Medical instrument and medical equipment for treatment, and rotational handle device

• US 20070088230A1
• Filed: 09/06/2006
• Published: 04/19/2007
• Est. Priority Date: 09/06/2005
• Status: Abandoned Application

• Current Assignee: FMD Co., Ltd.
• Original Assignee: FMD Co., Ltd.
• Inventors: Shimura, Seiji, Terashi, Tsuyoshi
• Application Number:
  US11/515,838
• Publication Number:
  US 20070088230A1
• Time in Patent Office: Days
• US Class Current: 600/585
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2090/031 torque limiting
• CPC Class Codes: A61M 2025/09083 having a coil around a core
• CPC Class Codes: A61M 2025/09125 Device for locking a guide wire in a fixed position with respect to the catheter or the human body
• CPC Class Codes: A61M 25/0043 characterised by structural features
• CPC Class Codes: A61M 25/0069 Tip not integral with tube
• CPC Class Codes: A61M 25/0097 characterised by the hub connectors A61M39/10
• CPC Class Codes: A61M 25/09 Guide wires

Abstract

A rotational handle device rotates a medical instrument for vascular treatment in a tubular form including a tube for insertion by guiding of a medical guide wire inside. The tube includes a helical coil of metal, a tubular tip of metal secured to an end of the helical coil, and a cutting head of a blade shape, formed on the tubular tip, for cutting a lesion upon being rotated. A first rotatable tube rotates with the tube, and has a wire lumen. An externally operable second rotatable tube is secured to the first rotatable tube in an axial direction. An over torque preventing mechanism is disposed between the first and second rotatable tubes, and causes the second rotatable tube to rotate free from the first rotatable tube upon application of torque higher than the predetermined level to the second rotatable tube.

Claims

1. A medical instrument for treatment in a tubular form including a tube for insertion by guiding of a medical guide wire inside, said medical instrument comprising:

said tube including;

a helical coil of metal;

a tubular tip of metal secured to an end of said helical coil; and

a cutting head of a blade shape, formed on said tubular tip, for cutting a lesion upon being rotated.

2. A medical instrument for treatment as defined in claim 1, wherein said tubular tip has a shape with a decreasing diameter toward a distal end thereof.

3. A medical instrument for treatment as defined in claim 2, wherein said tubular tip includes a U shaped cut or V shaped notch, formed in said cutting head at a front face and an outer face thereof, and directed in a direction along a tubular tip axis.

4. A medical instrument for treatment as defined in claim 2, wherein said cutting head includes a cut, formed to retreat from a front end face thereof, and having a cut surface inclined with reference to an axis of said tubular tip.

5. A medical instrument for treatment as defined in claim 2, wherein said tubular tip includes a spiral groove formed in a tubular tip outer surface to extend helically from a front end face of said cutting head.

6. A medical instrument for treatment as defined in claim 2, wherein said helical coil is a multi filament helical coil constituted by helically wound plural wires of metal.

7. A medical instrument for treatment as defined in claim 2, wherein said helical coil is shaped by helically winding a wire after twisting plural strands of metal in a form of said wire.

8. A medical instrument for treatment as defined in claim 2, wherein said helical coil is so wound as to decrease a diameter upon being rotated in a first rotational direction, and causes said cutting head to cut said lesion.

9. A medical instrument for treatment as defined in claim 2, wherein said helical coil has a shape with a decreasing diameter toward a distal end thereof.

10. A medical instrument for treatment as defined in claim 2, wherein said tubular tip is radiopaque.

11. A rotational handle device for rotating a medical instrument for treatment in a tubular form including a tube for insertion by guiding of a medical guide wire inside, said rotational handle device comprising:

wherein said tube includes a helical coil of metal, a tubular tip of metal secured to an end of said helical coil, and a cutting head of a blade shape, formed on said tubular tip, for cutting a lesion upon being rotated;

a first rotatable tube for rotating with said tube, said first rotatable tube having a wire lumen for receiving insertion of said medical guide wire;

an externally operable second rotatable tube secured to said first rotatable tube in an axial direction;

an over torque preventing mechanism, disposed between said first and second rotatable tubes, for transmitting rotation of said second rotatable tube to said first rotatable tube upon application of torque equal to or lower than a predetermined level to said second rotatable tube, and for causing said second rotatable tube to rotate free from said first rotatable tube upon application of torque higher than said predetermined level to said second rotatable tube.

12. A rotational handle device as defined in claim 11, wherein one of said first and second rotatable tubes has a retaining projection, and a remaining one thereof has a retaining recess engageable with said retaining projection;

said over torque preventing mechanism includes;

a tube support for keeping said first and second rotatable tubes movable in said axial direction between first and second positions, wherein said retaining projection retains said retaining recess when said first and second rotatable tubes are in said first position, and releases said retaining recess when said first and second rotatable tubes are in said second position;

a biasing portion for biasing said first or second rotatable tube with a predetermined bias, for retaining said first and second rotatable tubes in said first position upon application of said torque equal to or lower than said predetermined level, to rotate said first and second rotatable tubes together, and for setting said first and second rotatable tubes in said second position upon application of said torque higher than said predetermined level, to rotate said second rotatable tube free from said first rotatable tube.

13. A rotational handle device as defined in claim 12, wherein said retaining projection is a plurality of first ridges formed on a tube end face of said first rotatable tube to extend radially;

said second rotatable tube includes a plurality of second ridges formed on a tube end face thereof to extend radially, to define said retaining recess between, for mesh with said first ridges when said first and second rotatable tubes are in said first position, and for disengagement from said first ridges when said first and second rotatable tubes are in said second position.

14. A rotational handle device as defined in claim 13, wherein said first and second ridges are teeth, and are in a triangular shape as viewed in a section perpendicular to a direction of extending radially.

15. A rotational handle device as defined in claim 11, wherein said over torque limiting mechanism includes:

a first gear formed on said first rotatable tube;

a second gear, formed on said second rotatable tube, for mesh with said first gear;

a biasing portion for pressing said second gear on said first gear;

wherein said second gear is rotatable free from said first gear when said torque applied to said first and second gears becomes higher than said predetermined level.

16. A rotational handle device as defined in claim 11, wherein said first rotatable tube includes a shaft for supporting said second rotatable tube in a rotatable manner;

said over torque preventing mechanism includes;

a shaft recess formed in said shaft;

a lock ball engageable with said shaft recess;

a ball chamber for containing said lock ball movably between a first position where said lock ball is shifted in said shaft recess and a second position where said lock ball is offset from said shaft recess;

a biasing portion for biasing said lock ball with a predetermined bias, for retaining said lock ball in said first position upon application of said torque equal to or lower than said predetermined level, to rotate said first and second rotatable tubes together, and for setting said lock ball in said second position upon application of said torque higher than said predetermined level, to rotate said second rotatable tube free from said first rotatable tube.

17. A rotational handle device as defined in claim 16, further comprising an adjuster for adjusting said biasing portion in relation to said bias.

18. A rotational handle device as defined in claim 11, wherein said second rotatable tube includes a first sleeve and a second sleeve having a smaller diameter than said first sleeve.

19. A medical equipment for treatment, comprising:

a medical instrument for treatment in a tubular form including a tube for insertion by guiding of a medical guide wire inside;

wherein said tube includes a helical coil of metal, a tubular tip of metal secured to an end of said helical coil, and a cutting head of a blade shape, formed on said tubular tip, for cutting a lesion upon being rotated;

a first rotatable tube for rotating with said tube, said first rotatable tube having a wire lumen for receiving insertion of said medical guide wire;

a connector for removably connecting said tube with said first rotatable tube;

an externally operable second rotatable tube, secured to said first rotatable tube in an axial direction, for rotationally operating said medical instrument on a proximal side; and

an over torque preventing mechanism, disposed between said first and second rotatable tubes, for transmitting rotation of said second rotatable tube to said first rotatable tube upon application of torque equal to or lower than a predetermined level to said second rotatable tube, and for causing said second rotatable tube to rotate free from said first rotatable tube upon application of torque higher than said predetermined level to said second rotatable tube.

20. A guide wire fitted medical equipment for treatment, comprising:

a medical instrument for treatment in a tubular form including a tube;

wherein said tube includes a helical coil of metal, a tubular tip of metal secured to an end of said helical coil, and a cutting head of a blade shape, formed on said tubular tip, for cutting a lesion upon being rotated;

a first rotatable tube for rotating with said tube, said first rotatable tube having a wire lumen;

a connector for removably connecting said tube with said first rotatable tube;

an externally operable second rotatable tube, secured to said first rotatable tube in an axial direction, for rotationally operating said medical instrument on a proximal side;

an over torque preventing mechanism, disposed between said first and second rotatable tubes, for transmitting rotation of said second rotatable tube to said first rotatable tube upon application of torque equal to or lower than a predetermined level to said second rotatable tube, and for causing said second rotatable tube to rotate free from said first rotatable tube upon application of torque higher than said predetermined level to said second rotatable tube;

a medical guide wire, having a helical coil on at least a distal end thereof, for guiding insertion of said tube and said first rotatable tube thereabout;

wherein a direction of winding of said helical coil of said medical instrument is reverse to a direction of winding of said helical coil of said medical guide wire.

21. A rotational handle device for rotationally operating a medical instrument for treatment on a proximal side, said medical instrument in a tubular form including a tube for insertion by guiding of a medical guide wire inside, wherein said tube includes a helical coil of metal, and a tip secured to an end of said helical coil, said rotational handle device comprising:

a first rotatable tube for rotating with said tube, said first rotatable tube having a wire lumen for receiving insertion of said medical guide wire;

an externally operable second rotatable tube secured to said first rotatable tube in an axial direction;

an over torque preventing mechanism, disposed between said first and second rotatable tubes, for transmitting rotation of said second rotatable tube to said first rotatable tube upon application of torque equal to or lower than a predetermined level to said second rotatable tube, and for causing said second rotatable tube to rotate free from said first rotatable tube upon application of torque higher than said predetermined level to said second rotatable tube.

22. A rotational handle device as defined in claim 21, wherein one of said first and second rotatable tubes has a retaining projection, and a remaining one thereof has a retaining recess engageable with said retaining projection;

said over torque preventing mechanism includes;

a tube support for keeping said first and second rotatable tubes movable in said axial direction between first and second positions, wherein said retaining projection retains said retaining recess when said first and second rotatable tubes are in said first position, and releases said retaining recess when said first and second rotatable tubes are in said second position;

a biasing portion for biasing said first or second rotatable tube with a predetermined bias, for retaining said first and second rotatable tubes in said first position upon application of said torque equal to or lower than said predetermined level, to rotate said first and second rotatable tubes together, and for setting said first and second rotatable tubes in said second position upon application of said torque higher than said predetermined level, to rotate said second rotatable tube free from said first rotatable tube.

23. A rotational handle device as defined in claim 22, wherein said retaining projection is a plurality of first ridges formed on a tube end face of said first rotatable tube to extend radially;

said second rotatable tube includes a plurality of second ridges formed on a tube end face thereof to extend radially, to define said retaining recess between, for mesh with said first ridges when said first and second rotatable tubes are in said first position, and for disengagement from said first ridges when said first and second rotatable tubes are in said second position.

24. A rotational handle device as defined in claim 23, wherein said first and second ridges are teeth, and are in a triangular shape as viewed in a section perpendicular to a direction of extending radially.

25. A rotational handle device as defined in claim 21, wherein said over torque limiting mechanism includes:

a first gear formed on said first rotatable tube;

a second gear, formed on said second rotatable tube, for mesh with said first gear;

a biasing portion for pressing said second gear on said first gear;

wherein said second gear is rotatable free from said first gear when said torque applied to said first and second gears becomes higher than said predetermined level.

26. A rotational handle device as defined in claim 21, wherein said first rotatable tube includes a shaft for supporting said second rotatable tube in a rotatable manner;

said over torque preventing mechanism includes;

a shaft recess formed in said shaft;

a lock ball engageable with said shaft recess;

a ball chamber for containing said lock ball movably between a first position where said lock ball is shifted in said shaft recess and a second position where said lock ball is offset from said shaft recess;

a biasing portion for biasing said lock ball with a predetermined bias, for retaining said lock ball in said first position upon application of said torque equal to or lower than said predetermined level, to rotate said first and second rotatable tubes together, and for setting said lock ball in said second position upon application of said torque higher than said predetermined level, to rotate said second rotatable tube free from said first rotatable tube.

27. A rotational handle device as defined in claim 26, further comprising an adjuster for adjusting said biasing portion in relation to said bias.

28. A rotational handle device as defined in claim 21, wherein said second rotatable tube includes a first sleeve and a second sleeve having a smaller diameter than said first sleeve.

29. A medical equipment for treatment, comprising:

a medical instrument for treatment in a tubular form including a tube for insertion by guiding of a medical guide wire inside, wherein said tube includes a helical coil of metal, and a tip secured to an end of said helical coil;

a first rotatable tube for rotating with said tube, said first rotatable tube having a wire lumen for receiving insertion of said medical guide wire;

a connector for removably connecting said tube with said first rotatable tube;

an externally operable second rotatable tube, secured to said first rotatable tube in an axial direction, for rotationally operating said medical instrument on a proximal side; and

an over torque preventing mechanism, disposed between said first and second rotatable tubes, for transmitting rotation of said second rotatable tube to said first rotatable tube upon application of torque equal to or lower than a predetermined level to said second rotatable tube, and for causing said second rotatable tube to rotate free from said first rotatable tube upon application of torque higher than said predetermined level to said second rotatable tube.

30. A guide wire fitted medical equipment for treatment, comprising:

a medical instrument for treatment in a tubular form including a tube, wherein said tube includes a helical coil of metal, and a tip secured to an end of said helical coil;

a first rotatable tube for rotating with said tube, said first rotatable tube having a wire lumen;

a connector for removably connecting said tube with said first rotatable tube;

an externally operable second rotatable tube, secured to said first rotatable tube in an axial direction, for rotationally operating said medical instrument on a proximal side;

an over torque preventing mechanism, disposed between said first and second rotatable tubes, for transmitting rotation of said second rotatable tube to said first rotatable tube upon application of torque equal to or lower than a predetermined level to said second rotatable tube, and for causing said second rotatable tube to rotate free from said first rotatable tube upon application of torque higher than said predetermined level to said second rotatable tube;

a medical guide wire, having a helical coil on at least a distal end thereof, for guiding insertion of said tube and said first rotatable tube thereabout;

wherein a direction of winding of said helical coil of said medical instrument is reverse to a direction of winding of said helical coil of said medical guide wire.