JP5995194B2 - Guide wire shaping equipment - Google Patents

Description

  The present invention relates to a shaping device for a guide wire used for shaping a guide wire by brazing it in advance according to the bending or branching of a body lumen.

  Conventionally, a guide wire is used to guide a treatment catheter such as a balloon catheter to a lesion in a body lumen such as a blood vessel. The guide wire is inserted in advance into the lesion in the body lumen before insertion of the treatment catheter, and the treatment catheter is guided to the lesion in the body lumen by pushing the treatment catheter over the guide wire and pushing it forward. It is like that.

  By the way, when a guide wire is inserted into a lesion in a body lumen, the guide wire insertion tip (distal end) is bent or bent in advance according to the bending or branching of the body lumen. Is generally done. This shaping operation is performed by the practitioner bending the finger with his / her finger before inserting the guide wire, etc., but it is not easy to shape the guide wire with a very small diameter to the preferred shape with the finger, and it takes time and effort. Needed.

  In addition, the guide wire is inserted into a cylindrical member such as a guide wire introducer, and the guide wire is pulled while pressing the tip of the guide wire protruding from the cylindrical member with a finger from the side, so that the guide wire is pulled into the inner periphery of the cylindrical member. It is also performed to bend or bend against the edge. However, the cylindrical member used for such shaping operation should not be originally used for shaping the guide wire, and the guide wire surface may be damaged by being pressed against the sharp inner peripheral edge. It was.

  In view of this, Japanese Patent Laid-Open No. 2012-65913 (Patent Document 1) proposes a guide wire shaping device for brazing such a guide wire. According to this guide wire shaping device, the distal end portion of the guide wire is pressed against the surface of the shaping device to bend or bend, whereby a predetermined shape can be imparted to the distal end portion of the guide wire. ing.

  However, as shown in FIG. 3 and FIG. 4 of Patent Document 1, it is difficult to perform the shaping work easily because it requires a fine work with the fingertips, and the work requires time and effort. There was a risk of becoming. Moreover, if the guide wire is bent or bent along the outer peripheral surface of the shaping device, the guide wire is likely to be displaced from the shaping device during the operation, and the guide wire may not be brazed to the intended shape.

JP 2012-65913 A

  The present invention has been made in the background of the above-mentioned circumstances, and a solution to the problem is for a guide wire having a novel structure in which the guide wire can be bent or bent by a simple operation. It is to provide a shaping device.

That is, the first aspect of the present invention, there is provided a guidewire for shaping instrument used to so shaped by bending deformation of the guide wire, the portion close to the position so shaped in the guide wire is a through state with insertion holes to be inserted is formed in the opening end surface of the distal end side of the insertion hole of the guide wire ya is projected toward the base end side of the guide wire as the distance to the outer peripheral side from the insertion hole It is characterized in that an inclined surface that is inclined and presses the guide wire protruding from the opening on the distal end side of the insertion hole is provided.

  According to the guide wire shaping device having the structure according to the first aspect as described above, by bending the distal end portion of the guide wire protruding from the opening on the distal end side of the insertion hole with a finger and pressing it against the inclined surface, It is possible to easily shape the tip of the guide wire. Therefore, the shaping according to the shape of the inclined surface can be stably realized with respect to the distal end portion of the guide wire, and the work time required for shaping can be shortened.

  Moreover, the inclined surface is inclined toward the proximal end side of the guide wire as it moves away from the insertion hole toward the outer peripheral side, and can be greatly deformed by pressing the distal end portion of the guide wire against the inclined surface. Even if the shape is restored by the springback, a sufficient amount of deformation is secured.

  According to a second aspect of the present invention, in the guidewire shaping device described in the first aspect, the insertion portion in which the insertion hole is formed and the gripping portion to be gripped by the fingers are connected to form a rod as a whole. The step surface is formed at the boundary between the insertion portion and the grip portion, and an opening portion on the base end side of the insertion hole is provided on the step surface.

  According to the 2nd aspect, since it is set as the rod shape, it becomes easy to hold | grip with a finger and the handling at the time of shaping work is made easy.

  In addition, by providing an opening on the base end side of the insertion hole on the step surface formed at the boundary between the insertion part and the gripping part, the guide wire is placed on the outer peripheral surface of the gripping part from the opening on the base end side of the insertion hole. It is possible to hold down the guide wire while grasping the grip portion with fingers. Therefore, the relative movement of the guide wire with respect to the insertion portion is prevented, and a change in the protruding amount from the insertion hole of the guide wire to the distal end side is prevented. Accordingly, the distal end portion of the guide wire is stably deformed into the target shape.

  According to a third aspect of the present invention, in the guidewire shaping device described in the second aspect, the insertion portion and the grip portion are integrally formed.

  According to the third aspect, the guide wire shaping device can be realized with a small number of parts by integrating the insertion portion and the grip portion.

  According to a fourth aspect of the present invention, in the guide wire shaping device described in the second or third aspect, a guide groove is formed on a surface of the grip portion, and the guide groove is a base of the insertion hole. It communicates with the opening on the end side.

  According to the 4th aspect, a guide wire can be guide | induced to the opening part of the base end side of an insertion hole, and can be easily inserted by pushing the front-end | tip of a guide wire along a guide groove. In addition, the guide wire can be prevented from being displaced more effectively by pressing the proximal end portion of the guide wire protruding from the proximal end side opening of the insertion hole with the fingers in a state of being along the guide groove.

  According to a fifth aspect of the present invention, in the guide wire shaping device described in any one of the first to fourth aspects, the insertion hole has an opening on the proximal end side rather than an opening on the distal end side. It has a large taper shape.

  According to the 5th aspect, it becomes easy to insert a guide wire from the opening part of a base end side with respect to an insertion hole, and simplification of a shaping operation is achieved. The entire insertion hole may be tapered, but for example, from the proximal end opening to the intermediate portion in the insertion hole is tapered and from the intermediate portion to the distal opening. It may be formed with a substantially constant hole cross-sectional shape.

  According to a sixth aspect of the present invention, in the guidewire shaping device described in any one of the first to fifth aspects, a support recess that is supported by a finger on the outer peripheral surface of the distal end portion is provided. It is what.

  According to the sixth aspect, it is possible to stably support the distal end portion of the guidewire shaping device to which an external force is applied during shaping by bringing the finger into contact with the support recess. . In particular, if the support recess is arranged opposite to the direction in which the external force is applied during shaping, the support force exerted by the finger contact effectively prevents the guide wire shaping device from being displaced by the external force. Thus, the shaping operation can be performed stably.

  According to the present invention, the distal end portion of the guide wire protruding from the opening on the distal end side of the insertion hole is pressed against the inclined surface provided on the opening end surface on the distal end side of the insertion hole, thereby Shape shaping can be performed easily. In addition, since the inclined surface is inclined toward the proximal end side of the guide wire as it moves away from the insertion hole toward the outer peripheral side, the distal end portion of the guide wire is sufficiently deformed by pressing against the inclined surface. Can be shaped.

The perspective view which shows the shaping instrument for guide wires as one Embodiment of this invention. The top view of the shaping device for guide wires shown by FIG. The bottom view of the shaping instrument for guide wires shown by FIG. The front view of the shaping device for guide wires shown in FIG. The right view of the shaping apparatus for guide wires shown by FIG. FIG. 2 is a left side view of the guide wire shaping device shown in FIG. 1. FIG. 2 is a diagram for explaining how to use the guide wire shaping device shown in FIG. 1, in which (a) shows a state in which the guide wire is inserted into the insertion hole, and (b) shows the guide wire shaping device in the left hand. The state where the guide wire is pressed is shown, and (c) shows the state where the tip of the guide wire is pressed with the right hand. It is a principal part expanded sectional view explaining the shaping | molding operation | work shown by FIG.7 (c), Comprising: (a) is the state which pressed the guide wire with the thumb of the right hand, (b) moved the thumb of the right hand. The state where the guide wire is pressed against the inclined surface is shown respectively.

  Embodiments of the present invention will be described below with reference to the drawings.

  1 to 6 show a guide wire shaping device (hereinafter referred to as a shaping device) 10 as an embodiment of the present invention. The shaping device 10 is used for shaping a distal end portion of a guide wire 34, which will be described later, and has a circular rod shape as a whole and is large enough to be grasped and held with one hand. Yes. In the following description, as a general rule, the tip side is the right side in FIG. 2 which is one side in the axial direction, and the base side is the left side in FIG. Means the vertical direction in FIG. 4, and the width direction means the vertical direction in FIG.

  More specifically, the shaping device 10 includes an insertion portion 14 that forms a distal end portion and a grip portion 16 that forms a proximal end portion. The shaping device 10 is a hard member, and is formed of, for example, a synthetic resin such as polypropylene, polyethylene, or polystyrene, or a metal such as stainless steel.

  The insertion portion 14 has a circular cross section and extends in the axial direction, and an insertion hole 18 through which a guide wire 34 described later is inserted is formed on the central axis. The insertion hole 18 is a hole extending in a substantially circular cross section with a small diameter corresponding to the outer diameter dimension of the guide wire 34, extends linearly on the central axis of the insertion part 14, and the opening on the distal end side is the insertion part. 14 is open to a circular plane 20 at the tip surface. Further, the insertion hole 18 is formed in a tapered hole shape in which the opening on the proximal end side has a larger diameter than the opening on the distal end side, and the inner diameter dimension changes continuously.

  Furthermore, the distal end portion of the insertion portion 14 has a substantially truncated cone shape that gradually decreases in diameter toward the outer side in the axial direction, and the distal end surface of the insertion portion 14 has a circular plane 20 at the center portion and an inclined surface 22 at the outer peripheral portion. It has. The circular plane 20 extends in a direction substantially perpendicular to the axis, and an opening on the tip side of the insertion hole 18 is provided at the center thereof. The inclined surface 22 is an annular tapered surface that extends to the outer peripheral side of the circular plane 20 and has a truncated cone side surface shape that gradually inclines in the axial direction (base end side) as it goes to the outer peripheral side. Thereby, the inclined surface 22 is provided over the entire circumference so as to surround the periphery of the insertion hole 18, and is inclined to the proximal end side as it is separated from the insertion hole 18 toward the outer peripheral side. In addition, the connection part of the circular plane 20 and the inclined surface 22 is formed into a minute arc shape by chamfering or the like so as not to have a sharp angle. Similarly, a minute arc shape by chamfering or the like is given to a connection portion between the outer peripheral end of the inclined surface 22 and the outer peripheral surface of the insertion portion 14.

  The gripping portion 16 extends in the axial direction with a substantially constant semicircular cross section, and the upper surface is configured by a plane. Further, a minute step 24 is formed on the upper surface of the gripping portion 16, and the tip portion is a wire holding portion 26 protruding upward from the base end portion. The wire holding portion 26 is formed with a guide groove 28 that extends linearly in the axial direction while opening on the upper surface. The guide groove 28 is a concave groove having a substantially semicircular cross section with a small diameter corresponding to an outer diameter dimension of a guide wire 34 described later, and a base end opening is formed in the step 24. The vertical dimension of the step 24 is set to be approximately the same as the maximum depth dimension of the guide groove 28.

  The insertion portion 14 and the grip portion 16 are integrally formed of synthetic resin in the present embodiment, and are connected in series in the axial direction. By inserting the gripping part 16 having a semicircular cross section having the same diameter as the insertion part 14 to the insertion part 14 having a circular cross section, the insertion part 14 is provided at the boundary between the insertion part 14 and the gripping part 16. A step surface 30 constituted by the base end surface is formed. An opening on the base end side of the insertion hole 18 is provided at the center of the lower end of the stepped surface 30, and the distal end of the guide groove 28 is connected to and communicates with the base end opening of the insertion hole 18. In addition, as FIG. 6 also shows, the level | step difference surface 30 of this embodiment is made into the inclination plane which inclines gradually to a front end side as it goes upwards.

  Further, as shown in FIGS. 3 and 6, a support recess 32 that opens to the lower surface is formed at the distal end portion of the shaping device 10 including the boundary portion between the insertion portion 14 and the grip portion 16. . The support recess 32 has a curved cross-sectional shape that gradually becomes deeper toward the center in the axial direction and has a groove shape extending in the width direction. The support recess 32 is formed in a shape and size that can be easily supported by fingers (especially the second finger). ing.

  The shaping device 10 having such a structure is used to shape the distal end portion of the guide wire 34 by bending or bending it. Hereinafter, the shaping operation of the guide wire 34 using the shaping device 10 will be exemplified.

  First, as shown in FIG. 7A, the guide wire 34 is inserted into the insertion hole 18, and the distal end portion of the guide wire 34 to be given a predetermined shape is projected from the distal end opening portion of the insertion hole 18. . In the shaping device 10 of this embodiment, the guide wire 34 can be easily inserted into the insertion hole 18. That is, by pushing the guide wire 34 toward the distal end side while pushing the distal end of the guide wire 34 against the guide groove 28, the distal end of the guide wire 34 is guided to the proximal end opening of the insertion hole 18 and can be easily inserted. It has become. Furthermore, the insertion hole 18 has a larger diameter toward the proximal end opening, and the guide wire 34 can be more easily inserted into the insertion hole 18.

  Next, as shown in FIG. 7B, with the left hand 36 grasping and holding the gripping portion 16 with the tip of the guide wire 34 protruding from the insertion hole 18 to the tip side by a predetermined length. At the same time, the thumb (first finger) of the left hand 36 is superposed on the upper surface of the wire holding portion 26 provided at the distal end portion of the gripping portion 16, and the guide wire 34 is pressed against the upper surface of the wire holding portion 26 for positioning. . In this embodiment, the guide wire 34 is stably moved without moving on the wire holding portion 26 by holding the intermediate portion of the guide wire 34 positioned on the wire holding portion 26 along the guide groove 28. It is designed to be positioned.

  While gripping the grip 16 with the left hand 36 in this way, as shown in FIG. 7C, the right hand 38 holds and supports the insertion portion 14 and the tip of the grip 16, and the right hand 38 The thumb is made to approach the guide wire 34 from above along the distal end surface of the insertion portion 14. Then, as shown in FIG. 8, the distal end portion of the guide wire 34 is bent with the thumb of the right hand 38 and pressed against the distal end surface of the insertion portion 14, so that the distal end portion of the guide wire 34 has a predetermined curved shape. Or a bent shape is given. In the shaping device 10 of the present embodiment, the index finger (second finger) of the right hand 38 is brought into contact with the support recess 32 to support the tip portion of the shaping device 10, whereby the thumb of the right hand 38 and the shaping device 10 are supported. The shaping device 10 can be prevented from moving in the twisting direction by the frictional force acting between the front end surface and the shaping operation can be performed stably.

  In the shaping device 10 of the present embodiment, the central portion of the tip surface is a circular plane 20 and the outer peripheral portion of the tip surface is an inclined surface 22 that is inclined with respect to the circular plane 20. As a result, as shown in FIG. 8A, the guide wire 34 is bent at the distal end opening of the insertion hole 18, and the guide is formed at the connection between the circular plane 20 and the inclined surface 22 in FIG. 8B. The wire 34 can be bent.

  The guide wire 34 is displaced relative to the distal end side or the proximal end side with respect to the shaping device 10 and the shaping operation shown in FIGS. A smoother curved shape, a multistage bent shape whose angle changes stepwise, and the like can also be provided. Further, the guide wire 34 is rubbed against the distal end surface of the shaping device 10 by pulling the guide wire 34 toward the proximal end side in the state of FIG. Thus, the distal end portion of the guide wire 34 can be deformed into a curved shape.

  In addition, when shaping the distal end portion of the guide wire 34 is repeated, it is not necessary to deform only in one vertical direction, and it can be bent or bent in any direction. In particular, in this embodiment, the inclined surface 22 is formed over the entire circumference, and the distal end surface of the insertion portion 14 has a substantially constant shape around the insertion hole 18. By changing the direction of pressing with the thumb without rotating the wire 34, the guide wire 34 can be deformed in an arbitrary direction.

  According to the shaping device 10 having the structure according to the present embodiment as described above, the distal end portion of the guide wire 34 projected from the insertion hole 18 is pressed against the inclined surface 22, whereby the distal end portion of the guide wire 34 is pressed. A predetermined shape can be easily provided. Therefore, the necessary predetermined shape can be stably obtained while shortening the preparation time before inserting the guide wire 34 into the body lumen.

  Moreover, if the guide wire 34 is pressed against the inclined surface 22 and shaped, the guide wire 34 is less likely to be damaged than when the shape is shaped by squeezing with a finger or a cylindrical member. Furthermore, the inner and outer peripheral edge portions of the inclined surface 22 are all rounded by chamfering or the like, so that the guide wire 34 can be prevented from being damaged by being pressed against a sharp edge. In addition, if the insertion part 14 is formed with a synthetic resin, damage to the guide wire 34 is prevented more advantageously.

  In addition, the shaping device 10 is used by being gripped by hand and does not require a fine work with only the fingertips, so the operation is extremely simple and the storage and management of the device is also easy. is there.

  In addition, the lower surface of the gripping portion 16 is an arcuate curved surface that is easy to grip, making it easy to grip, and the upper surface of the gripping portion 16 is a flat surface, and positioning is performed by pressing the guide wire 34 with a thumb. It is easy to hold.

  In addition, a support recess 32 that opens to the lower surface is formed at the distal end portion of the shaping device 10 including the boundary between the insertion portion 14 and the gripping portion 16, and an appropriate position of the distal end portion of the shaping device 10 due to the tactile sensation of the fingertip. Can be determined and supported by fingers.

  In addition, the front end of the thumb of the left hand 36 is brought into contact with the stepped surface 30 formed at the boundary between the insertion portion 14 and the gripping portion 16 so as to protrude from the proximal end opening portion of the insertion hole 18 in the guide wire 34. The part to do is held securely. Further, since the thumb is positioned in the axial direction by the contact with the step surface 30, the position of the guide wire 34 is prevented from being displaced due to the movement of the finger, and the guide wire 34 protruding from the distal end opening of the insertion hole 18 is prevented. You can keep the length. In particular, in the present embodiment, since the step surface 30 is inclined toward the tip side as it goes upward, the position closer to the base end opening of the insertion hole 18 in a state where the tip of the thumb is in contact with the step surface 30. Thus, the guide wire 34 can be pressed and positioning of the guide wire 34 is realized more advantageously.

  As mentioned above, although embodiment of this invention was explained in full detail, this invention is not limited by the specific description. For example, in the above-described embodiment, the inclined surface 22 spreads at a substantially constant inclination angle in the longitudinal section. However, as the inclined surface, the inclination angle continuously changes to exhibit a curved shape in the longitudinal section, It is also possible to employ one that has a polygonal shape in a longitudinal section with the angle changing stepwise.

  Furthermore, the inclined surface does not necessarily need to be provided over the entire circumference, for example, a structure partially provided in a part of the circumference, or partially formed in a plurality of places on the circumference. Any structure that extends in different radial directions can be used. Specifically, the inclined surface may be constituted by a part or a plurality of portions of the frustoconical side surface extending at a predetermined circumferential length, or the inclined surface may be formed by a plane extending in the radial direction while inclining toward the base end side. It may be configured. In addition, for example, an inclined plane inclined in one direction can be provided as the distal end surface of the insertion portion 14, and the inclined surface can be configured by a part of the inclined plane.

  Furthermore, the circular plane 20 is not essential, and may be omitted and the inclined surface may have a conical side surface shape, or a hemispherical curve convex toward the tip side with respect to the central portion where the circular plane 20 is provided. A surface may be provided.

  The insertion hole 18 does not necessarily extend linearly on the central axis of the insertion part 14. For example, the insertion hole 18 extends obliquely with respect to the central axis, and the opening on the distal end side is the central axis of the insertion part 14. While opening upwards, the opening part of the base end side may open to the outer peripheral surface of the insertion part 14.

  Further, it is desirable to provide a step surface 30 at the boundary between the insertion portion 14 and the gripping portion 16 and provide an opening on the base end side of the insertion hole 18 in the step surface 30, but the step surface 30 is not essential. Specifically, for example, a guide wire shaping device is formed into a rod shape with a substantially constant cross section throughout, and an insertion hole is formed on the central axis thereof, and the opening on the tip side of the insertion hole is shaped. While opening to the front end surface of an instrument, the opening part of the base end side of an insertion hole may be opening to the base end surface of a shaping instrument.

  Further, as shown in the above embodiment, the shaping device is preferably a rod shape having a cylindrical surface on the outer peripheral surface from the viewpoint of ease of gripping, etc., but the shape is particularly limited. The shape may be an elliptical columnar shape, a polygonal columnar shape or the like, or a plate shape or a block shape.

  Further, in the shaping device of the above embodiment, only one concave portion is formed at the tip portion that can grasp the contact position of the finger with a tactile sensation. Can be guided to the correct way of holding. In addition, the shaping device does not necessarily have to be a linear rod shape, and may be curved and extended as a whole so as to be easily grasped, and a protrusion for defining the position of the finger is provided on the outer peripheral surface. May be.

  Moreover, although how to hold the shaping device 10 is shown in FIG. 7, this is merely an example and is not limited. Specifically, for example, when gripping the grip 16 with the left hand 36, the index finger of the left hand 36 is brought into contact with the support recess 32 to support the shaping device 10 with only the left hand 36 and the insertion hole is inserted with the finger of the right hand The tip of the guide wire 34 protruding from 18 can be pressed and pressed against the inclined surface 22 for shaping.

  In FIGS. 7 and 8, the guide wire shaping device 10 is grasped with the left hand 36, but the shaping device 10 may be grasped with the right hand 38. In that case, the shaping device 10 can be supported only by the right hand 38, and the tip of the guide wire 34 protruding from the insertion hole 18 can be pressed by the finger of the left hand 36 and pressed against the inclined surface 22. it can.

10: Guide wire shaping device, 14: insertion portion, 16: gripping portion, 18: insertion hole, 22: inclined surface, 28: guide groove, 30: step surface, 32: support recess, 34: guide wire, 36: Left hand, 38: Right hand

Claims (6)

Guide wire is deformed bending a guidewire shaping instrument used to so shaped,
Wherein with insertion hole portion adjacent to a position so shaped in the guide wire is inserted in the through state is formed, at the opening end surface of the distal end side of the insertion hole of the guide wire Ya is protruded, the insertion hole An inclined surface is provided which is inclined toward the proximal end side of the guide wire as it moves away from the outer peripheral side and presses the guide wire protruding from the opening on the distal end side of the insertion hole. Guide wire shaping equipment.   The insertion portion in which the insertion hole is formed and the grip portion to be gripped by a finger are connected to form a rod shape as a whole, and a step surface is formed at the boundary between the insertion portion and the grip portion. The shaping device for a guide wire according to claim 1, wherein an opening on the base end side of the insertion hole is provided on the surface.   The guide wire shaping device according to claim 2, wherein the insertion portion and the grip portion are integrally formed.   The guide wire shaping device according to claim 2 or 3, wherein a guide groove is formed on a surface of the grip portion, and the guide groove communicates with an opening on a proximal end side of the insertion hole.   The guide wire shaping device according to any one of claims 1 to 4, wherein the insertion hole has a tapered shape in which an opening on a proximal end side is made larger than an opening on a distal end side.   The shaping instrument for guide wires according to any one of claims 1 to 5, wherein a support recess that is abutted and supported by a finger is provided on the outer peripheral surface of the distal end portion.

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