JP7439619B2 - Stent for luminal interorgan bypass - Google Patents

Description

The present invention relates to a stent for bypass between hollow organs, which connects a hollow organ to another hollow organ by bypass.

In recent years, endoscopic ultrasound-guided biliary drainage (EUS-BD) has been used in cases of unresectable malignant biliary stenosis or obstruction that require biliary drainage and in which transduodenal papillary approach is not possible. There are reports of ultrasound-guided biliary drainage. EUS-BD involves inserting an ultrasound endoscope into the stomach or duodenum, puncturing the bile duct or gallbladder through the stomach or duodenal wall with a puncture needle while observing ultrasound images in real time, and inserting a guide wire into the bile duct or gallbladder. This is a procedure in which a bypass stent is inserted and placed so as to bridge the stomach wall or duodenal wall and the bile duct or gallbladder. This procedure allows bile duct drainage by implanting a stent inside the body.

Examples of stents used in EUS-BD include covered stents in which the surface of a metal stent base material is covered with a cover material made of a polymer film. Further, as a covered stent particularly suitable for use in EUS-BD, a covered stent having a hooking portion for preventing migration and the like has been proposed (see Patent Document 1).

In addition, the stent is often released from the stent delivery system and placed at the target site while checking the radiopaque marker provided near the distal end of the stent or stent delivery system under X-ray fluoroscopy. However, in recent years, a method has also been adopted in which the stent is released from the stent delivery system while checking images captured by an endoscopic camera on a monitor or the like.

International Publication No. WO2019/019459

When indwelling a stent that has a stent retention part such as a hooking part to prevent migration, the stent should be placed at the stent placement position in order to withstand deformation of the hollow organ and maintain bypass. It is necessary to determine and arrange the retaining part at an appropriate position. However, when placing a stent while checking images taken by an endoscopic camera, it may be difficult to check the stent removal prevention part housed in the stent delivery system from the images taken by the endoscopic camera. A problem may arise in that the position of the stent cannot be properly controlled to accurately deploy the stent. In particular, if the stent is placed in a state where part or all of the stent retention part is outside the hollow organ, a problem arises in that the stent retention part cannot sufficiently perform its function of preventing migration and the like.

The present invention has been made in view of the above-mentioned problems, and provides a stent for luminal interorgan bypass that can be placed in a precise position and in a precise state while being photographed by an endoscopic camera. With the goal.

In order to achieve the above object, a stent for a luminal organ bypass according to the present invention is a stent for a luminal organ bypass for connecting a luminal organ and another luminal organ by bypass, and comprises:
An elongated cylindrical main body,
a stent retainer for preventing displacement of the main body in the axial direction;
a colored area forming part that forms a colored area on the outer circumferential surface of the main body part that allows the position of the stent retaining part to be specified;
It is characterized by having the following.

According to this configuration, when the stent for luminal inter-organ bypass is placed in the body, the colored area formed on the outer circumferential surface of the stent for luminal inter-organ bypass can be confirmed from the image taken by the endoscopic camera. This makes it possible to specify the position of the stent-removal prevention portion provided on the stent for luminal inter-organ bypass. As a result, it becomes possible to appropriately control the position of the stent removal prevention part and to indwell the stent for luminal inter-organ bypass at an accurate position in an accurate state.

Furthermore, in the stent for a luminal inter-organ bypass according to the present invention, the stent removal prevention part, which can be identified by the colored area, may be provided at one end in the axial direction of the main body part.

According to this configuration, for example, the position of the stent removal prevention portion provided on the proximal side of the stent for luminal inter-organ bypass can be specified by the colored region. When a stent for bypass between luminal organs is released from the stent delivery system, the inside of the luminal organ is photographed using an endoscopic camera, and it is confirmed whether colored areas are visible in this photographed image. By doing so, it is possible to reliably confirm that the stent removal preventing portion is inside the hollow organ, and the position of the stent removal preventing portion can also be easily specified.

Furthermore, in the stent for a luminal inter-organ bypass according to the present invention, on the outer circumferential surface of the main body part, the edge part of the colored area is formed along the circumferential direction so as to pass through the position of the stent removal prevention part. It's okay.

According to this configuration, the position of the stent retention part can be determined by checking the edge of the ring-shaped colored area formed on the outer peripheral surface of the stent for luminal interorgan bypass from the image taken by the endoscopic camera. be easily identified.

Furthermore, the stent for luminal inter-organ bypass according to the present invention has an end hooking part provided at one end in the axial direction of the main body part as the stent removal prevention part,
A peripheral portion of the colored region may be formed along the circumferential direction so as to pass through the one end portion.

According to this configuration, by confirming the edge of the colored region formed in a ring shape on the outer peripheral surface of the stent for luminal organ-to-organ bypass from the captured image of the endoscopic camera, The position of the end hooking portion provided at the proximal end of the stent can be identified. In addition, since the end hooking part is provided at one end of the main body, the end hooking part contacts the inner wall of the hollow organ and functions as an anchor, effectively preventing migration. become able to.

Furthermore, in the stent for luminal inter-organ bypass according to the present invention, the end hooking portion may include:
Composed of an elastic linear member,
a proximal end portion integrally connected to the one end portion, and a distal end portion having a free end;
an intermediate portion between the proximal end and the distal end is curved;
At least a portion of the tip portion and the intermediate portion may be arranged radially outward from the outer circumferential surface.

According to this configuration, the distal end portion or the intermediate portion of the end hooking portion having elasticity can come into contact with the inner wall of the hollow organ, and migration of the stent for bypass between hollow organs can be effectively prevented. Further, since the intermediate portion of the end hooking portion is curved, the risk of the inner wall surface of the hollow organ being damaged by the end hooking portion can be reduced.

Furthermore, the stent for luminal inter-organ bypass according to the present invention has a main body hooking part provided on the outer circumferential surface of the main body part other than both ends in the axial direction as the stent removal preventing part,
A peripheral portion of the colored region may be formed along the circumferential direction so as to pass through the position of the main body hooking portion.

According to this configuration, by checking the edges of the colored area formed on the stent for luminal inter-organ bypass from the captured image of the endoscopic camera, It becomes possible to specify the position of the main body hooking part provided on the outer peripheral surface. In addition, since the main body hooking portion is provided on the outer circumferential surface of the main body other than both ends in the axial direction, the main body hooking contacts the inner wall of the hollow organ and functions as an anchor, thereby allowing the connection between the hollow organs. Migration of bypass stents can be effectively prevented.

Furthermore, in the stent for luminal inter-organ bypass according to the present invention, the main body hooking portion may include:
Composed of an elastic linear member,
having a proximal end portion integrally connected to the outer circumferential surface of the main body portion, and a distal end portion having a free end;
an intermediate portion between the proximal end and the distal end is curved;
At least a portion of the tip portion and the intermediate portion may be arranged radially outward from the outer circumferential surface.

According to this configuration, the distal end or intermediate portion of the main body hooking portion having elasticity can come into contact with the inner wall of the hollow organ, and migration of the stent for bypass between hollow organs can be effectively prevented. Further, since the intermediate portion of the main body hooking portion is curved, the risk of the inner wall surface of the hollow organ being damaged by the main body hooking portion can be reduced.

Furthermore, the stent for a luminal inter-organ bypass according to the present invention has, as the stent removal prevention part, an enlarged diameter part that is a part of the main body part and has a larger outer diameter than the other part of the main body part,
A peripheral portion of the colored region may be formed along the circumferential direction so as to pass through the position of the enlarged diameter portion.

According to this configuration, the edges of the colored region formed in a ring shape on the stent for luminal organ-to-organ bypass can be confirmed from images captured by the endoscopic camera, and the stent is provided for the purpose of preventing migration. It becomes possible to specify the position of the enlarged diameter part.

FIG. 1 is a front view showing an example of a stent for bypass between hollow organs in a first embodiment of the present invention. FIG. 2 is a cross-sectional view taken along the line AA in FIG. 1, and is a diagram illustrating a first method of providing a colored region forming portion on a stent. FIG. 2 is a cross-sectional view taken along the line AA in FIG. 1, and is a diagram illustrating a second method of providing a colored region forming portion on a stent. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an external view showing an example of a stent delivery system for transporting a stent for luminal interorgan bypass according to a first embodiment of the present invention. 5 is a partial enlarged view of the vicinity of the distal end of the stent delivery system shown in FIG. 4, (a) is a view showing a first state in which a stent with a reduced diameter is accommodated, and (b) is a view showing a first state in which a stent with a reduced diameter is accommodated; FIG. It is a figure which shows the 2nd state which discharge|released. It is a front view which shows the modification of the stent for bypass between hollow organs in 1st Embodiment of this invention. It is a front view which shows an example of the stent for bypass between luminal organs in 2nd Embodiment of this invention. It is a front view which shows an example of the stent for bypass between luminal organs in 3rd Embodiment of this invention. It is a front view which shows an example of the stent for luminal inter-organ bypass in 4th Embodiment of this invention, and is a figure which shows an example of the colored area|region on the outer peripheral surface of the stent for luminal inter-organ bypass.

Hereinafter, first to fourth embodiments of the present invention will be described with reference to the drawings. In this specification, with the operator as a reference, the inside of the patient's body is defined as the distal side, and the side near the operator's hand is defined as the proximal side.

The stent for bypass between luminal organs according to the present invention is a stent for bypass between luminal organs for connecting a luminal organ and another luminal organ, and is preferably used for EUS-BD. This is a bypass stent, that is, a bypass stent that connects the stomach or duodenum to the bile duct or gallbladder.

The stent for bypass between hollow organs according to the present invention has an elongated cylindrical main body, and when indwelled in the body, one end of the main body is placed in one hollow organ. The other end of the main body is disposed within the other hollow organ, and the lumen of the main body allows communication between the hollow organs.

Moreover, the stent for luminal inter-organ bypass according to the present invention has a stent withdrawal prevention part for preventing the main body from shifting in the axial direction, and when indwelled in the body, the stent withdrawal prevention part can come into contact with the wall of the hollow organ and restrict the movement of the main body in the axial direction.

Further, the stent for luminal inter-organ bypass according to the present invention has a colored region forming portion that forms a colored region on the outer circumferential surface of the main body portion that makes it possible to identify the position of the stent withdrawal prevention portion. The position of the stent retention part can be identified by the colored area formed on the surface.

Hereinafter, in the first to fourth embodiments of the present invention, a stent for luminal organ bypass having a specific configuration will be described as an example. , but is not limited to the examples given herein. In addition, in this specification, the stent for luminal interorgan bypass may be simply abbreviated as "stent."

[First embodiment]
A stent for bypass between luminal organs in a first embodiment of the present invention will be described. FIG. 1 is a front view showing an example of a stent for a hollow interorgan bypass according to a first embodiment of the present invention.

The stent 11 in this embodiment is a self-expanding covered stent that elastically contracts in the radial direction when compressive force is applied in the radial direction, and expands in the radial direction when the compressive force is released. FIG. 1 shows the stent 11 in a radially expanded state.

As shown in FIG. 1, the stent 11 includes an elongated, substantially cylindrical main body 12, a main body hooking portion 18 protruding upward from an outer circumferential surface 12d of the main body 12, and The positions of the plurality of end hooking parts 14 provided at the first end R (the right end in FIG. 1), the main body hooking part 18, and the end hooking part 14 can be specified. It has a colored area forming section 20 that forms a colored area 30.

Note that, hereinafter, the direction in which the central axis C of the substantially cylindrical main body portion 12 extends will be described as an axial direction D2 in the description of the stent 11. Further, one end (the right end in FIG. 1) of the both ends of the main body 12 is the first end R, and the other end (the left end in FIG. 1) of the both ends of the main body 12 is the first end R. This will be explained as two end portions L. When storing the stent 11 within the stent delivery system, the first end R is located on the proximal side and the second end L is located on the distal side.

The main body portion 12 includes a cylindrical frame portion 13 and a covering portion 12a that covers the frame portion 13. The frame portion 13 is formed by struts 13a and bridges 13b, which are linear members made of metal or resin. Although the frame portion 13 may be formed by weaving wire rods, it is preferably of the so-called laser cut type, in which struts 13a and bridges 13b are formed by performing laser processing on a tube-shaped or pipe-shaped base material. The cross-sectional shapes of the struts 13a and bridges 13b constituting the frame portion 13 can be square or circular.

As shown in FIG. 1, the frame portion 13 includes a plurality of zigzag annular struts 13a and a bridge 13b connecting adjacent struts 13a. The struts 13a continue in a triangular wave shape along the circumferential direction of the frame portion 13 and are connected in an annular shape. However, in the state where the frame portion 13 is most contracted (the state after laser cutting), the struts 13a are connected in the circumferential direction while meandering in an S-shape.

As shown in FIG. 1, the bridge 13b connects a portion of the triangular wave peak or meandering curved portion of the adjacent struts 13a in the axial direction D2. By connecting the plurality of struts 13a in this manner, the cylindrical frame portion 13 is configured. The bridges 13b connecting two adjacent struts 13a are arranged at substantially equal intervals, but the positions of the bridges 13b connecting two adjacent struts 13a are not aligned in the axial direction D2. , shifted in the circumferential direction.

The total length H of the main body portion 12 is determined depending on the distance between the hollow organs to be bypass-connected, but it can be set to 10 mm to 200 mm, and preferably 40 mm to 120 mm. Further, the outer diameter of the main body portion 12 when expanded (when no external force is applied) is determined depending on the type and size of the hollow organ to be connected by bypass, but can be between φ2 mm and φ40 mm. , preferably φ4 mm to φ15 mm, and more preferably φ6 mm to φ10 mm. The outer diameter of the main body portion 12 when contracted (when accommodated in the stent delivery system) is about a fraction of the outer diameter when expanded.

The wire diameter of the struts 13a constituting the frame portion 13 is preferably 0.05 to 1 mm. Further, when the cross section of the strut 13a is rectangular, the length in the long side direction of the cross section of the strut 13a is 0.06 to 1 mm, and the length in the short side direction is 0.05 to 0.9 mm. It is preferable that there be. The outer diameter dimension of the frame portion 13 is substantially the same as the dimension of the main body portion 12 described above.

As the material of the frame portion 13, resin or metal is used. As the resin used for the frame portion 13, it is possible to use a resin having appropriate hardness and elasticity, and a biocompatible resin is preferable. Examples of the resin used as the material for the frame portion 13 include polyolefin, polyester, and fluororesin. Examples of metals used for the frame portion 13 include nickel titanium (Ni-Ti) alloy, stainless steel, tantalum, titanium, cobalt chromium alloy, and magnesium alloy. Alloys are preferred. A specific example of the superelastic alloy used for the frame portion 13 is a Ni--Ti alloy containing 49 to 58% by weight Ni.

The frame portion 13 is covered with a covering portion 12a. The covering portion 12a has the function of protecting the frame portion 13 and smoothing the surface of the stent 11 to prevent waste materials from adhering to and accumulating on the surface of the stent 11. A specific configuration of the covering portion 12a will be described later with reference to FIGS. 2 and 3.

Further, as shown in FIG. 1, the stent 11 has a plurality of main body hooking parts 18 and a plurality of end hooking parts 14. The main body hooking portion 18 and the end hooking portion 14 have a function of preventing displacement of the stent 11 in the axial direction D2, and correspond to the stent removal prevention portion in the present invention.

A plurality of main body hooking portions 18 are provided on the outer circumferential surface 12d of the main body portion 12 other than both ends R and L in the axial direction D2. The main body hooking portion 18 has an elongated shape extending from a base end portion 18b connected to the outer circumferential surface 12d, through an intermediate portion 18c, to a distal end portion 18a which is a free end. The main body hooking portion 18 protrudes upward from the outer circumferential surface 12d of the main body portion 12 other than both ends R and L in the axial direction D2. That is, the main body hooking part 18 is composed of a proximal end 18b, a distal end 18a, and an intermediate part 18c between the proximal end 18b and the distal end 18a, and at least the distal end 18a and the intermediate part 18c. A portion is arranged radially outward from the outer circumferential surface 12d of the cylindrical main body 12. As a result, the movement of the stent 11 placed in the body in the axial direction D2 is restricted because the main body hooking portion 18 is caught (prevented from falling off) on the wall of the hollow organ.

The main body hooking part 18 may be formed from a pipe-shaped base material common to the frame part 13, for example. As an example, the base end 18b of the main body hooking part 18 is connected to the strut 13a of the frame part 13 adjacent to the second end L side with respect to the base end 18b, and from the strut 13a to the first end R It protrudes to the side. Further, the main body hooking portion 18 may be formed independently of the main body portion 12 and may be integrally fixed to the frame portion 13 by laser welding or the like.

The main body hooking portion 18 has a curved shape that swells and curves to become convex toward the first end R along the longitudinal direction from the base end 18b through the intermediate portion 18c to the distal end 18a. However, when the stent 11 is housed in the stent delivery system, the main body hooking portion 18 is in a stretched state in the axial direction D2 (see FIG. 5(a)). The main body hooking portion 18 is bent so that when the stent 11 is released from the stent delivery system, it will protrude outward in the radial direction of the outer circumferential surface 12d due to its own elastic force.

In the stent 11 shown in FIG. 1, three main body hooking portions 18 are provided at equal angular intervals (that is, at 120 degree intervals) in the circumferential direction. However, the number of main body hooking parts 18 may be two or four or more, and is not particularly limited.

In the stent 11 shown in FIG. 1, the proximal ends 18b of the plurality of main body hooking parts 18 are arranged at the same distance from the first end R. However, the present invention is not limited thereto, and two or more or all of the plurality of main body hooking parts 18 may be arranged at different distances from the first end R. The distance W from the first end R to the base end 18b of the main body hooking part 18 is not particularly limited, but is preferably 1/2 or less, and 1/4 or less of the total axial length H of the main body 12. It is more preferable that

The first end R is provided with a plurality of end hooking parts 14. The end hooking part 14 has an elongated shape extending from a base end 14b connected to the first end R, through an intermediate part 14c, to a distal end 14a which is a free end. The end hooking portion 14 extends in a direction away from the first end R with the base end 14b as a starting point, and then the intermediate portion 14c is curved toward the outside in the radial direction of the main body portion 12. That is, the end hooking part 14 is composed of a proximal end 14b connected to the first end R, a distal end 14a, and an intermediate part 14c between the proximal end 14b and the distal end 14a, At least a portion of the tip portion 14a and the intermediate portion 14c are arranged radially outward from the outer circumferential surface 12d of the substantially cylindrical main body portion 12. As a result, the end hooking portion 14 of the stent 11 indwelled in the body is hooked (prevented from falling off) on the wall of the hollow organ, thereby restricting movement in the axial direction D2.

The end hooking portion 14 may be formed from a common pipe-shaped base material with the frame portion 13, for example, and may be formed independently of the main body portion 12 and positioned at the first end R by laser welding or the like. It may be integrally fixed to the frame portion 13.

The end hooking part 14 bulges out in the longitudinal direction from the base end 14b to the distal end 14a so as to be convex toward the outside in the axial direction D2 (to the right in FIG. 1) from the first end R. It has a curved shape. However, when the stent 11 is housed in the stent delivery system, the end hooking portion 14 is stretched in the axial direction D2 (see FIG. 5(a)). The end hooking portion 14 is bent so that when the stent 11 is released from the stent delivery system, it will protrude outward in the radial direction of the outer circumferential surface 12d due to its own elastic force.

The stent 11 shown in FIG. 1 has three end hooking portions 14 provided at equal angular intervals (ie, 120 degree intervals) in the circumferential direction. However, the number of end hooking parts 14 may be two or four or more, and is not particularly limited.

The tip portion 14a of the end hooking portion 14 and the tip portion 18a of the main body hooking portion 18 are provided with tip protection portions having a substantially elliptical plate shape and having a smooth outer surface. This tip protection part has a function of preventing damage to the inner wall of a hollow organ when the tip comes into contact with the inner wall.

The stent 11 shown in FIG. 1 is also provided with a plurality of first end markers 16 and a plurality of second end markers 17 made of an X-ray opaque material. The first end marker 16 has a disk shape and is attached near the base end 14b of the end hooking portion 14 connected to the first end R. Further, the plurality of second end markers 17 are also disc-shaped and are attached to the second end L of the main body portion 12 . When the stent 11 is placed in the body, by confirming the positions of the first end marker 16 and the second end marker 17 under X-ray contrast, the positions of both ends R and L of the main body 12, that is, the stent 11 indwelling positions can be grasped.

In the stent 11 shown in FIG. 1, the main body hooking portion 18 and the end hooking portion 14 are curved in the same direction. Such a stent 11 is, for example, indwelled such that the main body hooking part 18 and the end hooking part 14 are both located on the proximal side of the wall of the hollow organ, so that the stent 11 is removed from the hollow organ and the body cavity. The problem of falling off to the side can be effectively prevented by the two steps of the main body hooking part 18 and the end hooking part 14. In other words, when indwelling the stent 11, the main body hooking part 18 can be placed in a position where it contacts the inner wall of the hollow organ from the hollow organ side. Even if the retainer 18 is released and the main body hooking part 18 moves into the body cavity from the hollow organ side, the end hooking part 14 comes into contact with the inner wall of the hollow organ, and the stent 11 can be prevented from falling off.

Further, a colored region forming portion 20 is provided on the outer circumferential surface 12d of the main body 12 on the first end R side from the center of the main body 12. Specifically, the colored area forming section 20 has two positions: a position where the base end 18b of the main body hooking part 18 connects to the outer peripheral surface 12d, and a position (where the base end 14b of the end hooking part 14 connects to the outer peripheral surface 12d). That is, the colored region 30 is formed on the entire outer circumferential surface 12d existing between the first end R) and the first end R). By providing the colored region forming part 20, the stent 11 shown in FIG. 1 is colored between the main body hooking part 18 and the end hooking part 14 (first end R), The area between the two ends L has an uncolored appearance.

When the colored region forming section 20 forms the colored region 30 on the outer peripheral surface 12d, at the same time, a region 40 having a color different from the colored region 30 (hereinafter referred to as non-colored region 40) is formed on the outer peripheral surface 12d of the stent 11. ) will occur. The color of the colored area 30 is not particularly limited as long as it is not the same color as the non-colored area 40, but it is preferably a color that allows easy visual identification of the area being different from the non-colored area 40. When the stent 11 is placed into the body and the stent 11 is photographed using an endoscopic camera, the non-colored region 40 that appears in the photographed image often appears as a bright color (whitish color). For this reason, the color of the colored region 30 is preferably a color with low brightness that increases the contrast with the non-colored region 40 and suppresses halation, and is preferably black, for example.

When the adjacent colored area 30 and non-colored area 40 are of different colors, the presence of an outline (edge) in the colored area 30 or the non-colored area 40, or the difference between the colored area 30 and the non-colored area 40. It is recognized that there are boundaries between. In this specification, the outline portion of the colored region 30 or the non-colored region 40, or the boundary portion between the colored region 30 and the non-colored region 40 is referred to as the edge portion of the colored region 30.

In the stent 11 shown in FIG. 1, the colored region 30 is formed in a ring shape. The edge portion 30d of the colored region 30 is formed along the circumferential direction so as to pass through the position of the base end portion 18b of the main body hooking portion 18. The edge portion 30p of the colored region 30 is formed along the circumferential direction so as to pass through the position of the base end portion 14b of the end hooking portion 14, that is, the first end portion R.

The edge portion 30d of the colored region 30 represents the position of the base end portion 18b of the main body hooking portion 18 in the axial direction D2. Visually, at the edge 30d of the colored area 30, the colored area 30 and the non-colored area 40 outside the colored area 30 appear to have different colors, so the edge 30d of the colored area 30 can be easily confirmed. As a result, the position of the main body hooking portion 18 in the axial direction D2 can be easily specified.

In addition, in the stent 11 shown in FIG. 1, the proximal ends 18b of the plurality of main body hooking parts 18 are arranged at the same distance from the first end R, but two or more of the plurality of main body hooking parts 18 or All may be located at different distances from the first end R. In such a case, for example, one or several body hooking parts 18 may be selected and a colored area 30 may be formed that allows the position of the selected body hooking part 18 to be specified.

The edge portion 30p of the colored region 30 represents the position of the base end portion 14b of the end hooking portion 14 in the axial direction D2. Visually, in the peripheral part 30p of the colored region 30, different colors appear between the colored region 30 and the space outside of it where the main body 12 does not exist, so the peripheral part 30p of the colored region 30 can be easily As a result, the position of the end hooking portion 14 in the axial direction D2 (the position of the first end R) can be easily specified.

The method of providing the colored region forming portion 20 on the outer circumferential surface 12d of the main body portion 12 is not particularly limited, but for example, the first and second methods described below can be adopted.

FIG. 2 is a cross-sectional view taken along the line AA in FIG. 1 (a cross-sectional view in the colored region 30), and is a diagram illustrating a first method of providing the colored region forming portion 20 on the stent 11. As described above, the frame portion 13 is covered with the covering portion 12a. According to the first method, as shown in FIG. 2, the covering portion 12a in the colored region 30 is composed of a coating film 12ac and a colored resin 20x colored in a desired color. Further, the covering portion 12a in the non-colored region 40 is composed of a coating film 12ac and a colorless and transparent non-colored resin.

As shown in FIG. 2, the frame portion 13 is covered with a coating film 12ac. The coating film 12ac spreads so as to fill the space between adjacent struts 13a, and covers the outer circumferential surface of the frame portion 13.

In the colored region 30, the colored resin 20x constituting the colored region forming portion 20 further covers the outer peripheral side of the frame portion 13 covered with the coating film 12ac. The colored resin 20x is a resin colored with a pigment of a desired color (for example, black). For example, the colored resin 20x can be formed on the outer circumferential side of the frame portion 13 covered with the coating film 12ac by a method of spray coating the colored resin 20x, a method of dipping it in a resin solution colored with a pigment, and drying it. can. According to the first method, in the colored region 30, the colored resin 20x forms the outer peripheral surface 12d.

On the other hand, in the non-colored area 40, for example, a colorless and transparent non-colored resin covers the outer peripheral side of the frame portion 13 covered with the coating film 12ac. That is, in the non-colored region 40, a colorless and transparent non-colored resin is used instead of the colored resin 20x shown in FIG. 2, and the colorless and transparent non-colored resin forms the outer peripheral surface 12d.

In this embodiment, a colored region 30 is formed on the first end R side from the position of the base end 18b of the main body hooking part 18, with the position of the base end 18b of the main body hooking part 18 as a boundary, and A non-colored region 40 is formed on the second end L side from the position of the base end 18b. According to the first method, for example, on the side of the first end R from the position of the base end 18b of the main body hooking part 18, the colored region 30 is covered with a colored resin 40 colored in a desired color. A non-colored region 40 can be formed by coating a colorless and transparent non-colored resin on the second end L side from the position of the base end 18b of the main body hooking portion 18.

Further, FIG. 3 is a cross-sectional view taken along the line AA in FIG. 1 (a cross-sectional view in the colored region 30), and is a diagram illustrating a second method of providing the colored region forming portion 20 on the stent 11. According to the second method, the covering portion 12a in the colored region 30 is composed of a coating film 12ac, a colored polymer film 20y colored in a desired color, and a protective layer 20z, as shown in FIG. Further, the covering portion 12a in the non-colored area 40 is composed of a coating film 12ac, a colorless and transparent non-colored polymer film, and a protective layer 20z.

In the colored region 30, a colored polymer film 20y that has been colored in a desired color (for example, black) is prepared, and the colored polymer film 20y is placed around the outer periphery of the frame portion 13 covered with the coating film 12ac, for example, in one turn. Wrap around. Furthermore, a protective layer 20z is formed on the outside of the colored polymer film 20y by spray coating a resin or by winding the film. According to the second method, the protective layer 20z forms the outer peripheral surface 12d.

On the other hand, in the non-colored region 40, for example, a colorless and transparent colored polymer film is prepared, and the non-colored polymer film is wound, for example, once around the outer circumferential side of the frame portion 13 covered with the coating film 12ac. Furthermore, a protective layer 20z is formed on the outside of the non-colored polymer film by spray coating a resin or by winding the film. That is, in the non-colored region 40, a colorless and transparent non-colored polymer film is wound around the outer peripheral side of the frame portion 13 instead of the colored polymer film 20y shown in FIG.

In this embodiment, a colored region 30 is formed on the first end R side from the position of the base end 18b of the main body hooking part 18, with the position of the base end 18b of the main body hooking part 18 as a boundary, and A non-colored region 40 is formed on the second end L side from the position of the base end 18b. According to the second method, for example, on the side of the first end R from the position of the base end 18b of the main body hooking part 18, the colored region 30 is covered with a colored polymer film 20y colored in a desired color. A non-colored area 40 can be formed by covering a colorless and transparent non-colored polymer film on the second end L side from the position of the base end 18b of the main body hooking part 18.

In either of the first and second methods described above, the thickness of the layer formed on the outer peripheral side of the frame portion 13 covered with the coating film 12ac is not particularly limited, but it depends on the flexibility and self-expandability of the stent 11. It is preferable to make it thin so as not to lose it. Further, in the first and second methods described above, the non-colored region 40 is formed using a colorless and transparent non-colored resin or a non-colored polymer film. Instead of the film, the non-colored area 40 may be actively colored using a resin or polymer film that is colored in a different color (for example, white) from the colored area 30.

Next, a stent delivery system for transporting the stent 11 will be described. FIG. 4 is an external view showing an example of a stent delivery system 50 that transports the stent 11. FIG. 5 is a partially enlarged view of the vicinity of the distal end of the stent delivery system 50 shown in FIG. 4, and FIG. FIG. 5(b) shows a second state in which the outer sheath is moved and the stent 11 is released. Note that in FIGS. 5(a) and 5(b), the outer sheath 66 is drawn with a dotted line.

As shown in FIG. 4, the stent delivery system 50 includes a stent 11 and a transport mechanism 52 that transports the stent 11 to a predetermined position within the body. The transport mechanism 52 includes an operating section 60, an outermost tube 64, an outer sheath 66, an inner shaft 68, a distal tip 62, and the like. The total length of the stent delivery system 50 varies depending on the placement position of the stent 11, the transport route, etc., but is, for example, about 300 to 2500 mm.

As shown in FIG. 4, stent 11 is housed near the distal end of stent delivery system 50. As shown in FIG. The operator of the stent delivery system 50 transports the stent 11 to the target position in the body in the first state shown in FIG. 5(a), and then moves the stent delivery system 50 to the second state shown in FIG. By releasing the stent 11, the stent 11 is placed in a predetermined position within the body.

As shown in FIG. 4, the inner shaft 68 extends in the axial direction D1 from the operating section 60 provided at the proximal end of the stent delivery system 50 to the distal tip 62 provided at the distal end of the stent delivery system 50. It is extending. In the first state shown in FIG. 5A, the inner shaft 68 is housed inside the outer sheath 66, the housing 61 of the operating section 60, and the like.

The inner shaft 68 has a small diameter portion 68a near the distal end that is smaller in outer diameter than other portions. The small diameter portion 68a is a portion where the stent 11 is accommodated in a reduced diameter state. When indwelling the stent 11, the outer sheath 66 moves proximally to expose the small diameter portion 68a at the distal end. The diameter is expanded by After the diameter of the stent 11 is expanded, the inner shaft 68 is moved proximally to enter the second state shown in FIG. 5(b). Further, a guide wire lumen for passing a guide wire is formed inside the inner shaft 68.

A distal tip 62 is provided at the distal end of the inner shaft 68, and a through hole communicating with the guide wire lumen of the inner shaft 68 is formed in the distal tip 62. The distal tip 62 is made of resin or the like, and has a rounded outer shape to prevent damage to the inner wall of a hollow organ when it comes into contact with it.

The outer sheath 66 is movable relative to the inner shaft 68 in the axial direction D1 from the first state shown in FIG. 5(a) to the second state shown in FIG. 5(b). A proximal end of the outer sheath 66 is housed inside the housing 61 of the operating section 60. The operating section 60 moves the outer sheath 66 relative to the inner shaft 68 toward one proximal side in the axial direction D1 in conjunction with the operation of the operating lever 63 attached to the housing 61. As a result, the stent delivery system 50 changes from the first state (see FIG. 5(a)) in which the outer sheath 66 covers the small diameter portion 68a of the inner shaft 68 and the accommodated stent 11 to the small diameter portion 68a of the inner shaft 68 and the accommodated stent 11. The state changes to a second state (see FIG. 5(b)) in which the stent 11 that has been removed is exposed. Note that an outermost tube 64 that further covers the outer periphery of the outer sheath 66 is provided near the operating section 60. If the operator directly grasps the outer sheath 66, movement of the outer sheath 66 by the operating section 60 may be hindered, but such a problem can be prevented by the outermost tube 64 covering the outer sheath 66.

The outermost tube 64 and the inner shaft 68 of the transport mechanism 52 are made of, for example, flexible resin tubes. The outer sheath 66 is similarly composed of a flexible resin tube or the like, but in order to make the colored region 30 of the stent 11 accommodated therein visible through the outer sheath 66, A transparent polymeric material is used. Further, a metal wire may be embedded inside the resin tube used for the outer sheath 66.

A push ring 69 that pushes the stent 11 in the axial direction D1 when the stent 11 is released may be provided on the proximal side of the small diameter portion 68a in the inner shaft 68, and the push ring 69 is made of a radiopaque material. may have been done. Further, the materials of the tip 62 and the operating section 60 in the transport mechanism 52 are not particularly limited, but for example, molded or processed resin can be used.

Hereinafter, an example of a procedure for indwelling the stent 11 in the present embodiment in the body using the stent delivery system 50 will be described.

For example, an ultrasonic endoscope system with a camera is used to indwell the stent 11 in this embodiment. This endoscope is equipped with a camera constituted by a CCD or the like at the distal end of an ultrasound endoscope (EUS). The photographed image signal obtained by photographing with the camera is sent to a monitor or the like that can be visually viewed by the operator of the stent delivery system 50 through the internal wiring of the endoscope. The operator can determine the placement position of the stent 11 and release the stent 11 while checking the captured image displayed on the monitor.

When indwelling the stent 11 in this embodiment in the body, a guide wire is inserted into the bile duct or gallbladder and the distal end of the stent delivery system 50 is moved along the guide wire, as in conventional procedures. Then, the stent 11 is carried to the indwelling position in the first state in which the outer sheath 66 covers the accommodated stent 11 (see FIG. 5(a)). At this time, the area around the distal end of the stent delivery system 50 is photographed using an endoscopic camera, and the operator adjusts the position at which the stent 11 is to be released while checking the photographed image on the monitor.

As shown in FIG. 1, the stent 11 in this embodiment has a main body hooking part 18 and an end hooking part 14, and a colored region 30 is formed between the main body hooking part 18 and the end hooking part 14. has been done. While checking the photographed image displayed on the monitor, the operator places, for example, the edge part 30d of the colored area 30 representing the position of the main body hooking part 18 on the proximal side of the inner wall of the hollow organ, and places the edge part 30d at that position. By relatively moving the outer sheath 66 proximally with respect to the inner shaft 68 in a fixed state, the diameter of the stent 11 is expanded. By releasing the stent 11 with the alignment performed in this manner, the main body hooking portion 18 is placed on the proximal side of the inner wall of the hollow organ, and the stent 11 is indwelled at the exact position desired by the operator. You will be able to do so. Note that when it is desired to place the end hooking part 14 on the proximal side of the inner wall of the hollow organ, the operator can adjust the position of the end hooking part 14 while checking the captured image displayed on the monitor. The stent 11 may be released by placing the edge 30p of the colored region 30 on the proximal side of the inner wall of the hollow organ.

FIG. 6 is a front view showing a modification of the stent for bypass between hollow organs in the first embodiment of the present invention. In the description of the stent 11a shown in FIG. 6, components having the same functions as those of the stent 11 shown in FIG. 1 are given the same reference numerals, and the description will be simplified or omitted.

The stent 11a shown in FIG. 6 is different from the stent 11 shown in FIG. 1 in the positions of colored regions 30a, 30b formed by colored region forming parts 20a, 20b. In the stent 11a shown in FIG. 6, the colored region forming portion 20a is located at a position where the proximal end portion 14b of the end hooking portion 14 connects to the outer circumferential surface 12d of the main body portion 12 (i.e., the first end portion R), and at the first end portion R. A colored region 30a is formed on the entire outer circumferential surface 12d existing between the end R and a position a predetermined distance d1 (within a width d1).

In addition, in the stent 11a shown in FIG. 6, the colored region forming portion 20b is located at a position where the proximal end portion 18b of the main body hooking portion 18 connects to the outer circumferential surface 12d of the main body portion 12, and from this position toward the second end portion L side. A colored region 30b is formed on the entire outer circumferential surface 12d existing between the outer circumferential surface 12d and a position separated by a predetermined distance d2 (within a width d2). By providing the colored region forming parts 20a and 20b, the stent 11 shown in FIG. 1 is colored near the end hooking part 14 (first end R) and the main body hooking part 18, and Areas other than the original will appear uncolored. In the stent 11a shown in FIG. 6, two colored regions 30a and 30b are each formed in a ring shape, and contrast occurs between adjacent non-colored regions 40a and 40b.

The colored regions 30a, 30b and the non-colored regions 40a, 40b can be formed using the first and second methods described above with reference to FIGS. 2 and 3. For example, after wrapping a colorless and transparent non-colored polymer film around the first end R side and the second end L side from this position with the position of the base end 18b of the main body hooking part 18 as a boundary, Furthermore, the colored regions 30a, 30b and the non-colored regions 40a, 40b may be formed by wrapping a colored polymer film 20y colored in a desired color around the positions where the colored regions 30a, 30b are to be formed.

The edge portion 30ap of the colored region 30a is formed along the circumferential direction so as to pass through the position in the axial direction D2 of the proximal end portion 14b of the end hooking portion 14. It represents the position of D2. Visually, in the edge part 30ap of the colored area 30a, different colors appear between the colored area 30a and the space outside of it where the main body part 12 does not exist, so the edge part 30ap of the colored area 30a can be easily As a result, the position of the end hooking portion 14 in the axial direction D2 (the position of the first end R) can be easily specified. Note that if the predetermined distance d1 is small, the width d1 of the colored region 30a in the axial direction D2 becomes small, and the colored region 30a becomes invisible. For this reason, it is preferable that the predetermined distance d1 is a size that makes the colored region 30a visible, and although it varies depending on the size of the stent 11a and the observable range of the endoscopic camera, for example, the predetermined distance d1 should be set to 1 mm or more. It can be done.

Furthermore, the edge portion 30bp of the colored region 30b is formed along the circumferential direction so as to pass through the position in the axial direction D2 of the base end portion 18b of the main body hooking portion 18, thereby allowing the axial direction of the base end portion 18b to It represents the position in direction D2. Visually, the colored area 30b and the non-colored area 40a appear to have different colors in the edge 30bp of the colored area 30b, so the edge 30bp of the colored area 30b can be easily confirmed. As a result, the position of the main body hooking portion 18 in the axial direction D2 can be easily specified. Note that if the predetermined distance d2 is small, the width d2 of the colored region 30b in the axial direction D2 becomes small, and the colored region 30b becomes invisible. For this reason, it is preferable that the predetermined distance d2 is a size that makes the colored region 30b visible, and although it varies depending on the size of the stent 11a and the observable range of the endoscopic camera, for example, the predetermined distance d2 should be set to 1 mm or more. It can be done.

According to the first embodiment described above, by forming the colored regions 30, 30a, and 30b on the outer circumferential surface 12d of the main body 12, which make it possible to specify the positions of the main body hooking part 18 and the end hooking part 14, the main body hooking The positions of the portion 18 and the end hooking portion 14 in the axial direction D2 can be easily specified, and the stents 11 and 11a can be placed in accurate positions. In particular, the edges 30p, 30d, 30ap, and 30bp of the colored regions 30, 30a, and 30b make it easy to identify the position in the axial direction D2 where the main body hooking portion 18 and the end hooking portion 14 connect to the outer peripheral surface 12d. become.

[Second embodiment]
A stent for bypass between luminal organs in a second embodiment of the present invention will be described. FIG. 7 is a front view showing an example of a stent for bypass between hollow organs according to the second embodiment of the present invention. In the description of the stent 111 shown in FIG. 7, components having the same functions as the stent 11 shown in FIG. 1 are designated by the same reference numerals, and the description will be simplified or omitted.

The stent 111 shown in FIG. 7 differs from the stent 11 shown in FIG. 1 in the shape of the main body hooking portion 118. In the stent 111 shown in FIG. 7, the main body hooking portion 118 bulges out toward the second end L along the longitudinal direction from the proximal end 118b through the intermediate portion 118c to the distal end 118a. There is. Note that, similar to the main body hooking part 18 of the stent 11 shown in FIG. This corresponds to

In the stent 111 shown in FIG. 7, the colored region forming part 20c is located at a position where the proximal end 14b of the end hooking part 14 connects to the outer circumferential surface 12d of the main body 12 (i.e., the first end R), and at the stent delivery A colored region 30c is formed on the entire outer circumferential surface 12d that exists between the position of the distal end 118a of the main body hooking section 18 (within a width d2) when the stent 111 is housed in the system 50.

The colored region 30c and the non-colored region 40c can be formed using the first and second methods described above with reference to FIGS. 2 and 3. However, since there is a possibility that the protrusion of the main body hooking part 18 radially outward when released from the stent delivery system is suppressed, a polymer film is wrapped around the proximal end 18b of the main body hooking part 18. I don't like that. From this point of view, for example, with the position of the base end 18b of the main body hooking part 18 as a boundary, a colored polymer film 20y colored in a desired color is wound around the first end R side from this position, and from this position After wrapping a colorless and transparent non-colored polymer film around the second end L side, coloring is applied between this position and the position of the distal end 118a of the main body hooking part 18 when accommodated in the stent delivery system. The colored region 30c and the non-colored region 40c may be formed by winding the polymer film 20y.

The edge portion 30cp of the colored region 30c is formed along the circumferential direction so as to pass through the position in the axial direction D2 of the proximal end portion 14b of the end hooking portion 14. It represents the position of D2. Visually, in the edge part 30cp of the colored area 30c, the color appears to be different between the colored area 30c and the space outside of it where the main body part 12 does not exist, so the edge part 30cp of the colored area 30c can be easily As a result, the position of the end hooking portion 14 in the axial direction D2 (the position of the first end R) can be easily specified.

Furthermore, the edge portion 30cd of the colored region 30c is formed along the circumferential direction so as to pass through the position in the axial direction D2 of the distal end portion 118a of the main body hooking portion 18 when accommodated in the stent delivery system. represents the position of the distal end portion 118a in the axial direction D2 when accommodated in the stent delivery system. Visually, the colored area 30c and the non-colored area 40c appear to have different colors in the edge 30cd of the colored area 30c, so the edge 30cd of the colored area 30c can be easily confirmed. As a result, the position of the tip portion 118a of the main body hooking portion 18 in the axial direction D2 can be easily specified.

It is conceivable that the stent 111 shown in FIG. 7 is used by being indwelled in the body, for example, so that the wall of the hollow organ is sandwiched between the main body hooking part 118 and the end hooking part 14 from both the outside and inside. . In such a stent 111, the main body hooking portion 118 and the end hooking portion 14 work together to prevent both migration, in which the stent 111 moves toward the body cavity, and migration, in which the stent 111 moves toward the hollow organ. Can be effectively prevented. When using the stent 111 in this manner, the operator places the edge portion 30cp of the colored region 30c representing the position of the end hooking portion 14 on the proximal side of the inner wall of the hollow organ, and All you have to do is release it.

Furthermore, similar to the stent 11a shown in FIG. 6, the stent 111 shown in FIG. It can also be used by being placed inside the body. In this case, the operator confirms the position of the tip 118a of the main body hooking part 118 by confirming the position of the edge 30cd of the colored region 30c, and moves the tip 118a near the inner wall of the hollow organ. The stent 111 may be released by placing the stent 111 on the patient's side.

According to the second embodiment described above, by forming the colored region 30c on the outer circumferential surface 12d of the main body 12, which makes it possible to identify the positions of the main body hooking part 118 and the end hooking part 14, the main body hooking part 118 and the end hooking part 14 can be identified. The position of the hooking part 14 can be easily specified, and the stent 111 can be placed in an accurate position. In particular, the edge portion 30cp of the colored region 30c makes it possible to easily identify the position in the axial direction D2 where the end hooking portion 14 connects to the outer peripheral surface 12d, and the edge portion 30cd of the colored region 30c facilitates stent delivery. With the stent 111 housed in the system 50, the position of the distal end portion 118a of the main body hooking portion 118 in the axial direction D2 can be easily specified.

[Third embodiment]
A stent for bypass between luminal organs in a third embodiment of the present invention will be described. FIG. 8 is a front view showing an example of a stent for bypass between hollow organs according to the third embodiment of the present invention. In the description of the stent 211 shown in FIG. 8, components having the same functions as those of the stent 11a shown in FIG. 6 are denoted by the same reference numerals, and the description will be simplified or omitted.

A stent 211 shown in FIG. 8 differs from the stent 11a shown in FIG. 6 in that it does not have a main body hooking part 18 and does not have a colored region forming part 20b that forms a colored region 30b.

The stent 211 shown in FIG. 8 has only the end hooking part 14 as a stent removal prevention part for preventing the stent 211 from shifting in the axial direction D2, and the outer peripheral surface 212d of the main body part 212 has , only one colored region 30a is formed in a ring shape.

According to the third embodiment described above, the position of the end hooking part 14 can be easily identified by forming the colored region 30a on the outer circumferential surface 212d of the main body part 212, which allows the position of the end hooking part 14 to be identified. This allows the stent 211 to be placed in an accurate position. In particular, the edge portion 30ap of the colored region 30a allows the position of the end hooking portion 14 in the axial direction D2 to be easily specified.

[Fourth embodiment]
A stent for a luminal inter-organ bypass according to a fourth embodiment of the present invention will be described. FIG. 9 is a front view showing an example of a stent according to the fourth embodiment of the present invention. FIG. 9 schematically shows the outer shape of the stent 311 in a radially expanded state.

A stent 311 shown in FIG. 9 has an elongated, generally cylindrical main body portion 312. The main body part 312 has two enlarged diameter parts 314 and 316 located near both ends of the main body part 312, and two enlarged diameter parts 314 and 316 located in the axial center of the main body part 312. and a saddle portion 318 that connects the.

Stent 311 shown in FIG. 9 is a self-expanding covered stent. The diameter of the main body portion 312 of the stent 311 expands to a non-uniform size depending on the axial position during diameter expansion, and the expanded diameter dimension in which the two expanded diameter portions 314 and 316 expand radially outward is the saddle portion. 318 is formed to be larger than the expanded diameter dimension that expands radially outward.

When the stent 311 shown in FIG. 9 is placed, the enlarged diameter portions 314 and 316 are arranged so as to sandwich the walls of the hollow organ. The enlarged diameter portions 314 and 316 are portions of the main body portion 312 that have been deformed so as to protrude more radially outward than the outer peripheral surface of the saddle portion 318. The stent 311 placed in the body is prevented from moving in the axial direction by the enlarged diameter portions 314 and 316 being caught (prevented from coming off) by the wall of the hollow organ. The enlarged diameter portions 314 and 316 have a function of preventing the stent 311 from shifting in the axial direction, and correspond to the stent removal prevention portion in the present invention.

In the stent 311 shown in FIG. 9, a colored region forming portion 320 is provided on the entire outer peripheral surface of the enlarged diameter portion 314. The colored region forming section 320 forms a colored region 330 on the entire outer circumferential surface of the enlarged diameter section 314 .

The edge portions 330p and 330d of the colored region 330 are formed along the circumferential direction so as to pass through the positions in the axial direction D2 of both ends of the enlarged diameter portion 314. The respective positions in the axial direction D2 are shown. Visually, the colored area 330 and the non-colored area 340a appear to have different colors at the edge 330p of the colored area 330, so the edge 330p of the colored area 330 can be easily confirmed. Furthermore, since the colored region 330 and the non-colored region 340b appear to have different colors in the edge portion 330d of the colored region 330, the edge portion 330d of the colored region 330 can be easily confirmed. As a result, the position of the enlarged diameter portion 314 in the axial direction D2 can be easily specified.

According to the fourth embodiment described above, by forming the colored region 330 that allows the position of the enlarged diameter portion 314 to be specified on the outer peripheral surface of the main body portion 312, the position of the enlarged diameter portion 314 can be easily specified. This allows the stent 311 to be placed in an accurate position. In particular, the edge portions 330d and 330p of the colored region 330 allow the position of the enlarged diameter portion 314 in the axial direction D2 to be easily specified.

Hereinafter, the effects of the present invention will be explained.

The stent for bypass between hollow organs according to the present invention is a stent for bypass between hollow organs for connecting a hollow organ and another hollow organ by bypass, and includes an elongated cylindrical main body part and a main body part. The main body has a colored area forming part that forms a colored area on the outer circumferential surface of the main body part, which makes it possible to specify the position of the stent retention part.

According to this configuration, when the stent for luminal inter-organ bypass is placed in the body, the colored area formed on the outer circumferential surface of the stent for luminal inter-organ bypass can be confirmed from the image taken by the endoscopic camera. This makes it possible to specify the position of the stent-removal prevention portion provided on the stent for luminal inter-organ bypass. As a result, it becomes possible to appropriately control the position of the stent removal prevention part and to indwell the stent for luminal inter-organ bypass at an accurate position in an accurate state.

The stent removal prevention part is a part that is attached to the stent for lumen inter-organ bypass in order to prevent the stent for lumen inter-organ bypass placed in a predetermined position in the body from migrating from its proper position. means a provided member or structure. The main body hooking portions 18, 118 and the end hooking portions 14 in the first to third embodiments described above, and the enlarged diameter portions 314, 316 in the fourth embodiment described above correspond to the stent removal prevention portion according to the present invention.

Furthermore, the position of the stent retaining portion refers to the relative position of the stent retaining portion to the main body, such as the connection point where the stent retaining portion connects to the main body, or when the stent retaining portion is housed in the stent delivery system. The position of the stent-removal prevention part, etc. In the first embodiment described above, the position where the proximal end 18b of the main body hooking part 18 connects with the main body 12 and the position where the proximal end 14b of the end hooking part 14 connects with the main body 12 are such that the stent does not come out. This corresponds to the position of the part. In the second embodiment described above, the position of the distal end portion 118a of the main body hooking portion 118 when accommodated in the stent delivery system 50 and the position where the proximal end portion 14b of the end hooking portion 14 connects to the main body portion 12 are different. , corresponds to the position of the stent retention part. In the third embodiment described above, the position where the proximal end portion 14b of the end hooking portion 14 connects to the main body portion 212 corresponds to the position of the stent retention portion. Further, in the fourth embodiment described above, the enlarged diameter portions 314 and 316 are constituted by a part of the main body portion 312 that largely protrudes outward in the radial direction, and the position of the enlarged diameter portion 314 in the main body portion 312 is , corresponds to the position of the stent retention part.

Further, in the stent for a luminal inter-organ bypass according to the present invention, a stent removal prevention portion that can be identified by a colored region may be provided at one end in the axial direction of the main body.

According to this configuration, for example, the position of the stent removal prevention portion provided on the proximal side of the stent for luminal inter-organ bypass can be specified by the colored region. When a stent for bypass between luminal organs is released from the stent delivery system, the inside of the luminal organ is photographed using an endoscopic camera, and it is confirmed whether colored areas are visible in this photographed image. By doing so, it is possible to reliably confirm that the stent removal preventing portion is inside the hollow organ, and the position of the stent removal preventing portion can also be easily specified.

Furthermore, in the stent for luminal inter-organ bypass according to the present invention, on the outer peripheral surface of the main body, the edge of the colored region may be formed along the circumferential direction so as to pass through the position of the stent removal prevention part. .

According to this configuration, the position of the stent retention part can be determined by visually confirming the edge of the colored area formed in a ring shape on the outer peripheral surface of the stent for luminal interorgan bypass from the image taken by the endoscopic camera. be easily identified.

Furthermore, the stent for luminal inter-organ bypass according to the present invention has an end hooking part provided at one end in the axial direction of the main body part as a stent removal prevention part, and the edge part of the colored region is It may be formed along the circumferential direction so as to pass through one end.

According to this configuration, by confirming the edge of the colored region formed in a ring shape on the outer peripheral surface of the stent for luminal organ-to-organ bypass from the captured image of the endoscopic camera, The position of the end hooking portion provided at the proximal end of the stent can be identified. In addition, since the end hooking part is provided at one end of the main body, the end hooking part contacts the inner wall of the hollow organ and functions as an anchor, effectively preventing migration. become able to.

Furthermore, in the stent for luminal inter-organ bypass according to the present invention, the end hooking portion is constituted by an elastic linear member, and the proximal end portion is integrally connected to one end portion, and the free end portion is formed of a linear member having elasticity. an intermediate portion between the proximal end and the distal end is curved, and at least a portion of the distal end and the intermediate portion are arranged radially outward than the outer circumferential surface. It may be as follows.

According to this configuration, the distal end portion or the intermediate portion of the end hooking portion having elasticity can come into contact with the inner wall of the hollow organ, and migration of the stent for bypass between hollow organs can be effectively prevented. Further, since the intermediate portion of the end hooking portion is curved, the risk of the inner wall surface of the hollow organ being damaged by the end hooking portion can be reduced.

Furthermore, the stent for luminal inter-organ bypass according to the present invention has a main body hooking part provided on the outer circumferential surface of the main body other than both ends in the axial direction as a stent removal preventing part, and the peripheral part of the colored region is , may be formed along the circumferential direction so as to pass through the position of the main body hooking part.

According to this configuration, by checking the edges of the colored area formed on the stent for luminal inter-organ bypass from the captured image of the endoscopic camera, It becomes possible to specify the position of the main body hooking part provided on the outer peripheral surface. In addition, since the main body hooking portion is provided on the outer circumferential surface of the main body other than both ends in the axial direction, the main body hooking contacts the inner wall of the hollow organ and functions as an anchor, thereby allowing the connection between the hollow organs. Migration of bypass stents can be effectively prevented.

Furthermore, in the stent for luminal inter-organ bypass according to the present invention, the main body hooking part is constituted by an elastic linear member, and has a proximal end part integrally connected to the outer peripheral surface of the main body part, and a free end. The intermediate portion between the proximal end and the distal end is curved, and at least a portion of the distal end and the intermediate portion are arranged radially outward than the outer circumferential surface. It may be .

According to this configuration, the distal end or intermediate portion of the main body hooking portion having elasticity can come into contact with the inner wall of the hollow organ, and migration of the stent for bypass between hollow organs can be effectively prevented. Further, since the intermediate portion of the main body hooking portion is curved, the risk of the inner wall surface of the hollow organ being damaged by the main body hooking portion can be reduced.

Furthermore, the stent for luminal inter-organ bypass according to the present invention has, as a stent removal prevention part, an enlarged diameter part that is a part of the main body part and has a larger outer diameter than the other part of the main body part, The edge portion may be formed along the circumferential direction so as to pass through the position of the enlarged diameter portion.

According to this configuration, the edges of the colored region formed in a ring shape on the stent for luminal organ-to-organ bypass can be confirmed from images captured by the endoscopic camera, and the stent is provided for the purpose of preventing migration. It becomes possible to specify the position of the enlarged diameter part.

The embodiments described above are described to facilitate understanding of the present invention, and are not described to limit the present invention. Therefore, each element disclosed in the embodiments described above is intended to include all design changes and equivalents that fall within the technical scope of the present invention.

For example, in the first to third embodiments described above, a main body hooking portion may be provided on the second end L side, and an end hooking portion connected to the second end L may be provided. Good too. In this case, a colored area may be formed on the outer circumferential surface of the main body portion to enable the position of the main body hooking portion on the second end L side and the end hooking portion to be specified. Further, similarly, a colored region that allows the position of the distal enlarged diameter portion 316 in the fourth embodiment described above to be specified may be formed on the outer circumferential surface of the main body portion.

11, 11a, 111, 211, 311 Stent for luminal interorgan bypass (stent)
12, 212, 312 Main body portion 12a Covering portion 12ac Coating film 12d, 212d Outer peripheral surface 13 Frame portion 13a Strut 13b Bridge 14 End hooking portion (stent removal prevention portion)
14a, 18a, 118a distal end portion 14b, 18b, 118b proximal end portion 14c, 18c, 118c intermediate portion 16 first end marker 17 second end marker 18, 118 main body hooking portion (stent removal prevention portion)
20, 20a, 20b, 320 Colored area forming part 20x Colored resin 20y Colored polymer film 20z Protective layer 30p, 30d, 30ap, 30ad, 30bp, 30bd, 30cp, 30cd, 330d, 330p Edge part 30, 30a, 30b, 30c , 330 Colored region 40, 40a, 40b, 40c, 340a, 340b Non-colored region 50 Stent delivery system 52 Transport mechanism 60 Operation section 61 Housing 62 Tip tip 63 Operation lever 64 Outermost tube 66 Outer sheath 68 Inner shaft 68a Small diameter section 69 Push ring 314, 316 Expanded diameter part (stent removal prevention part)
318 Saddle part

Claims (7)

A stent for bypass between hollow organs for bypass connection between a hollow organ and another hollow organ,
An elongated cylindrical main body,
a stent retainer for preventing displacement of the main body in the axial direction;
a colored area forming part that forms a colored area on the outer circumferential surface of the main body part that allows the position of the stent retaining part to be specified;
has
A stent for a hollow inter-organ bypass, characterized in that, on the outer circumferential surface of the main body portion, a peripheral portion of the colored region is formed along the circumferential direction so as to pass through the position of the stent removal prevention portion. 2. The stent for a hollow inter-organ bypass according to claim 1, wherein the stent removal prevention portion, which can be identified by the colored area, is provided at one end in the axial direction of the main body. The stent removal preventing portion includes an end hooking portion provided at one end in the axial direction of the main body portion;
The stent for bypass between hollow organs according to claim 1 or 2 , wherein a peripheral portion of the colored region is formed along the circumferential direction so as to pass through the one end portion. The end hooking part is
Composed of an elastic linear member,
a proximal end portion integrally connected to the one end portion, and a distal end portion having a free end;
an intermediate portion between the proximal end and the distal end is curved;
The stent for a luminal interorgan bypass according to claim 3, wherein at least a portion of the distal end portion and the intermediate portion are arranged radially outward from the outer circumferential surface. The stent retaining portion includes a main body hooking portion provided on an outer circumferential surface of the main body other than both ends in the axial direction;
The interlumen organ according to any one of claims 1 to 4 , wherein a peripheral portion of the colored region is formed along a circumferential direction so as to pass through a position of the main body hooking portion. Bypass stent. The main body hooking part is
Composed of an elastic linear member,
having a proximal end portion integrally connected to the outer circumferential surface of the main body portion, and a distal end portion having a free end;
an intermediate portion between the proximal end and the distal end is curved;
The stent for a luminal interorgan bypass according to claim 5 , wherein at least a portion of the distal end portion and the intermediate portion are arranged radially outside the outer circumferential surface. The stent removal preventing portion includes an enlarged diameter portion that is a part of the main body and has a larger outer diameter than other parts of the main body;
The stent for a hollow interorgan bypass according to claim 1 or 2 , wherein a peripheral portion of the colored region is formed along the circumferential direction so as to pass through the position of the enlarged diameter portion.