JPH0344542B2 - - Google Patents

Description

[Detailed Description of the Invention] <Industrial Application Field> The present invention is directed to DSA (Digital Subtraction).
Angiography) and other puncture needles with dilators used in computer-based angiography tests.

<Prior art> In DSA and other computer image-based angiographic examinations, transbrachial artery catheterization is still infrequently used, and transfemoral artery catheterization is currently used frequently. The reason for this is thought to be that safety in catheter operation and selective/superselective catheter operation methods targeting systemic arteries have not yet been established.

However, according to transbrachial artery catheterization,
The selective and super-selective catheter manipulation method described above and its safety have been established because it has the clinical advantage of being able to stop hemostasis after the test while the patient is able to walk, and can be applied to outpatients. There is no doubt that this technique will play a major role in the development of angiography in the future.

By the way, in general, in transbrachial artery catheterization, the catheter must be inserted through a puncture hole opened in a small brachial artery, and it is known that this is likely to result in thrombus formation or occlusion of the brachial artery after the examination. In order to prevent these, it is necessary to use a catheter as thin as possible, which is less than the inner diameter of the brachial artery, and to ensure blood flow even when the catheter is inserted.

Increasing blood flow in the brachial artery also prevents thrombus formation and occlusion. In this regard, in more than 250 cases in which the present inventor tried a technique in which the patient held an exercise device in their hand and squeezed it tightly over time when inserting or operating the catheter, it was found that thrombus formation and occlusion of the brachial artery were not observed. It was not recognized.

However, even if a thin catheter is used, bleeding during insertion or manipulation, excessive direct stimulation of the brachial artery, or damage to the artery wall may result in thrombus formation or occlusion. Therefore, eliminating these triggering factors is essential to improving the safety of transbrachial catheterization.

Conventionally, the cause of subcutaneous bleeding at the catheter insertion site after angiography has been determined to be poor hemostasis after the catheter is removed, and bleeding from the puncture hole in the posterior wall of the artery with the puncture needle is almost always caused by bleeding. It has not been seen as a problem. However, in 250 cases in which the present inventor introduced a catheter into the brachial artery using a 19-gauge puncture needle, excessive swelling of the elbow joint was observed at the end of the examination in more than half of the cases.

On the other hand, in 20 cases performed in exactly the same manner using a thin 21-gauge puncture needle, no such swelling of the elbow joint was observed. This suggests that preventing bleeding from the puncture hole in the posterior wall of the artery with the puncture needle is one of the important conditions for improving the safety of transbrachial artery catheterization. I can say that.

In order to prevent bleeding from the puncture hole in the posterior wall of the artery, it is desirable to use a puncture needle as thin as possible; Having a diameter (opening diameter) is convenient for insertion of the catheter. In this regard, in the past, a puncture hole in the front wall of the artery was opened using a puncture needle, and then a dilator (dilator) separate from the puncture needle was used to expand the puncture hole to a size that corresponded to the outer diameter of the catheter. It's here.

That is, by using a puncture needle consisting of a needle body 1 and a sheath 2 attached thereto as shown in FIGS. 10 and 11, a puncture hole is first opened in the artery, and then the needle body 1 A catheter introduction guide wire is inserted into the artery through the sheath 2 placed in the puncture hole, and the sheath 2 of the puncture needle is removed, leaving the guide wire behind.

A separate dilator is then inserted into the puncture hole along the indwelling guidewire to dilate the puncture hole, and then the dilator is removed from the guidewire and the dilator is inserted into the puncture hole along the remaining guidewire. Currently, catheters are inserted into arteries.

<Problems to be solved by the invention> However, such a method has the following problems.

That is, as is clear from both figures, the sheath 2 of the puncture needle has the form of a simple straight hollow round pipe as a whole, and its opening diameter d is such that the guide wire can be inserted through it. Needless to say, the catheter sheath introducer is not large enough to pass through the catheter sheath introducer, so the puncture hole once opened by the sheath 2 is still small, and as a result, it is difficult to remove the sheath 2. The puncture hole must then be greatly dilated again with a separate dilator. A total of two puncturing operations are required, which is extremely complicated to operate.

Furthermore, the puncture hole once opened by the sheath 2 is small, and the dilator is a blunt instrument, so rough dilation of the puncture hole with this dilator is likely to cause damage to the arterial wall or collapse. , causing blood clot formation. This phenomenon occurs particularly in the brachial artery, which is a small blood vessel, and it is clear that it causes difficulty in hemostasis later on.

Furthermore, as a puncture tool, in addition to a puncture needle consisting of a needle body 1 and its sheath 2, a dilator that allows insertion of a catheter is also required, making preparations complicated and even more difficult. The sheath 2 of the puncture needle and the dilator must be removed one by one from the guide wire placed in the guide wire, and handling them is extremely troublesome, and without advanced technique and extensive experience, it can cause serious damage to the patient. It also imposes a burden.

In particular, the sheath 2 and dilator of the puncture needle both have a hollow pipe shape with a circular cross section, while the guide wire is long for guiding the introduction of the catheter, so the sheath 2 and the dilator are They cannot be completely removed from the guidewire unless the dilator and dilator are moved backwards, which is extremely troublesome for one person to operate, and increases the burden and risk to the patient. Become.

The present invention is intended to improve these problems, and in addition to the fact that the sheath of the needle body of the puncture needle also functions as a dilator, it also prevents the sheath from tearing or splitting. It is characterized by its presence. Therefore, by using such a puncture needle, the operability and safety of catheter introduction are significantly improved, and the occurrence of occlusion, dislocation, and thrombus formation of the arteries can be effectively reduced.

That is, the object of the present invention is, firstly, to be able to receive only the catheter introduction guide wire at the front end position of the sheath which is set so that the needle tip of the needle body of the puncture needle protrudes; A small-diameter primary insertion portion that can be closely attached to the needle body is provided, and a catheter guided by the guide wire or a slightly thicker catheter introducer can be received at a position subsequent to the primary insertion portion of the sheath. A large-diameter secondary insertion part is formed, and the boundary position between the primary insertion part and the secondary insertion part is smoothly continuous as a conical dilator part that tapers (downwards from the front) and connects the needle body. At the same time, the puncture hole opened in the front wall of the blood vessel by the primary insertion part of the sheath is set so that it can be expanded by itself by the dilator part and the secondary insertion part of the sheath, The purpose of this invention is to make it possible to open a large puncture hole through which the catheter can be easily inserted, as well as the catheter introduction guide wire, by the puncturing action of the present invention.

Secondly, the primary insertion part of the sheath that forms the puncture needle will be buried in the blood vessel first due to the action of puncturing the blood vessel. By making the size as thin as possible, even if a puncture hole were to be made in the rear wall of the blood vessel,
The aim is to minimize the puncture hole in the subsequent wall and reduce future bleeding.

Moreover, thirdly, by providing a slit line or a weak part of a certain length extending along the longitudinal direction of the sheath, and determining that the entire sheath can be torn or split open from the slit line or the weak part. It is not necessary to move the sheath backward along the length of the catheter introduction guidewire and completely remove it from the guidewire, but by splitting or tearing the sheath, the sheath can be easily removed even from a mid-way position on the guidewire. It can be removed and the operability can be improved.

<Means for Solving the Problems> In order to achieve the above objects, the present invention includes a needle body for puncturing a blood vessel, a needle tip protruding from the needle body, and a needle that can be freely inserted and withdrawn. A puncture needle for angiography consists of a sheath that is attached to the main body, and at the front end of the sheath, there is a primary tube with a small diameter that can accept only a guide wire for catheter introduction and that can be tightly attached to the needle main body. An insertion section is provided, also at a position subsequent to the primary insertion section of the sheath,
A secondary insertion section with a large diameter tube that can accept a catheter guided by the guide wire or a slightly thicker catheter introducer is formed, and the boundary position between the primary insertion section and the secondary insertion section is determined. ,
By smoothly connecting the tapered conical dilator section, the puncture hole opened into the blood vessel by the primary insertion section of the sheath, which closely cooperates with the needle body, can be continuously connected to the dilator section of the sheath and the secondary insertion section. A slit line or a weak portion of a certain length is defined so as to be able to expand automatically by the insertion portion, and at least the tip portion corresponding to the needle tip portion of the needle body maintains a continuous state in advance. The above-mentioned guide wire is attached along the longitudinal direction of the sheath, and the entire sheath is divided or torn from the slit line or the weak part without pulling out the sheath along the guide wire received in the sheath. The wire is characterized in that it can be removed from a midway position in the longitudinal direction of the wire.

<Example> The specific structure of the present invention will be described in detail with reference to the accompanying drawings. Figures 1 and 2 show the assembled and disassembled states of the puncture needle with dilator for angiography. The needle consists of a needle main body 10 of a certain length and a hollow tubular sheath 12 attached to the needle main body 10, and the sheath 12 and the needle main body 10 can be inserted into and removed from each other.

The needle body 10 is made as thin as possible from a metal such as stainless steel, and the needle tip 10a
The blade is sharpened by providing an inclined cut surface for smooth puncture into a blood vessel 14 such as a brachial artery or a femoral artery. Reference numeral 16 denotes a large-diameter hub or mouthpiece tube fixedly attached to the rear end of the needle body 10, so that the rear end of the sheath 12 can be received and held in a stable manner. 18 is the hub 1
Although the handle is preferably inserted into and removed from the hub 16, the provision of this handle may be omitted and the function of the handle may be provided to the hub 16 itself.

Although the illustrated example shows a hollow round pipe as the needle body 10, it is also possible to adopt a solid round bar instead.

The sheath 12 for puncturing is made of polyester resin, for example, and has a length that does not cover the needle tip 10a of the needle body 10 when it is attached to the needle body 10 as shown in FIG. It is molded from plastic, fluorine resin, and other synthetic resins. The needle tip 10a always protrudes forward from the sheath 12 to ensure reliable puncturing action.

Moreover, as is particularly clear from FIGS. 3 and 4, the front end position of the sheath 12 is located at the catheter introduction guide wire 2 which is thinner than the contrast agent injection catheter 20.
The primary insertion portion 12a has a small diameter diameter D1 with an acceptable inner diameter dimension D1 of only 2, and is configured to perform a puncturing action on the blood vessel 14 while closely cooperating with the needle body 10.

In that case, the primary insertion portion 12a into the blood vessel 14
In order to reduce the puncture resistance of the sheath 12, it is preferable that the most forward end of the sheath 12 has a tapered (frontward downward) conical shape as shown in the figure or a rounded shape. It goes without saying that the primary insertion portion 12a has a length equal to or longer than the puncture distance from the skin surface to the front wall 14a of the blood vessel 14.

On the other hand, similarly, the position subsequent to the primary insertion part 12a of the sheath 12 is a large-diameter secondary insertion part 12b, which has an inner diameter D2 of the catheter 20 itself or a catheter introducer slightly thicker than this. The size is set to accept 24. The boundary position between the primary insertion section 12a and the secondary insertion section 12b is smoothly connected by a conical dilator section 12c that tapers (downwards from the front).

In other words, the sheath 12 is formed in a so-called stepped configuration in which the outer diameter changes overall, and the primary insertion portion 12a, in conjunction with the needle body 10, allows the insertion of the blood vessel 14. The puncture hole 26 opened in the middle front wall 14a can be expanded naturally and without strain by the dilator section 12c and the secondary insertion section 12b.

In that case, the dilator section 12c of the sheath 12
It is preferable that the secondary insertion part 12b be thicker or harder than the primary insertion part 12a. For example, the wall thickness of the primary insertion portion 12a is approximately
Assuming that the thickness is determined to be 0.05 to 0.3 m, the wall thickness of the dilator portion 12c and the secondary insertion portion 12b are each formed to be approximately 0.3 mm or more. Close the lid,
This is because even after the needle body 10 is removed, it becomes easier to reliably expand the puncture hole 26 using only the sheath 12.

Also, the dilator section 12c of the sheath 12
When the puncture hole 26 has been expanded by the secondary insertion part 12b, the primary insertion part 12a and the needle body 1 are still
The total length L1 of the primary insertion section 12a and dilator section 12c of the sheath 12 is determined by the inner diameter dimension of the blood vessel 14 so that the needle tip 10a of the sheath 12 does not reach the rear wall 14b of the blood vessel 14. It is desirable to set it slightly shorter than . The depth of insertion into the blood vessel 14 during the puncture action is determined by the sheath 1
This can be easily recognized by the scales and markings (not shown) provided on the secondary insertion portion 12b of No. 2.

Note that the primary insertion portion 12a of the sheath 12 is inserted into the blood vessel 14.
Since it will be completely buried in the inside as soon as possible, in order to prevent damage to the rear wall 14b of the blood vessel 14,
It is also conceivable to provide flexibility, especially to the frontmost end of the next insertion section 12a.

Further, reference numeral 28 in FIGS. 1 to 4 is a slit line of a certain length cut along the longitudinal direction of the sheath 12, and serves to split or tear the sheath 12 later. However, in order to prevent the blood vessel 14 from opening and cracking when puncturing the blood vessel 14, a small continuous portion of a constant length L2 is left at the most anterior end thereof.

In other words, by cutting off only a small constant length L2 with a cutter or hand and opening and splitting the entire sheath 12, the sheath 12 can be inserted even from an intermediate position in the longitudinal direction of the catheter introduction guide wire 22. It is now possible to completely remove it.

Therefore, while moving the sheath 12 along the length of the guide wire 22, the catheter 20 or the catheter introducer 24 can be easily inserted along the wire 22 without having to completely pull it out backward from the guide wire 22 one by one. That means you can send it in.

Next, FIGS. 5 to 8 show various modifications of the puncture sheath 12. As is clear from the first modification shown in FIGS. 5 and 6, a tapered (frontward downward) conical dilator section 12c is interposed and coupled at the boundary between the primary insertion section 12a and the secondary insertion section 12b. As far as this is possible, it is also possible to set the length of the secondary insertion portion 12b to be short and form the rear end into a conical shape that slopes downward.

The structure for splitting the sheath 12 is not limited to a through-opening structure such as the slit line 28, but a V-shaped groove 30 as shown in FIG.
By arranging them over the entire length of 2, a weak portion may be provided that can be easily torn from these.

In addition, as shown in the second modified example of FIG. 7, the sheath 1
The second secondary insertion portion 12b may be formed into a conical shape with a gradual downward slope over its entire length. As the slit wire 28 for opening the sheath 12,
An engraved form of dotted lines or chain lines as shown in the figure can be adopted.

Furthermore, as is clear from the third modification in FIG.
As long as the conical dilator part 12c that is tapered (downwards in the front) following the primary insertion part 12a of the sheath 12 is provided, the outer diameter of the surface of the secondary insertion part 12b can be formed into a wave form that alternately changes in size. It can be said that it is also possible to define it in a sawtooth shape or the like. It is also conceivable that a handle 32 for opening and splitting the sheath 12 is extended and connected to the rear end of the sheath 12.

The other configurations in the first to third variations are as follows:
Since it is substantially the same as the above-mentioned basic example of FIGS. 1 to 4, the detailed explanation thereof will be omitted except that the corresponding symbols with those of FIGS. 1 to 4 are written in FIGS. 5 to 8.
In any case, as suggested from Figures 5 to 8,
At the rear end of the sheath 12 is a large-diameter hub 34 that serves as a handle.
can be extended continuously.

<Function> The usage of the dilator-equipped puncture needle configured as described above will be explained as follows.

That is, when performing an angiographic examination according to the present invention, first, as is clear from FIG. The needle is inserted in a piercing manner into a blood vessel 14 such as a brachial artery or a femoral artery.

Then, the dilator section 12c of the puncture sheath 12 and the secondary insertion section 12 following this
b acts as a dilator for the blood vessel 14,
The front wall 14a of the blood vessel 14 has a puncture hole 26 large enough to safely and smoothly accept not only the catheter 20 but also the slightly thicker catheter introducer 24. This means that no aperture is generated.

Therefore, as shown in FIG. 9, the needle body 10 is removed from the sheath 12 while leaving the sheath 12 inserted and held in the blood vessel 14. Needless to say, under this condition, the primary insertion portion 12a of the sheath 12 will be buried within the blood vessel 14.

On the other hand, a relatively short catheter introduction guide wire 22 prepared in advance is inserted into the hollow inner tube 24a of the catheter introducer 24, and the guide wire 22 is inserted into the sheath as shown in FIG. After inserting the sheath 12 into the blood vessel 14 based on the guidance in step 12,
The material is extracted from the puncture hole 26, and is removed by splitting or tearing it from the slit line 28 or the weak portion, as shown by the chain line in the figure.

However, before pulling out the sheath 12 from the puncture hole 26, the sheath 12 must be inserted along the guide wire 22.
The puncture hole 26 may be expanded by pushing the dilator part 12c and the secondary insertion part 12b deeply into the blood vessel 14 while rotating the dilator part 12c. be.

According to this, the primary insertion portion 12a of the sheath 12
is guided along the way by the guide wire 22,
Damage to the rear wall 14b of the blood vessel 14 and bleeding caused therefrom can be effectively prevented.

Next, the catheter introducer 24
is inserted into the blood vessel 14 along the guide wire 22 as shown in FIG. The hollow inner tube 24a and the guide wire 22 are then removed.

In that case, as described above, the puncture hole 26 is enlarged by the puncture needle before the introducer 24 is inserted, so the insertion action of the mantle tube 24b in the introducer 24 is It will also be extremely smooth.

Then, the catheter 20 is continued along the remaining mantle tube 24b as shown in FIG.
At the same time, the mantle tube 24b of the introducer 24 is also removed, and a contrast agent 36 is injected into the catheter 20 as shown in the figure, thereby conducting a contrast examination of the blood vessel 14. .

In addition, the other reference numerals 24c in FIG. 9 indicate the drug injection tube of the catheter introducer 24, and 14c indicates the subcutaneous tissue.

Since the catheter 20 is fed into the blood vessel 14 through the mantle tube 24b of the introducer 24, there is no risk of excessive physical stimulation such as rubbing the opening edge of the puncture hole 26. As a result, contraction of the blood vessel 14 can be effectively prevented, and there is no risk of bleeding.

When the catheter 20 is selectively or superselectively inserted into the primary limb, secondary limb, or tertiary limb of the aorta, the catheter introducer 24 and a short length thereof are used. By repeating the above-described operations while using the introduction guide wire 22 as it is, it is possible to perform a contrast examination of systemic arteries in exactly the same manner. However, through the relatively long guide wire 22 prepared in advance,
It is not impossible, so to speak, to directly insert the catheter 20 and pour the contrast medium 36 into it.

In other words, if the guide wire 22 inserted in the process shown in FIG. 9 is relatively long,
The catheter 20 is attached to this in advance, and in the subsequent process shown in the same figure, after the puncture sheath 12 is opened and removed, the catheter 20 is
Immediately insert the blood vessel 14 along the guide wire 22.
At the same time, the guide wire 22 is also removed and the remaining catheter 20 is inserted into the catheter.
A contrast agent 36 can be injected into the area.

Even in that case, the puncture hole 26 of the blood vessel 14 is opened by the sheath 12 of the puncture needle to an expanded state larger than the external dimensions of the catheter 20, so when the catheter 20 or the guide wire 22 is inserted, There is no risk of rubbing against the opening edge of the puncture hole 26, and operability and safety are maintained, and the puncture hole 26 of the blood vessel 14 can be closed with a single puncture action, similar to the above-mentioned operation method. can be expanded.

<Effects of the Invention> As described above, the present invention includes a needle body 10 for puncturing a blood vessel 14, and a sheath 12 that is attached to and set on the needle body 10 so that its needle tip portion 10a protrudes and can be freely inserted and removed. A puncture needle for angiography is provided with a small-diameter primary insertion part 12a at the front end position of the sheath 12, which can receive only the guide wire 22 for catheter introduction and can be brought into close contact with the needle body 10. , Similarly, at a position subsequent to the primary insertion section 12a of the sheath 12, there is a secondary insertion section with a large diameter tube that can accept the catheter 20 guided by the guide wire 22 or the catheter introducer 24 which is slightly thicker than the catheter 20. 12b, and the boundary position between the primary insertion part 12a and the secondary insertion part 12b is connected to the tapered conical dilator part 12.
1 of the sheath 12 that closely cooperates with the needle body 10 by making it smoothly continuous as c.
The puncture hole 26 opened in the blood vessel 14 by the secondary insertion part 12a is subsequently defined so as to be able to expand automatically by the dilator part 12c of the sheath 12 and the secondary insertion part 12b, and at least the needle A slit line 28 of a certain length or a weak portion where the distal end corresponding to the needle tip 10a of the main body 10 maintains a continuous state is inserted into the sheath 12.
Splitting or tearing the entire sheath 12 from the slit line 28 or the weak part without pulling out the sheath 12 along the guide wire 22 that has been applied along the longitudinal direction and received into the sheath 12. According to
Since the guide wire 22 is set so that it can be removed from an intermediate position in the longitudinal direction, it has the effect of improving the various problems of the prior art described at the beginning.

That is, according to the above configuration of the present invention, the primary insertion portion 12a of the puncture sheath 12 has an inner diameter dimension D that can accept only the catheter introduction guide wire 22.
1, it is formed as thin as possible, so that it may precede the inside of the blood vessel 14 and in the unlikely event that the rear wall 1
Even if a puncture hole is formed in 4b,
Thereafter, the puncture hole in the wall 14b can be minimized, and further bleeding can be reduced, and the bleeding can be easily stopped.

This can be achieved more effectively by adopting an operation method in which the sheath 12 is pushed deeply based on the guidance of the guide wire 22, especially when the guide wire 22 is inserted into the blood vessel 14. Become.

Further, at a position subsequent to the primary insertion portion 12a, a tapered (front downward) conical dilator portion 12c is provided.
A large-diameter tubular secondary insertion section 12b is connected to the catheter 20 through the catheter introducer 24, which is slightly thicker than the catheter 20. As equipped, a dilator section 12c
Since it also plays the role of expanding the puncture hole 26, it prevents bleeding from the rear wall 14b of the blood vessel 14 as described above, while also expanding the front wall 14b of the blood vessel 14.
4a, a large puncture hole 26 into which the catheter 20 can be easily inserted can be opened automatically from the dilator portion 12c smoothly and effortlessly. There is no need to remove the sheath prior to insertion of the dilator.

Furthermore, the sheath 12 of the present invention has a weak portion due to the slit lines 28 and grooves 30 carved along its longitudinal direction.
2 can be split open or torn as a whole, so in the working process shown in Figure 9,
Introducing the sheath 12 into the catheter guide wire 22
Even from a midway position in the longitudinal direction of the guide wire 22, there is no need to move it backwards and completely pull it out from the guide wire 22 one by one.
The sheath 12 can be easily removed, and as a result, the catheter 20 and the catheter introducer 24 can be simply fed along the guide wire 22 as they are, resulting in significantly improved handling and operability.

Further, the small diameter primary insertion portion 12 of the sheath 12
a is shaped so as to be in close contact with the needle body 10, and even when the slit line 28 and the weak part are provided, a continuous part of a constant length L2 is left at the front end of the sheath 12. Therefore, due to the cooperative action between the primary insertion portion 12a of the sheath 12 and the needle body 10, the puncture action into the blood vessel 14 can be reliably and smoothly performed as the puncture hole 26 has an extremely small opening.

[Brief explanation of drawings]

Fig. 1 is a side sectional view showing the assembled state of the dilator-equipped puncture needle according to the present invention, Fig. 2 is a plan view showing the disassembled state of the needle body and sheath, and Fig. 3 shows the sheath extracted. FIG. 4 is an enlarged sectional view taken along line 4-4 in FIG. 3, FIG. 5 is a plan view showing the first modification of the sheath, and FIG.
6 is an enlarged sectional view taken along line 6, FIGS. 7 and 8 are plan views showing the second and third modified examples of the sheath, respectively, and FIGS. Figure, No. 10, 1
FIG. 1 is an assembled sectional view and an exploded plan view of a conventional product corresponding to FIGS. 1 and 2. 10... Needle body, 10a... Needle tip, 12...
Sheath, 12a... Primary insertion part, 12b... Secondary insertion part, 12c... Dilator part, 14... Blood vessel, 20... Catheter, 22... Guide wire, 24... Catheter introducer, 2
6...Puncture hole, 28...Slit line, 30...Concave groove, L1, L2...Constant length dimension, D1, D2...
...Inner diameter dimension.

Claims (1)

[Scope of Claims] 1 An angiography device comprising a needle body 10 for puncturing a blood vessel 14, and a sheath 12 that is set on the needle body 10 so that the needle tip 10a protrudes and can be freely inserted and withdrawn. In this puncture needle, a small-diameter primary insertion part 12a is provided at the front end position of the sheath 12, which can receive only the guide wire 22 for catheter introduction and which can be brought into close contact with the needle body 10. A large-diameter tubular secondary insertion section 12b capable of receiving the catheter 20 guided by the guide wire 22 or a catheter introducer 24 slightly thicker than this is formed at a position subsequent to the secondary insertion section 12a. The boundary position between the primary insertion section 12a and the secondary insertion section 12b is located at the tapered conical dilator section 12.
1 of the sheath 12 that closely cooperates with the needle body 10 by making it smoothly continuous as c.
The puncture hole 26 opened in the blood vessel 14 by the secondary insertion part 12a is subsequently defined so as to be able to expand automatically by the dilator part 12c of the sheath 12 and the secondary insertion part 12b, and at least the needle The tip of the body 10 corresponding to the needle tip 10a is connected to the sheath 12 by inserting a slit line 28 or a weak portion of a certain length that maintains a continuous state in advance.
Splitting or tearing the entire sheath 12 from the slit line 28 or the weak part without pulling out the sheath 12 along the guide wire 22 that has been applied along the longitudinal direction and received into the sheath 12. According to
A puncture needle with a dilator for angiography, characterized in that it is set so that it can be removed from an intermediate position in the longitudinal direction of the guide wire 22.