CN106163451B - 用于分叉的支架移植物的递送和部署系统 - Google Patents

用于分叉的支架移植物的递送和部署系统 Download PDF

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CN106163451B
CN106163451B CN201580017682.XA CN201580017682A CN106163451B CN 106163451 B CN106163451 B CN 106163451B CN 201580017682 A CN201580017682 A CN 201580017682A CN 106163451 B CN106163451 B CN 106163451B
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M·S·比尔得
M·J·赛克特
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WL Gore and Associates Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2002/065—Y-shaped blood vessels

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Transplantation (AREA)
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Abstract

一种用于管腔内递送医疗装置的系统，其中所述医疗装置包括分叉的支架移植物，所述分叉的支架移植物具有主体、第一腿部和比所述第一腿部更短的第二腿部。所述系统包括：鞘管，其具有管状壁，所述管状壁具有限定管腔的圆柱形内表面，所述管腔用于在其中接纳所述支架移植物以将其约束为适于管腔内递送的递送构造；以及大致圆柱形芯体构件，其延伸通过所述管腔。所述芯体构件具有用于接合所述第一腿部的末端的第一环形表面。所述芯体具有用于当至少所述第二腿部的所述末端保持受所述鞘管约束时接合所述第二腿部的末端的第二环形表面。

Description

用于分叉的支架移植物的递送和部署系统
技术背景
技术领域
本发明涉及医疗装置部署系统。更具体地，本发明涉及用于分叉的支架移植物的部署系统。
现有技术
需要对用于主动脉疾病的管腔内治疗装置、工具、系统和方法的改进。具体地，仍然需要对可以适应装置的日益复杂的部署模式，诸如转向、重新限制、多阶段部署、多装置部署，的部署系统的改进，同时促进临床医生的使用的便利性。同样还需要日益减小的轮廓递送机构。
附图简述
附图用于提供对本发明的进一步理解且被并入而构成本说明书一部分，附图中示出了本发明的实施例，并且与说明书一起用于解释本发明的构思。
图1-3图示了分叉的支架移植物和根据各种实施例的一部分部署系统；
图4-5图示了由根据各种实施例的部署系统保持在递送构造中的分叉的支架移植物；
图6-7分别是沿着图5中的6-6和7-7指示的平面获得的分叉的支架移植物和部署系统的剖视图；以及
图8是图5中的分叉的支架移植物和部署系统的纵向剖视图。
具体实施方式
在各种实施例中，一种用于管腔内递送医疗装置的系统包括分叉的支架移植物，所述分叉的支架移植物具有主体、第一腿部和第二腿部，其中第一腿部长于第二腿部；鞘管，其具有管状壁，所述管状壁具有限定管腔的圆柱形内表面，所述管腔用于在其中接纳所述支架移植物以将其约束为适于管腔内递送的递送构造；以及大致圆柱形芯体构件，其延伸通过所述管腔，所述芯体构件具有具有第一直径的第一区段、具有比所述第一直径小的第二直径的第二区段、以及比所述第二直径更小的第三直径的第三区段，所述芯体具有在所述第一与第二区段之间的环形的第一末端表面和在第二与第三区段之间的环形的第二末端表面，其中所述芯体构件的所述第一和第二末端表面在所述鞘管相对于所述芯体构件的轴向移位期间分别接合所述支架移植物的轴向间隔开的部分。
参考图1-8，例如，用于递送分叉的支架移植物10的递送系统总的如附图标记100指示。如图所示，支架移植物10包括主体20、第一腿部30和第二腿部40，其中第一腿部30长于第二腿部40。递送系统100包括具有管状壁210的鞘管200。管状壁包括外表面212和构成管腔216的相对内表面214。管腔216构造为在其中接纳支架移植物10，以约束并维持支架移植物10处于适于管腔内递送到血管治疗部位的递送构造。
递送系统100包括芯体构件300。芯体构件300具有纵向轴线302并且经过鞘管200的管腔216。芯体构件300包括具有第一直径的第一区段310。芯体构件300包括具有比第一直径小的第二直径的第二区段320。芯体构件300包括比第二直径更小的第三直径的第三区段330。
芯体构件300包括在第一区段310与第二区段320之间的环形的第一末端表面350。第一末端表面350可以大体上垂直于芯体构件300的纵向轴线302。类似地，芯体构件300包括在第二区段320与第三区段330之间的环形的第二末端表面360。第二末端表面360可以大体上垂直于芯体构件300的纵向轴线302。
在安装期间，芯体构件300可以插入支架移植物10的第一腿部30，如图1所示，直至第一腿部30的终端32紧靠第一末端表面350，如图2和3所示。支架移植物10的第二腿部40的终端42与第二末端表面360大致轴向对齐，如在图3中的平面"P"处指出的。
在支架移植物10以图3所示的构造进行安装时，支架移植物10然后通过鞘管200大致径向地紧压到芯体构件300上并且保持处于递送构造，如图4-8所示。如在图7的剖视图(图5中的7-7处指示的平面获得)中最佳地示出的，当第一腿部30紧压并与第三区段330大致同轴对齐时，第二腿部40沿着第三区段330的圆周的一部分紧压。
藉由这种布置，第二腿部40沿着芯体构件300将裂断强度增添给支架移植物10，以在鞘管200相对于芯体的轴向移位期间防止支架移植物10的轴向起皱。因此，在支架移植物10的部署期间，鞘管200相对于芯体构件300沿着由图8中的箭头"a"大致指示的方向移位。第一腿部30和第二腿部40的终端32和42分别与第一末端表面350和第二末端表面360之间的紧靠防止由于当鞘管200移位时支架移植物10与鞘管10之间的摩擦而引起支架移植物10的轴向移位。紧压的支架移植物沿着芯体构件300的第三区段330的增强裂断强度还有助于阻止由于当鞘管200相对于芯体构件300移位时支架移植物10与鞘管10之间的摩擦引起支架移植物的轴向起皱。
鞘管200相对于芯体构件300的轴向移位允许支架移植物10从递送构造的向外扩展。可选地，辅助鞘管或约束套筒可以用来将支架移植物的扩展限制成中间构造，该中间构造大于递送构造并且小于与血管壁接合的完全部署构造。这样的约束套筒的进一步细节例如Leopold等人发布的美国专利号6,352,561、Thornton等人发布的美国专利号6,551,350、以及共同待决美国专利申请US2010/0049293A1(Zukowski等人)中，其内容以引用方式完全并入本文。
在支架移植物10完全部署后，芯体构件300和鞘管200可以从患者的治疗部位和体内移除。
对于本领域的技术人员显而易见的是，在不脱离本发明的实质或范围的前提下，可以在本发明中进行各种修改和变型。因此，本文所述实施例旨在涵盖本发明的修改和变型，只要这些修改和变型落入所附权利要求及其等同物的范围内。

Claims (11)

1.一种用于管腔内递送医疗装置的系统，其中所述医疗装置包括分叉的支架移植物，所述分叉的支架移植物具有主体、第一腿部和比所述第一腿部短的第二腿部，所述系统包括：
鞘管，具有管状壁，所述管状壁具有限定管腔的圆柱形内表面，所述管腔中用于接纳所述分叉的支架移植物以将所述分叉的支架移植物约束成适于管腔内递送的递送构造；以及
大致圆柱形芯体构件，延伸通过所述管腔，所述芯体构件具有用于接合所述第一腿部的末端的第一环形表面，所述芯体具有第二环形表面，用于当所述第二环形表面位于所述第一腿部的管腔内时以及当至少所述第二腿部的末端保持受所述鞘管约束时接合所述第二腿部的末端。
2.根据权利要求1所述的系统，其中所述芯体构件包括具有第一直径的第一区段和具有第二直径的第二区段，所述第一直径大于所述第二直径。
3.根据权利要求2所述的系统，其中所述第一环形表面在所述第一区段的外表面与所述第二区段的外表面之间延伸。
4.根据权利要求3所述的系统，其中所述第一环形表面垂直于所述芯体的纵向轴线。
5.根据权利要求3所述的系统，其中所述芯体构件包括具有第三直径的第三区段，所述第二直径大于所述第三直径。
6.根据权利要求5所述的系统，其中所述第二环形表面在所述第二区段的外表面与所述第三区段的外表面之间延伸。
7.根据权利要求6所述的系统，其中所述第二环形表面垂直于所述芯体的纵向轴线。
8.根据权利要求6所述的系统，其中所述第一环形表面与所述第二环形表面平行。
9.根据权利要求5所述的系统，其中所述芯体构件的所述第一、第二和第三区段同轴地对齐。
10.根据权利要求5所述的系统，其中所述芯体构件的所述第二和第三区段延伸通过所述分叉的支架移植物的所述第一腿部。
11.一种医疗装置递送系统，所述系统包括：
分叉的支架移植物，在其近端和与所述近端相对的其远端之间延伸，所述分叉的支架移植物具有所述近端与分叉之间延伸的主体，所述分叉的支架移植物具有从所述分叉延伸出的第一和第二腿部，所述第一腿部具有限定所述分叉的支架移植物的所述远端的末端，所述第二腿部具有在所述分叉的支架移植物的所述分叉与所述远端之间的位置处终止的末端；
鞘管，具有管状壁，所述具有限定管腔的圆柱形内表面，所述管腔用于在其中接纳所述分叉的支架移植物以将所述分叉的支架移植物约束成适于管腔内递送的递送构造；以及
大致圆柱形芯体构件，延伸通过所述管腔并与所述鞘管滑动地接合，所述芯体构件具有用于接合所述分叉的支架移植物的远端的第一环形表面，所述芯体具有第二环形表面，所述第二环形表面用于在所述鞘管相对于所述芯体构件的移位期间当所述第二环形表面位于所述第一腿部的管腔内时以及当至少所述第二腿部的末端保持受所述鞘管约束时接合所述第二腿部的末端，以使所述分叉的支架移植物沿着所述芯体构件的移位最小化。
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