first main body tube 23 inserted into the outer tube 13. In the illustrated example, the rear portion of the first main body tube 23 is inserted into a portion of the outer tube 13 that is located forward of the rear end. When the guidewire 100 is in standby mode before being operated, the first engagement protrusion 26 is positioned within the front end of the first guide groove 27. The third engagement protrusion 38 is formed on the inner peripheral surface of the rear end of the outer tube 13, and the notch 13a is provided in the rear portion of the outer tube 13. The circumferential groove 39 is formed on the outer peripheral surface of the rear portion of the second main body tube 33 that protrudes rearward from the first main body tube 23. The third engagement protrusion 38 and the circumferential groove 39 are located rearward of the first guide portion 25 and the second guide portion 35. In the above configuration, when the outer tube 13, which is provided on the second tubular member 12 in a state where its movement in the front-to-rear direction is restricted, is rotated around the central axis O, the first guide portion 25 formed on the inner peripheral surface of the outer tube 13 and the outer peripheral surface of the first tubular member 11 moves the first tubular member 11 forward relative to the second tubular member 12. At this time, the first tubular member 11 pushes the support tube 114 forward, thereby shortening the front-to-rear distance between the front-side fixed body 113 and the front end of the support tube 114, and compressively deforming the flexible tubular member 111. Furthermore, in this modification, as the outer tube 13 rotates about the central axis O relative to the first cylindrical member 11, the first cylindrical member 11 moves forward relative to the second cylindrical member 12, so that the flexible tubular body 111 can be deformed without changing the position of the front-to-rear direction of the front-to-rear fixed body 113.

[0046] 1 and 2 may be configured in a reversed order, with the second tubular member 12 (first tubular member) fixed to the rear end of the support tube 114 and the first tubular member 11 (second tubular member) connected to a portion of the operation wire 112 that protrudes rearward from the support tube 114. In this case, the same effects as those of the guidewire operation member 1b shown in FIG.

[0047] In addition, it is possible to replace the components in the above-described embodiments with well-known components as appropriate, without departing from the spirit of the present invention, and the above-described embodiments and variations may be combined as appropriate.

[0048] According to the present invention, it is possible to provide a guidewire manipulation member that can accurately deform the front end portion of a guidewire into a desired shape.

[0049] 1, 1a, 1b Guide wire operating member 11 First tubular member 12 Second tubular member 13 Outer tube 25 First guide portion 26 First engaging protrusion 27 First guide groove 35 Second guide portion 36 Second engaging protrusion 37 Second guide groove 111 Flexible tubular body 112 Operating wire 113 Front-side fixed body (fixed body) 114 Support tubular body 100 Guide wire O Central axis (axis)

Claims

1. A guidewire operating member to be attached to a guidewire comprising: a flexible tubular body extending in a front-rear direction; an operating wire extending in the front-rear direction and provided inside the flexible tubular body; a fixed body to which a front end edge of the operating wire is fixed; and a support tubular body provided rearward of the fixed body, sandwiching the flexible tubular body between the fixed body and the flexible tubular body in the front-rear direction and having the operating wire inserted inside, the guidewire operating member comprising: a first tubular member fixed to a rear end of the support tubular body and extending in the front-rear direction; a second tubular member connected to a portion of the operating wire protruding rearward from the support tubular body and extending in the front-rear direction; and an outer tube extending in the front-rear direction and sheathed on the first tubular member and the second tubular member so as to be rotatable about an axis extending in the front-rear direction, the first tubular member and the second tubular member being provided in a state in which they are movable relative to each other in the front-rear direction and their relative rotation about the axis is restricted, a first guiding portion formed on an inner peripheral surface of the outer tube and an outer peripheral surface of the other of the first and second tubular members such that the front-to-rear distance between the fixed body and the front end of the support tube changes as the outer tube and the other tubular member rotate relative to each other about the axis; 2. A guidewire operating member as described in claim 1, wherein the first guide portion is composed of a first engaging protrusion and a first guide groove extending about the axis and housing the first engaging protrusion so as to be movably disposed about the axis, the first tubular member and the second tubular member are formed with second guide portions which allow relative movement in the front-to-rear direction while restricting relative rotation about the axis between the first tubular member and the second tubular member, the second guide portion is composed of a second engaging protrusion and a second guide groove extending in the front-to-rear direction and housing the second engaging protrusion so as to be movably disposed in the front-to-rear direction, and the first guide portion and the second guide portion are separated in the front-to-rear direction.

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