CN107847332B - 用于偏转递送导管的系统和方法 - Google Patents
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- 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
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
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- 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
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- A61M25/0043—Catheters; Hollow probes characterised by structural features
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- 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
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2002/9623—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve the sleeve being reinforced
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- A—HUMAN NECESSITIES
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- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0018—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
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- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0029—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in bending or flexure capacity
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- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires
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Abstract
公开了与递送导管(100)一起使用的远侧末端部(110),其被构造为当导管通过脉管系统前进到所需治疗部位时促进导管的偏转。如此构造的远侧末端部实现了通过脉管系统更安全、更精确地操纵导管的一个或多个目标。具体地公开的是如下的一种导管(100),该导管包括:护套部件(104),其具有远侧边缘(129);以及末端部(110),其设置在护套部件的远侧,该末端部具有向近侧延伸的突起(211),其中,当护套部件抵着末端部向远侧前进时,护套部件的远侧边缘接合该末端部的向近侧延伸的突起,引起导管的至少一部分偏转。
Description
技术领域
本发明涉及递送导管,例如用于递送假体的递送导管,更具体地涉及递送导管的远侧末端部。
背景技术
患病的或因其它原因有缺陷的心脏瓣膜可被修复或用植入的假体心脏瓣膜置换。术语“修复”和“置换”在本说明书全文中可互换使用,并且对有缺陷的天然心脏瓣膜的“修复”的引用包括假体心脏瓣膜,其使得天然瓣叶不起作用,或者保留天然瓣叶完整且功能齐全。常规地,心脏瓣膜置换手术是在全身麻醉下进行的开放式心脏手术,在此期间,心脏停止跳动且血流由心肺旁路机来控制。传统的开放式手术造成显著的患者创伤和不适,并使患者暴露于许多潜在的风险,例如感染、中风、肾衰竭以及与使用例如心肺旁路机相关联的不利影响。
由于开放式心脏手术程序的缺点,人们对心脏瓣膜的微创和经皮置换的兴趣增加。使用经皮经导管(或经腔)技术,将瓣膜假体压缩以在导管中递送,然后例如通过股动脉中的开口并通过降主动脉推进到心脏中,然后将假体在心脏内部署在待复原的瓣膜的瓣环(例如,主动脉瓣瓣环)处。虽然经导管技术在递送常规支架以恢复血管通畅方面得到广泛接受,但是对于更复杂的假体心脏瓣膜的经皮递送,仅实现了好坏参半的结果。
各种类型和构型的假体心脏瓣膜可用于或者已经被建议用于经皮经导管瓣膜置换手术。通常,假体心脏瓣膜设计试图复制被置换的天然心脏瓣膜的功能,并且因此将包括以某种方式安装在可膨胀支架框架内的瓣叶状结构,该框架在一些情况下由形状记忆材料和构造制成。利用这样的形状记忆或自膨胀支架框架,假体心脏瓣膜被压握到所需尺寸并且以递送构型保持在递送导管的保持护套、套管或胶囊内,例如以用于递送到心脏内的治疗部位。在某些经皮经导管瓣膜置换手术中,递送导管被引入脉管,例如股动脉或肱动脉,并通过脉管系统跟踪至心脏。一旦递送导管以及更具体地是假体心脏瓣膜被适当地定位在待置换的天然瓣膜内,则从假体心脏瓣膜缩回保持护套、套管或胶囊,以允许支架框架返回到其膨胀的直径以便植入天然瓣膜内。
当通过脉管系统跟踪到心脏内的治疗部位时,递送导管常常必须导航通过曲折的解剖结构,以包括穿过主动脉弓。
为了使导管在其在脉管系统(包括主动脉弓的急剧弯曲)内行进时可以被导航通过各种解剖学转弯部,希望临床医生在导管被引导和推进到治疗部位时能够准确地转向或偏转导管。用于导管偏转的典型机构采用一根或多根拉线,所述拉线连接到导管的远侧部分,并且在位于近侧的手柄处受控制。对于这样的机构,当牵拉线时,导管在拉线的方向上偏转。虽然这些拉线机构可以有效地工作,但是它们增加了导管的附加部件和复杂性,并且可能增加假体心脏瓣膜递送系统的本已相对较大的轮廓。因此,需要一种用于假体心脏瓣膜递送系统的改进的转向机构,该机构在递送导管前进到期望的治疗部位的同时导航脉管系统的解剖结构时可以准确、安全和成功地实现递送导管的偏转,而不增加导管的附加部件、复杂性和/或轮廓。
发明内容
本发明旨在通过提供具有改善的偏转能力的假体瓣膜递送系统来克服现有技术递送系统的缺点和不足。这种递送系统使用压缩力来实现导管偏转。
在本发明的一个方面中,提供了一种导管,该导管包括护套部件,护套部件具有远侧边缘和设置在护套部件的远侧的末端部,末端部具有向近侧延伸的突起,其中当护套部件向远侧抵着末端部前进时,护套部件的远侧边缘接合末端部的向近端延伸的突起,引起导管的至少一部分的偏转。
根据另一方面,提供了一种导管,该导管包括:细长管状部件,其具有形成其远侧部分的胶囊段,胶囊段被构造用于将处于压缩构型的假体保持在其中;以及内部部件,其在细长管状部件内可滑动地延伸,内部部件具有设置在胶囊段内的假体保持器,假体保持器具有向近侧延伸的突起,其中当细长管状部件相对于内部部件向远侧前进时,胶囊段接合假体保持器的向近侧延伸的突起,引起导管的至少一部分的偏转。
根据本发明的又一方面,提供了一种导管,该导管包括护套部件,护套部件具有远侧边缘和设置在护套部件远侧的末端部,末端部具有由可压缩材料形成的第一部分和由不可压缩材料形成的第二部分,其中当护套部件抵着末端部向远侧前进时,末端部的第一部分压缩,同时第二部分保持其形状,从而引起导管的至少一部分的偏转。
附图说明
本发明的前述和其它特征和优点将从在附图中示出的本发明的实施例的以下描述显而易见。并入本文并形成说明书一部分的附图还用来说明本发明的原理,并且使得相关领域的技术人员能够制作和使用本发明。附图未按比例绘制。
图1是根据本发明的实施例的处于递送构型的递送导管的截面图。
图2描绘了处于部署构型的图1的递送导管,其中假体心脏瓣膜处于部分部署构型。
图3描绘了根据本发明的实施例的处于重新捕获构型的图1的递送导管,其中如图2所示的部分部署的假体心脏瓣膜被重新捕获并压缩。
图4A是可用于本文的系统和方法并且处于正常的膨胀布置的假体心脏瓣膜的侧视图。
图4B是处于压缩布置的图4A的假体心脏瓣膜的侧视图。
图5是根据本发明的实施例的图1的递送导管的远侧部分的放大图。
图5A是图5中所示的递送导管远侧部分沿着其线A-A截取的截面图。
图6是根据本发明的实施例的图1中的递送导管的远侧部分的放大侧视图。
图6A是图6中所示的递送导管远侧部分沿着其线A-A截取的的横截面图。
图6B是为了说明的目的而从递送导管的其余部分拆下的图6所示递送导管的远侧末端部的近端视图。
图6C是根据本发明的实施例的在用压缩力偏转时的图6中所示的递送导管的远侧部分的放大侧视图。
图7A是为了说明目的而从图6的递送导管的胶囊段拆下的根据本发明的另一实施例的增强结构的侧视图。
图7B是处于偏转状态的图7A的增强结构的侧视图。
图7C是根据本发明的另一实施例的胶囊段的示意性截面图。
图8是根据本发明的另一实施例的递送导管的远侧部分的放大侧视图。
图8A是为了说明的目的而从递送导管的其余部分拆下的图8的递送导管的远侧末端部的近端的立体图。
图8B是根据本发明的实施例的图8A的远侧末端部沿着其线B-B截取的横截面图。
图8C是根据本发明的实施例的在用压缩力偏转时的图8中所示的递送导管的远侧部分的侧视图。
图9是根据本发明的另一实施例的递送导管的远侧部分的截面图。
图9A是根据本发明的实施例的在用压缩力偏转时的图9中所示的递送导管的远侧部分的侧视图。
图9B是为了说明的目的而从递送导管的其余部分拆下的图9所示递送导管的假体保持器的近端视图。
图9C和图9D是根据本发明的另一实施例的递送导管的远侧部分的截面图。
具体实施方式
现在将参照附图描述本发明的具体实施例,其中,类似的附图标记指示相同的或功能上类似的元件。术语“远侧的”和“近侧的”在下面的描述中结合相对于治疗临床医生的位置或方向而使用。“远侧的”和“向远侧”是在远离临床医生的位置或在远离临床医生的方向上,并且“近侧的”和“向近侧”是在靠近临床医生的位置或在朝向临床医生的方向上。
以下详细描述在本质上仅为示例性的,而并非意图限制本发明或本发明的应用和用途。虽然本发明的描述是在心脏瓣膜的治疗的语境下进行,但是本发明也可以在认为可用于冠状动脉或外周血管中的手术中的情况下使用。此外,不打算受限于此前的技术领域、背景技术、发明内容或以下的具体实施方式中所提供的任何明示的或隐含的理论。
图1-3以简化形式示出了根据本发明的实施例的递送导管100,其被构造为用于有缺陷的心脏瓣膜的腔内经导管修复/置换。递送导管100在图1中被描绘为递送构型,其中示例性假体心脏瓣膜150被加载在管状护套部件104的远侧胶囊段102内。一般而言,假体心脏瓣膜150包括支架框架,其将瓣膜结构(组织或合成物)保持在支架框架内,并且具有正常的膨胀布置以及可塌缩成压缩的递送布置以供加载在递送导管100内。支架框架被构造成,当从递送导管100释放时自行部署或自膨胀。在一个实施例中,可用于本发明的实施例的假体心脏瓣膜可以是如在Tuval等人的美国专利申请公开第2008/0071361号中公开的假体心脏瓣膜,,该专利文献以引用方式全文并入本文中。可以适用于本发明的系统和方法的经导管心脏瓣膜假体的其他非限制性示例描述于以下专利中:Nguyen等人的美国专利申请公开第2006/0265056号;Birdsall的美国专利申请公开第2007/0239266号;以及Dolan等人的美国专利申请公开第2007/0239269号,这些专利文献中的每一份均以引用方式全文并入本文中,并且在图4A和图4B中更详细地描述。
在图1的递送构型中,远侧胶囊段102设置在假体心脏瓣膜150上,以压缩地保持假体心脏瓣膜与管状内轴或内部部件106的压握接合。远侧胶囊段102的可张开漏斗段108具有形状记忆构造,并且在图1的递送构型中与假体心脏瓣膜150向远侧地间隔开。在一个实施例中,漏斗段108的长度可以在0.5cm至1cm的范围内。在假体心脏瓣膜150的重新捕获和/或完全部署之后,赋予漏斗段108的形状记忆性质使得漏斗段基本上返回到图1所示的管状缩径状态,如下面更全面描述的。
递送导管100在图2中被描绘为处于部署构型,其中假体心脏瓣膜150部分地部署/膨胀。远侧胶囊段102被示出为相对于假体心脏瓣膜150向近侧缩回,以允许假体心脏瓣膜150的远侧区域152自膨胀。漏斗段108不限制或阻碍该膨胀,而是通过假体心脏瓣膜150的远侧区域152而膨胀至与部署的远侧区域152的形状大体对应的形状。在对假体心脏瓣膜150进行部署的这个阶段,如果临床医生认为在待修复的天然心脏瓣膜内的定位是正确的,则远侧胶囊段102相对于假体心脏瓣膜150向近侧缩回,以允许假体心脏瓣膜从那里完全释放和部署。
当假体心脏瓣膜150在天然心脏瓣膜内的部分部署定位被认为不太理想时,假体心脏瓣膜150可通过向远侧推进护套部件104而被重新入鞘或重新捕获在远侧胶囊段102内,如在图3中所示的递送导管100的重新捕获构型中大体上描绘的。为了执行该再入鞘/重新捕获功能,处于膨胀状态的漏斗段108容易沿假体心脏瓣膜150的外部滑动,并且有效地用作在假体心脏瓣膜150的结构和远侧胶囊段102的更硬的近侧部分之间的缓冲器。随着远侧胶囊段102在假体心脏瓣膜150的膨胀的远侧区域152上向远侧推进,假体心脏瓣膜被强制地压回到图1中所描绘的初始压缩递送构型。由于漏斗段108的形状记忆特性,当漏斗段108在塌缩的假体心脏瓣膜150的远侧被操纵时,漏斗段108基本上返回或自行过渡回到图1中描绘的管状缩径状态。然而,本领域的普通技术人员应当理解,在假体心脏瓣膜的再入鞘/重新捕获之后和/或在其完全部署之后,漏斗段108的最远端可能已经经历了一些变形和/或直径增加。
通常,通过使用第一致动器机构或控制器154使护套部件104相对于内轴106和假体心脏瓣膜150向近侧移动,以实现假体心脏瓣膜150的部署,而第二致动器机构或控制器156用于向内轴106提供相对于护套部件104的近侧力,以便当需要重新捕获时将部分膨胀的假体心脏瓣膜150缩回到远侧胶囊段102中。第一致动器机构154和第二致动器机构156仅被大体描绘,并且可以采取任何合适的形式来执行上述功能,这对于本领域的普通技术人员来说是显而易见的。例如,在一个实施例中,第一致动器154和第二致动器156中的每一个可以是由临床医生致动的螺旋齿轮机构。护套部件104和内轴106通常是聚合物材料(例如,聚乙烯嵌段酰胺共聚物、聚氯乙烯、聚乙烯、聚对苯二甲酸乙二醇酯、聚酰胺或聚酰亚胺)的薄壁柔性管状结构,并且可以由一个或多个管状部件形成。在本发明的实施例中,远侧胶囊段102和漏斗段108可以是聚合物材料的复合管状结构,其用合适的生物相容性金属或金属合金(例如镍钛诺)的编织或网状层来增强,其中漏斗段108具有镍钛诺增强层,该增强层允许漏斗段被成形为图1所示的形状记忆构型。在本发明的其他实施例中,可以适合在本文中使用的假体递送系统及其部件如下列专利中所示和所述:Shipley等人的美国专利申请公开第2011/0251681号;Deshmukh等人的美国专利申请公开第2014/0148889号;Yeung等人的美国专利申请公开第2011/0098804号;Murray等人的美国专利申请公开第2012/0310332号;Murray等人的美国专利申请公开第2012/0305441号;或Murray III等人的美国专利申请公开第2011/0251682号,这些专利文献中的每一份均以引用方式全文并入本文中。
递送导管100包括根据本发明的实施例的无创远侧末端部110,其具有如本领域普通技术人员将理解的向远侧渐缩的外表面或轮廓。当递送导管100处于递送构型时,远侧末端部110附接在内轴106的远端,以与护套部件104的远侧开口109接合或接触,该递送构型包括在递送导管100向着治疗部位的初始追踪期间,在重新捕获假体心脏瓣膜150之后以及在递送导管100的后续重新定位期间,以及在完成介入手术时从脉管系统移除递送导管100期间。当递送导管100处于部署构型时,在假体心脏瓣膜150的部分和/或完全部署期间,远侧末端部110从护套部件104的远侧开口109脱离。在本发明的实施例中,远侧末端部110通过诸如胶合、焊接和包覆成型的手段、例如通过注塑成型而固定到内轴106。
如本文所提到的,可用于本文所述各种系统、装置和方法和/或作为其一部分的带支架的经导管假体心脏瓣膜可以呈现各种各样的不同构型,例如,具有组织瓣叶的生物假体心脏瓣膜或具有聚合物、金属或组织工程化瓣叶的合成心脏瓣膜,并可被特定地构造用于置换任何心脏瓣膜。瓣叶可以由多种材料形成,例如本领域已知的自体组织、异体移植材料或合成物。或者,瓣叶可以作为均一的生物瓣膜结构来提供,例如,猪、牛或马瓣膜。因此,可用于本文所述系统、装置和方法的带支架的假体心脏瓣膜可被大体上用于置换天然的主动脉瓣、二尖瓣、肺动脉瓣或三尖瓣,用作静脉瓣膜,或者置换例如在主动脉瓣或二尖瓣的区域中的失效的生物假体。
一般而言,带支架的假体心脏瓣膜包括保持瓣膜结构(组织或合成物)的管状支架框架或支撑结构,其中支架框架具有正常膨胀布置并可塌缩至压缩布置以用于加载在递送装置内。支架框架通常构造成当从递送装置释放时自部署或自膨胀的。例如,适合在本发明的实施例中使用的支架框架可以由形状记忆材料形成,例如镍钛合金(例如,镍钛诺TM)。利用这种材料,支架框架可以从压缩布置自膨胀到正常的膨胀布置,例如通过移除递送装置的护套部件。可以适用于本发明的实施例的带支架的假体心脏瓣膜的示例是可以商品名从Medtronic CoreValve,LLC获得的假体心脏瓣膜。可以用于本发明的系统、装置和方法的经导管心脏瓣膜假体的其他非限制性示例描述于以下专利中:美国专利申请公开第2006/0265056号、第2007/0239266号和第2007/0239269号,这些专利的教导此前以引用方式并入本文中。
鉴于上述情况,图4A中示出了可用于本文所述系统、装置和方法的带支架的假体心脏瓣膜150的一个非限制性示例。作为参考点,假体心脏瓣膜150在图4A的视图中以正常或膨胀的布置示出,并且在图4B中以压缩的递送布置示出,例如当被压缩地保持在护套部件104的远侧胶囊段102内时。假体心脏瓣膜150包括支架框架或支撑结构432和瓣膜结构434。支架框架432可以呈现上述形式中的任一种,并且大体上被构造成能够从压缩的递送布置(图4B)自膨胀到正常的膨胀布置(图4A)。在其他实施例中,支架框架432能够通过单独的装置(例如,位于支架框架432内部的球囊)膨胀到膨胀布置。瓣膜结构434组装到支架框架432并且提供两个或更多个(通常三个)瓣叶436。瓣膜结构434可以采用上述任何形式,并且可以以各种方式组装到支架框架432,例如通过将瓣膜结构434缝合到由支架框架432限定的一个或多个丝段。
对于示出可接受的构造之一的图4A和图4B的实施例,假体心脏瓣膜150被构造为置换或修复主动脉瓣。或者,也可以设想到适合待修复的天然瓣膜的具体解剖结构的其他形状(例如,根据本公开的带支架假体心脏瓣膜可以被成形为和/或尺寸设计为用于置换天然的二尖瓣、肺动脉瓣或三尖瓣)。就图4A和图4B的一种构造而言,瓣膜结构434延伸小于支架框架432的整个长度,但是在其他实施例中,可以沿着支架框架432的整个长度或几乎整个长度延伸。各种各样的其他结构也是可接受的,并且在本发明的范围内。例如,支架框架432在正常的膨胀布置下可以具有更加圆柱形的形状。
参照图5和图5A,其是没有加载假体心脏瓣膜150的递送导管100的远侧部分101的放大视图,用于可滑动地接收导丝的导丝内腔107延伸穿过内轴106和远侧末端部110,并且远侧开口109由远侧胶囊段102的漏斗段108所限定。在根据本发明的其他实施例中,远侧开口109可以由不包括漏斗段的胶囊段的远端或由不包括胶囊段或漏斗段中的任一个的护套部件的远端所限定。由临床医生致动或操纵一个或两个致动机构154、156所引起的远侧末端部110与护套部件104之间的相对运动将导致远侧末端部110与远侧开口109分离,以允许部署假体心脏瓣膜150,如本领域的普通技术人员将理解的。
如上所述,当通过脉管系统跟踪到心脏内的所需治疗部位时,递送导管经常必须导航通过曲折的解剖结构(包括穿过主动脉弓)。尽管递送导管可以大体上沿着导丝前进,但它也必须被转向或偏转以将假体安全而准确地递送到其目的地。本领域中已知的偏转机构通常使用一个或多个拉线,其可操作地联接到递送导管的远侧部分并且在递送系统的近端处被控制或操纵,以便当拉动线时,递送导管的远侧部分偏转。通过在递送导管的部件之间使用压缩力来实现导管的改善的偏转,根据本发明的实施例的递送导管消除了对拉线和与其相关联的伴随机构的需求。
图6、图6A、图6B和图6C是根据本发明的实施例的递送导管100的远侧部分101的各种视图。远侧边缘129限定远侧胶囊段102的远侧开口109。参照图6和图6B,远侧末端部110包括向近侧延伸的突起211,其在图6中被示出为从远侧边缘129的相对段向远侧间隔开。参照图6C,当护套部件104和胶囊段102在箭头212的方向上抵着远侧末端部110而向远侧前进时,在近侧力在箭头214的方向上经由内轴106施加到远侧末端部110的同时,远侧边缘129接合向近侧延伸的突起211,导致导管的至少远侧部分在箭头213的方向上偏转。在一个实施例中,可通过位于手柄部件中的胶囊移动机构或致动器来施加压缩力。在这样的一种实施例中,胶囊移动机构或致动器已经具有将胶囊段向远侧压入或压缩到远侧末端部中的能力,以克服在加载胶囊段内的假体心脏瓣膜时可见的典型的轴压缩,其被称为由临床医生执行“过驱动”操纵。递送导管的相同结构和/或其使用可以适合于将胶囊段102推进到远侧末端部110中,使得向近侧延伸的突起211与导管的至少远侧部分接合并引起其偏转。
在图6B中所示的实施例中,远侧末端部110的近端127的周向段形成突起211,其中周向段从远侧末端部110的近端127的其余表面向近侧延伸或者相对于该其余表面被升高。在各种实施例中,形成突起211的周向段可以围绕远侧末端部110的近端127的周向的多于或少于三分之一延伸,并且可以具有任何合适的形状或尺寸,以接合胶囊段102的远侧边缘129。带有突起211的远侧末端部110可以形成为聚醚嵌段酰胺(PEBAX)、聚氨酯、硅树脂或适用于远侧末端部或头锥的其他弹性体材料或柔性聚合物材料的模制部件,如本领域普通技术人员将理解的那样。在一个实施例中,诸如硬塑料和金属之一的更刚性的材料可以被包覆成型到形成远侧末端部110的其余部分的材料上,以在其上提供“隆起”或突起211。
参照图6、图6A和图6C并且根据本发明的实施例,胶囊段102具有管状形状,在其内部和外部聚合物层之间在直径上相对的位置或相隔180度处在其壁中嵌入一对纵向延伸的支撑件或花键125,以使得它们彼此平行延伸。在这样的实施例中,远侧末端部110的向近侧延伸的突起211被定位成在一对纵向延伸的支撑件125之间的基本上中间的点处(或者换句话讲在距每个支撑件大约90度的点处)接合胶囊段102的远侧边缘129,以允许胶囊段102沿着延伸穿过一对纵向延伸的支撑件125的所期望的挠曲平面FP挠曲或偏转,如图6A所示。因此,胶囊段102在“向上”或“向下”的方向上相对于图6和图6C的比较中所示出的位置围绕挠曲平面FP弯曲,如本领域普通技术人员将理解那样。
在一个实施例中,胶囊段102的纵向延伸支撑件125是在激光切割管中形成的纵向延伸且平行的花键,例如在图7A和图7B所示的激光切割管780中形成的纵向延伸的花键725,其被两者间的具有一系列间隙784的一系列C形段782分开和连接。如图7B所示,形成为包括激光切割管780的胶囊段的所期望的挠曲平面FP延伸穿过一对平行花键725,并且胶囊段在“向上”或“向下”方向上的挠曲或弯曲(相对于图7A和图7B的比较中示出的位置)还通过由一系列C形段782和间隙784所赋予的从每一个花键725移置90度的胶囊段部分的柔韧性或可压缩性来进一步适应。为了形成用于在本发明的实施例中使用的胶囊段102或其他胶囊段,激光切割管780被嵌入或封装在合适材料的聚合物层内,其中激光切割管780的可张开远侧部分792位于漏斗段108内,并且激光切割管780的近侧部分790位于胶囊段102的近端内。激光切割管的更具体特征以及采用该激光切割管的胶囊段的构造和功能可以在美国专利申请公开第2011/00988804号中找到,该专利此前以引用方式并入本文中。为了本实施例的目的,图7A和图7B示出了可用于图1-3、图5和图6的胶囊段102以及本文所述其他实施例(例如图8和图9中示出的那些)的激光切割管780的一个实施例。在采用激光切割管780的实施例中,远侧末端部110的突起211对齐,以在一对纵向延伸的花键725之间的基本上中间的点处接合胶囊段102的远侧边缘129,以便于沿着延伸穿过一对平行花键725的所需挠曲平面FP挠曲,如图7B所示。因此,结合有激光切割管780的胶囊段102在“向上”或“向下”的方向上相对于图7A和图7B的比较中所示出的位置围绕挠曲平面FP弯曲,如本领域普通技术人员将理解那样。
在另一个实施例中,图7C中以示意性横截面示出的胶囊段702包括一对花键725C,其围绕其纵向轴线缠绕或弯曲。更具体地说,该对花键725C从胶囊段702的近侧部分740中的第一平行取向弯曲到与胶囊段702的远侧部分742中的第一平行取向成90度异相的第二平行取向,以便为胶囊段提供双轴线或多轴线偏转。在这样的实施例中,胶囊段702的近侧部分740将相对于图7C所示的位置围绕在一对平行的花键725C之间延伸的第一挠曲平面FP1“向上”或“向下”偏转或弯曲,如由箭头U和D表示。此外,在这样的实施例中,胶囊段702的远侧部分742将相对于图7C所示的位置围绕在一对平行的花键725C之间延伸的第二挠曲平面FP2“向右”(向页面外)或“向左”(向页面内)偏转或弯曲,如由箭头R和L表示。这样,当抵着远侧末端部110的突起211进行压缩或挤压时,或者当抵着下面描述的远侧末端部810进行压缩或挤压时,胶囊段702将沿着双轴线偏转。应当理解,一对花键725C可以是激光切割管的一部分,其具有附加特征,例如可张开的远侧部分和/或一系列交替的C形段和间隙,如上面关于激光切割管780所描述的。
图8、图8A、图8B和图8C示出了根据本发明的另一个实施例的递送导管800的远侧部分801。远侧末端部810在图8A中被示出为与递送导管800的其余部分分开,图8B是沿图8A中的线B-B截取的远侧末端部810的横截面图。如在此前的实施例中那样,远侧末端部810包括穿过其中的导丝内腔807,导丝内腔807的尺寸被设计成接收用于将脉管系统和心脏结构内的递送导管800跟踪到所需的治疗部位的导丝。在本实施例中,远侧末端部810由两种材料形成,其中第一材料可以被认为是可压缩的,并且其中第二材料可以被认为是不可压缩的。参照图8A和图8B,远侧末端部810的纵向延伸的第一部分815由可以被认为是由柔软且可变形的可压缩第一材料形成,并且远侧末端部810的纵向延伸的第二部分816由可以被认为是由硬的和/或刚性的不可压缩第二材料形成。在本发明的实施例中,可压缩的或软且可变形的第一材料可以是低硬度聚醚嵌段酰胺(PEBAX),例如35D PEBAX,不可压缩的或硬且刚性的第二材料可以是高硬度PEBAX,例如70D PEBAX。在另一个实施例中,远侧末端部810的可压缩的或可变形的纵向延伸第一部分815可以由例如可得自马萨诸塞州威尔明顿的AdvanSource Biomaterials Corp.的ChronoPreneTM15A或75A的材料形成。在一个实施例中,远侧末端部810的第一部分815和第二部分816可以被认为分别形成第一纵向延伸部段815和第二纵向延伸部段816,其中每个部段815、816从远侧末端部810的近端827向远端831向远侧渐缩,以提供无创的轮廓。同样,第一纵向延伸部段815和第二纵向延伸部段816具有形成近端827的面向近侧的表面,并具有形成远端831的面向远侧的表面。在一个实施例中,第一纵向延伸部段815包括形成远侧末端部810的材料的超过50%。在一个实施例中,远侧末端部810可以形成为模制部件,其中第一部分815包覆成型到第二部分816上。
根据本发明的实施例,远侧末端部810连接到内轴106并且设置在护套部件104(并且更具体地说是其远侧胶囊段102)的远侧。当护套部件104和胶囊段102沿箭头812的方向抵着远侧末端部810向远侧推进时,在沿着箭头814的方向经由内轴106向远侧末端部810施加近侧力的同时,远侧末端部810的第一部分815在与胶囊段的接触点817处压缩或变形,而远侧末端部810的第二部分816保持其原始形状/长度,从而导致导管800的至少远侧部分801偏转,如图8C所示。
在另一个实施例中,参照图9、图9A和图9B,递送导管900的远侧部分901包括具有形成其远端的胶囊段902的细长管状或护套部件904。如此前的实施例中所述,胶囊段902被构造用于将处于压缩构型的诸如假体心脏瓣膜150(未示出)的假体瓣膜保持在其中。在图9所示的实施例中,管状内部部件906在细长管状部件904内可滑动地延伸,并且包括附接到其上的假体或瓣膜保持器920。如本领域技术人员将理解的,假体保持器920是被构造用于在加载和递送瓣膜假体期间固定瓣膜假体的近端的模制部件,并且被沿着内部部件904固定,以设置在胶囊段902内,如图9所示。根据本发明的实施例,假体保持器920包括向近侧延伸的突起911,如图9B所示和如下更详细地解释的。无创远侧末端部910附接到内部部件906的远端,以与胶囊段902的远侧边缘929配合,其中假体保持器920从远侧末端部910向近侧地间隔开。
当细长管状部件904在箭头912的方向上向远侧推进时,胶囊段902与假体保持器920的向近侧延伸的突起911接合,导致递送导管900的至少远侧部分901围绕枢轴点PP偏转,如图9A所示。在一个实施例中,当细长管状部件904相对于内部部件906向远侧推进时,胶囊段902的相对的面向远侧的内表面921与向近侧延伸的突起911接合。在这样的实施例中,当递送导管900处于递送构型时,假体保持器920可以被认为通过突起911与胶囊段902的面向远侧的内表面921间隔开。在一个实施例中,突起911是假体保持器920的近端的周向段,该周向段从近端的其余部分延伸。在图9B所示的实施例中,假体保持器920的近端928形成突起911,其中周向段从假体保持器920的近端928的其余表面向近侧延伸或相对于所述其余表面升高。在各种实施例中,形成突起911的周向段可以围绕假体保持器920的近端928的周向的多于或少于三分之一延伸,并且可以具有用于接合胶囊段902的面向远侧的内表面921的任何合适的形状或尺寸。
在图9C和图9D所示的另一个实施例中,假体保持器920C允许临床医生选择或改变递送导管900的远侧部分901的偏转方向。假体保持器920包括可旋转地联接到外部构件957的内部构件955。外部构件957固定到递送导管900的内部部件906,而具有突起911C的内部构件955附接到在细长管状部件904内向近侧延伸的管状轴905,以可操作地联接到递送导管900的手柄部件(未示出)。管状轴905被构造成围绕递送导管900的纵向轴线旋转,以便同时使假体保持器920C的内部构件955相对于细长管状部件904旋转,更具体地说使内部部件955的突起911C相对于细长管状部件904的胶囊段902旋转。这样,突起911C可以被重新定位成在各个接触点处作用于胶囊段902的面向远侧的内表面921以允许改变偏转方向。例如,突起911C可以作用于接触点CP1,如图9C所示,以在箭头D1的方向上偏转或弯曲远侧部分901,或者突起911C可以被旋转以作用于接触点CP2,如图9D所示,以在箭头D2的方向上偏转或弯曲远侧部分901,这导致与图9C中的偏转方向成180度的偏转方向。
在根据本发明的实施例中,用于可滑动地接收导丝的导丝内腔907延伸穿过内部部件906、假体保持器920和远侧末端部910。在本发明的另一个实施例中,远侧末端部910强制地与远侧开口909相互作用,以在递送导管900处于递送构型时被远侧开口909保持。被远侧开口909保持意味着远侧末端部910被强制地固定或保持在远侧开口909内,使得在使递送导管900跟踪通过患者的解剖结构期间,防止了远侧末端部910与胶囊段902的无意或非故意的纵向分离。换句话说,当递送导管900处于递送构型时,远侧末端部910相对于远侧开口909的纵向位置被保持。在这样的布置中,在递送导管900推进通过脉管系统和心脏结构期间,远侧末端部910的近侧搁架段932连续径向地支撑远侧开口909。在一个实施例中,远侧末端部910在远侧开口909内的过盈配合或紧密插塞式压缩配合允许远侧末端部910被远侧开口909所保持。在根据图9的实施例中,远侧末端部910包括位于远侧末端部910的近端927和远侧末端部910的面向近侧的邻接表面933之间的搁架段932,搁架段932形成围绕远侧末端部910的径向延伸的周向脊,以便于远侧末端部910在胶囊段902的远侧开口909内的过盈配合或紧密的插塞式压缩配合。可以与本文的系统、装置和方法一起使用的远侧末端部和胶囊段或护套部件接合的其他非限制性示例描述于美国专利申请公开第2014/0148889号中,该专利的教导此前以引用方式并入本文中。
根据本发明的实施例,细长管状部件904、胶囊段902、内部部件906和远侧末端部910可以由以上提到的用于形成管状护套部件104、胶囊段102、内轴106和远侧末端部110的任何材料形成。在本发明的实施例中,假体保持器920可以是由不锈钢、例如合适的聚碳酸酯、聚醚醚酮(PEEK)、硬尼龙或合适的ULTEM聚醚酰亚胺(PEI)的可机加工硬聚合物所形成的模制部件。
具有各种具体设计和特征的递送系统可适用于本文所述的本发明的远侧末端部、胶囊段和实施例。一些这样的系统及其具体特征的描述可以在被引用且并入本文的各种美国专利和专利申请公开中找到。如上所述,假体心脏瓣膜可以通过如本文所示的递送系统递送,因为这样的假体心脏瓣膜可以被设计成用于通过患者的脉管系统(例如,包括通过患者的股动脉或股静脉的通路或其他方式,如根据已知的或开发的利用经皮递送的递送技术合适的那样)置换主动脉瓣、二尖瓣、三尖瓣或肺动脉瓣。
虽然上文已描述了各种实施例,但应当理解,这些实施例仅作为本发明的例示和示例提供,而不以任何方式进行限制。相关领域的技术人员应理解,在不脱离本发明的精神和范围的情况下,可以在这些实施例中进行形式和细节上的各种改变。因此,本发明的广度和范围不应受上述示例性实施例中任一个的限制,而应仅根据所附权利要求和它们的等同物限定。还应当理解,本文所讨论的每个实施例的每个特征以及本文所引用的每个参考文献都可结合任何其它实施例的特征使用。本文所讨论的所有专利和公开以引用方式全文并入本文中。
Claims (7)
1.一种导管,包括:
护套部件,所述护套部件具有远侧边缘;以及
末端部,所述末端部设置在所述护套部件的远侧,所述末端部具有向近侧延伸的突起,
其中,当所述护套部件抵着所述末端部向远侧前进时,所述护套部件的所述远侧边缘接合所述末端部的所述向近侧延伸的突起,引起所述导管的至少一部分的偏转。
2.根据权利要求1所述的导管,其特征在于,所述末端部的近端的周向段形成所述突起。
3.根据权利要求2所述的导管,其特征在于,所述周向段围绕所述末端部的所述近端的周向的少于三分之一延伸。
4.根据权利要求1所述的导管,其特征在于,所述突起是所述末端部的近端的从所述末端部的所述近端的其余部分延伸的周向段。
5.根据权利要求1所述的导管,其特征在于,所述护套部件包括胶囊段,所述胶囊段被构造成用于将处于压缩构型的假体保持在其中,并且其中,所述胶囊段限定所述护套部件的所述远侧边缘。
6.根据权利要求5所述的导管,其特征在于,所述胶囊段具有管状形状,一对纵向延伸支撑件在直径上相对的位置处嵌入于所述胶囊段的壁中。
7.根据权利要求6所述的导管,其特征在于,所述胶囊段的所述远侧边缘在所述一对纵向延伸支撑件之间的中点处与所述向近侧延伸的突起相接合。
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BRPI0617652A2 (pt) | 2005-10-19 | 2011-08-02 | Pulsar Vascular Inc | métodos e sistemas para incisão endovascular e reparo de defeitos de tecido e lúmen |
US9402707B2 (en) | 2008-07-22 | 2016-08-02 | Neuravi Limited | Clot capture systems and associated methods |
EP2326259B1 (en) | 2008-09-05 | 2021-06-23 | Pulsar Vascular, Inc. | Systems for supporting or occluding a physiological opening or cavity |
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US9301769B2 (en) | 2011-03-09 | 2016-04-05 | Neuravi Limited | Clot retrieval device for removing clot from a blood vessel |
US11259824B2 (en) | 2011-03-09 | 2022-03-01 | Neuravi Limited | Clot retrieval device for removing occlusive clot from a blood vessel |
CN103582460B (zh) | 2011-06-03 | 2019-03-19 | 帕尔萨维斯库勒公司 | 具有额外锚固机构的动脉瘤装置以及相关系统及方法 |
EP2763602B1 (en) | 2011-10-05 | 2020-07-01 | Pulsar Vascular, Inc. | Devices and systems for enclosing an anatomical opening |
US10603157B2 (en) | 2013-03-13 | 2020-03-31 | DePuy Synthes Products, Inc. | Braid implant delivery and retraction device with distal engagement |
US10561509B2 (en) | 2013-03-13 | 2020-02-18 | DePuy Synthes Products, Inc. | Braided stent with expansion ring and method of delivery |
TR201901830T4 (tr) | 2013-03-14 | 2019-03-21 | Neuravi Ltd | Kan damarlarından akut tıkanıkların giderilmesine yönelik cihazlar ve metotlar. |
JP2016513505A (ja) | 2013-03-14 | 2016-05-16 | ニューラヴィ・リミテッド | 血管から閉塞血餅を除去するための血餅回収デバイス |
US9433429B2 (en) | 2013-03-14 | 2016-09-06 | Neuravi Limited | Clot retrieval devices |
US10285720B2 (en) | 2014-03-11 | 2019-05-14 | Neuravi Limited | Clot retrieval system for removing occlusive clot from a blood vessel |
US11154302B2 (en) | 2014-03-31 | 2021-10-26 | DePuy Synthes Products, Inc. | Aneurysm occlusion device |
US11076860B2 (en) | 2014-03-31 | 2021-08-03 | DePuy Synthes Products, Inc. | Aneurysm occlusion device |
WO2015189354A1 (en) | 2014-06-13 | 2015-12-17 | Neuravi Limited | Devices for removal of acute blockages from blood vessels |
US10265086B2 (en) | 2014-06-30 | 2019-04-23 | Neuravi Limited | System for removing a clot from a blood vessel |
US9918718B2 (en) | 2014-08-08 | 2018-03-20 | DePuy Synthes Products, Inc. | Embolic coil delivery system with retractable mechanical release mechanism |
US10206796B2 (en) | 2014-08-27 | 2019-02-19 | DePuy Synthes Products, Inc. | Multi-strand implant with enhanced radiopacity |
US9782178B2 (en) | 2014-09-19 | 2017-10-10 | DePuy Synthes Products, Inc. | Vasculature occlusion device detachment system with tapered corewire and heater activated fiber detachment |
US10617435B2 (en) | 2014-11-26 | 2020-04-14 | Neuravi Limited | Clot retrieval device for removing clot from a blood vessel |
CN111743601A (zh) | 2014-11-26 | 2020-10-09 | 尼尔拉维有限公司 | 从血管除去阻塞性血栓的取血栓装置 |
US11253278B2 (en) | 2014-11-26 | 2022-02-22 | Neuravi Limited | Clot retrieval system for removing occlusive clot from a blood vessel |
US10285710B2 (en) | 2016-06-01 | 2019-05-14 | DePuy Synthes Products, Inc. | Endovascular detachment system with flexible distal end and heater activated detachment |
CN109862835B (zh) | 2016-08-17 | 2022-09-13 | 尼尔拉维有限公司 | 用于从血管中移除闭塞凝块的凝块收回系统 |
US10076428B2 (en) | 2016-08-25 | 2018-09-18 | DePuy Synthes Products, Inc. | Expansion ring for a braided stent |
WO2018046408A2 (en) | 2016-09-06 | 2018-03-15 | Neuravi Limited | A clot retrieval device for removing occlusive clot from a blood vessel |
US10292851B2 (en) | 2016-09-30 | 2019-05-21 | DePuy Synthes Products, Inc. | Self-expanding device delivery apparatus with dual function bump |
US10517708B2 (en) | 2016-10-26 | 2019-12-31 | DePuy Synthes Products, Inc. | Multi-basket clot capturing device |
US10905853B2 (en) | 2017-01-17 | 2021-02-02 | DePuy Synthes Products, Inc. | System and method for delivering a catheter |
US10881497B2 (en) | 2017-01-26 | 2021-01-05 | DePuy Synthes Products, Inc. | Composite vascular flow diverter |
US10888309B2 (en) * | 2017-01-31 | 2021-01-12 | Covidien Lp | Surgical fastener devices with geometric tubes |
US10751066B2 (en) | 2017-02-23 | 2020-08-25 | DePuy Synthes Products, Inc. | Aneurysm device and delivery system |
WO2018181326A1 (ja) | 2017-03-31 | 2018-10-04 | 日本ゼオン株式会社 | ステントデリバリー装置 |
ES2923913T3 (es) | 2017-07-06 | 2022-10-03 | Edwards Lifesciences Corp | Sistema de suministro de carril orientable |
CN107496055B (zh) * | 2017-08-10 | 2021-06-08 | 上海微创心通医疗科技有限公司 | 心脏瓣膜输送导管及输送系统 |
US10806462B2 (en) | 2017-12-21 | 2020-10-20 | DePuy Synthes Products, Inc. | Implantable medical device detachment system with split tube and cylindrical coupling |
US10751065B2 (en) | 2017-12-22 | 2020-08-25 | DePuy Synthes Products, Inc. | Aneurysm device and delivery system |
US10905430B2 (en) | 2018-01-24 | 2021-02-02 | DePuy Synthes Products, Inc. | Aneurysm device and delivery system |
US11051934B2 (en) | 2018-02-28 | 2021-07-06 | Edwards Lifesciences Corporation | Prosthetic mitral valve with improved anchors and seal |
US10786259B2 (en) | 2018-03-30 | 2020-09-29 | DePuy Synthes Products, Inc. | Split balloon assist device and method for using the same |
US10918390B2 (en) | 2018-03-30 | 2021-02-16 | DePuy Synthes Products, Inc. | Helical balloon assist device and method for using the same |
WO2019195860A2 (en) | 2018-04-04 | 2019-10-10 | Vdyne, Llc | Devices and methods for anchoring transcatheter heart valve |
US10806461B2 (en) | 2018-04-27 | 2020-10-20 | DePuy Synthes Products, Inc. | Implantable medical device detachment system with split tube |
US11058430B2 (en) | 2018-05-25 | 2021-07-13 | DePuy Synthes Products, Inc. | Aneurysm device and delivery system |
US11596412B2 (en) | 2018-05-25 | 2023-03-07 | DePuy Synthes Products, Inc. | Aneurysm device and delivery system |
US10939915B2 (en) | 2018-05-31 | 2021-03-09 | DePuy Synthes Products, Inc. | Aneurysm device and delivery system |
US10667833B2 (en) | 2018-06-08 | 2020-06-02 | Neuravi Limited | Guidewire with an atraumatic clot-circumventing configured distal end for use in an endovascular medical system |
US10898216B2 (en) | 2018-06-13 | 2021-01-26 | DePuy Synthes Products, Inc. | Vasculature obstruction capture device |
AU2019204522A1 (en) | 2018-07-30 | 2020-02-13 | DePuy Synthes Products, Inc. | Systems and methods of manufacturing and using an expansion ring |
US10905431B2 (en) | 2018-08-03 | 2021-02-02 | DePuy Synthes Products, Inc. | Spiral delivery system for embolic braid |
US10278848B1 (en) | 2018-08-06 | 2019-05-07 | DePuy Synthes Products, Inc. | Stent delivery with expansion assisting delivery wire |
US10456280B1 (en) | 2018-08-06 | 2019-10-29 | DePuy Synthes Products, Inc. | Systems and methods of using a braided implant |
US10813780B2 (en) | 2018-08-08 | 2020-10-27 | DePuy Synthes Products, Inc. | Intraluminal implant delivery system and method |
US11051825B2 (en) | 2018-08-08 | 2021-07-06 | DePuy Synthes Products, Inc. | Delivery system for embolic braid |
US10842498B2 (en) | 2018-09-13 | 2020-11-24 | Neuravi Limited | Systems and methods of restoring perfusion to a vessel |
US11278437B2 (en) | 2018-12-08 | 2022-03-22 | Vdyne, Inc. | Compression capable annular frames for side delivery of transcatheter heart valve replacement |
US11344413B2 (en) | 2018-09-20 | 2022-05-31 | Vdyne, Inc. | Transcatheter deliverable prosthetic heart valves and methods of delivery |
US10595994B1 (en) | 2018-09-20 | 2020-03-24 | Vdyne, Llc | Side-delivered transcatheter heart valve replacement |
US10321995B1 (en) | 2018-09-20 | 2019-06-18 | Vdyne, Llc | Orthogonally delivered transcatheter heart valve replacement |
US11071627B2 (en) | 2018-10-18 | 2021-07-27 | Vdyne, Inc. | Orthogonally delivered transcatheter heart valve frame for valve in valve prosthesis |
BR102019019522A2 (pt) | 2018-09-20 | 2020-04-07 | Depuy Synthes Products Inc | stent com fios conformados |
US11123077B2 (en) | 2018-09-25 | 2021-09-21 | DePuy Synthes Products, Inc. | Intrasaccular device positioning and deployment system |
US11406416B2 (en) | 2018-10-02 | 2022-08-09 | Neuravi Limited | Joint assembly for vasculature obstruction capture device |
US11253287B2 (en) | 2018-10-04 | 2022-02-22 | Neuravi Limited | Retrograde blood flow occlusion flushing device |
US11076861B2 (en) | 2018-10-12 | 2021-08-03 | DePuy Synthes Products, Inc. | Folded aneurysm treatment device and delivery method |
US11109969B2 (en) | 2018-10-22 | 2021-09-07 | Vdyne, Inc. | Guidewire delivery of transcatheter heart valve |
US11147562B2 (en) | 2018-12-12 | 2021-10-19 | DePuy Synthes Products, Inc. | Systems and methods for embolic implant detachment |
US11406392B2 (en) | 2018-12-12 | 2022-08-09 | DePuy Synthes Products, Inc. | Aneurysm occluding device for use with coagulating agents |
US11272939B2 (en) | 2018-12-18 | 2022-03-15 | DePuy Synthes Products, Inc. | Intrasaccular flow diverter for treating cerebral aneurysms |
US11253359B2 (en) | 2018-12-20 | 2022-02-22 | Vdyne, Inc. | Proximal tab for side-delivered transcatheter heart valves and methods of delivery |
US10653522B1 (en) | 2018-12-20 | 2020-05-19 | Vdyne, Inc. | Proximal tab for side-delivered transcatheter heart valve prosthesis |
US11039944B2 (en) | 2018-12-27 | 2021-06-22 | DePuy Synthes Products, Inc. | Braided stent system with one or more expansion rings |
US11185409B2 (en) | 2019-01-26 | 2021-11-30 | Vdyne, Inc. | Collapsible inner flow control component for side-delivered transcatheter heart valve prosthesis |
US11273032B2 (en) | 2019-01-26 | 2022-03-15 | Vdyne, Inc. | Collapsible inner flow control component for side-deliverable transcatheter heart valve prosthesis |
US11134953B2 (en) | 2019-02-06 | 2021-10-05 | DePuy Synthes Products, Inc. | Adhesive cover occluding device for aneurysm treatment |
US11273285B2 (en) | 2019-02-07 | 2022-03-15 | DePuy Synthes Products, Inc. | Ancillary device for detaching implants |
ES2910600T3 (es) | 2019-03-04 | 2022-05-12 | Neuravi Ltd | Catéter de recuperación de coágulos accionado |
EP4364706A2 (en) | 2019-03-05 | 2024-05-08 | Vdyne, Inc. | Tricuspid regurgitation control devices for orthogonal transcatheter heart valve prosthesis |
US11382633B2 (en) | 2019-03-06 | 2022-07-12 | DePuy Synthes Products, Inc. | Strut flow diverter for cerebral aneurysms and methods for preventing strut entanglement |
US11076956B2 (en) | 2019-03-14 | 2021-08-03 | Vdyne, Inc. | Proximal, distal, and anterior anchoring tabs for side-delivered transcatheter mitral valve prosthesis |
US11173027B2 (en) | 2019-03-14 | 2021-11-16 | Vdyne, Inc. | Side-deliverable transcatheter prosthetic valves and methods for delivering and anchoring the same |
US10631983B1 (en) | 2019-03-14 | 2020-04-28 | Vdyne, Inc. | Distal subannular anchoring tab for side-delivered transcatheter valve prosthesis |
US10758346B1 (en) | 2019-03-14 | 2020-09-01 | Vdyne, Inc. | A2 clip for side-delivered transcatheter mitral valve prosthesis |
US11337706B2 (en) | 2019-03-27 | 2022-05-24 | DePuy Synthes Products, Inc. | Aneurysm treatment device |
US11185334B2 (en) | 2019-03-28 | 2021-11-30 | DePuy Synthes Products, Inc. | Single lumen reduced profile occlusion balloon catheter |
US11051928B2 (en) | 2019-04-11 | 2021-07-06 | Neuravi Limited | Floating carotid filter |
AU2020267390A1 (en) | 2019-05-04 | 2021-11-11 | Vdyne, Inc. | Cinch device and method for deployment of a side-delivered prosthetic heart valve in a native annulus |
US11571553B2 (en) | 2019-05-09 | 2023-02-07 | Neuravi Limited | Balloon guide catheter with thermally expandable material |
US11931522B2 (en) | 2019-05-09 | 2024-03-19 | Neuravi Limited | Inflation lumen kink protection and balloon profile |
US11957855B2 (en) | 2019-05-09 | 2024-04-16 | Neuravi Limited | Balloon guide catheter with positive venting of residual air |
US11607531B2 (en) | 2019-05-09 | 2023-03-21 | Neuravi Limited | Balloon catheter with venting of residual air in a proximal direction |
USD959659S1 (en) | 2019-05-10 | 2022-08-02 | DePuy Synthes Products, Inc. | Implant release handle |
US11497504B2 (en) | 2019-05-21 | 2022-11-15 | DePuy Synthes Products, Inc. | Aneurysm treatment with pushable implanted braid |
US10653425B1 (en) | 2019-05-21 | 2020-05-19 | DePuy Synthes Products, Inc. | Layered braided aneurysm treatment device |
US11672542B2 (en) | 2019-05-21 | 2023-06-13 | DePuy Synthes Products, Inc. | Aneurysm treatment with pushable ball segment |
US11607226B2 (en) | 2019-05-21 | 2023-03-21 | DePuy Synthes Products, Inc. | Layered braided aneurysm treatment device with corrugations |
US11413046B2 (en) | 2019-05-21 | 2022-08-16 | DePuy Synthes Products, Inc. | Layered braided aneurysm treatment device |
US11278292B2 (en) | 2019-05-21 | 2022-03-22 | DePuy Synthes Products, Inc. | Inverting braided aneurysm treatment system and method |
US11602350B2 (en) | 2019-12-05 | 2023-03-14 | DePuy Synthes Products, Inc. | Intrasaccular inverting braid with highly flexible fill material |
US11406403B2 (en) | 2019-06-14 | 2022-08-09 | Neuravi Limited | Visibility of mechanical thrombectomy device during diagnostic imaging |
US11109939B2 (en) | 2019-06-14 | 2021-09-07 | DePuy Synthes Products, Inc. | Intravascular devices with radiopaque body markers |
US11253265B2 (en) | 2019-06-18 | 2022-02-22 | DePuy Synthes Products, Inc. | Pull wire detachment for intravascular devices |
US11426174B2 (en) | 2019-10-03 | 2022-08-30 | DePuy Synthes Products, Inc. | Medical device delivery member with flexible stretch resistant mechanical release |
US11207494B2 (en) | 2019-07-03 | 2021-12-28 | DePuy Synthes Products, Inc. | Medical device delivery member with flexible stretch resistant distal portion |
US11266426B2 (en) | 2019-07-10 | 2022-03-08 | DePuy Synthes Products, Inc. | Streamlined treatment of clot removal, angioplasty and prevention of restenosis using a single integrated intravascular device |
US11266427B2 (en) | 2019-07-10 | 2022-03-08 | Neuravi Limited | Self-expanding intravascular medical device |
US11395675B2 (en) | 2019-07-11 | 2022-07-26 | DePuy Synthes Products, Inc. | Clot retriever cleaning for reinsertion |
JP2022544707A (ja) | 2019-08-20 | 2022-10-20 | ブイダイン,インコーポレイテッド | 側方送達可能な経カテーテル人工弁の送達及び回収のデバイス及び方法 |
JP2022545728A (ja) | 2019-08-26 | 2022-10-28 | ブイダイン,インコーポレイテッド | 側方送達可能な経カテーテル人工弁ならびにそれらを送達及び固定するための方法 |
JP2021041169A (ja) | 2019-09-11 | 2021-03-18 | ニューラヴィ・リミテッド | 拡大可能な口腔カテーテル |
US11439403B2 (en) | 2019-09-17 | 2022-09-13 | DePuy Synthes Products, Inc. | Embolic coil proximal connecting element and stretch resistant fiber |
US11712231B2 (en) | 2019-10-29 | 2023-08-01 | Neuravi Limited | Proximal locking assembly design for dual stent mechanical thrombectomy device |
US11376013B2 (en) | 2019-11-18 | 2022-07-05 | DePuy Synthes Products, Inc. | Implant delivery system with braid cup formation |
US11628282B2 (en) | 2019-11-25 | 2023-04-18 | Neuravi Limited | No preparation balloon guide catheter |
US11839725B2 (en) | 2019-11-27 | 2023-12-12 | Neuravi Limited | Clot retrieval device with outer sheath and inner catheter |
US11779364B2 (en) | 2019-11-27 | 2023-10-10 | Neuravi Limited | Actuated expandable mouth thrombectomy catheter |
US11517340B2 (en) | 2019-12-03 | 2022-12-06 | Neuravi Limited | Stentriever devices for removing an occlusive clot from a vessel and methods thereof |
US11457926B2 (en) | 2019-12-18 | 2022-10-04 | DePuy Synthes Products, Inc. | Implant having an intrasaccular section and intravascular section |
US11234813B2 (en) | 2020-01-17 | 2022-02-01 | Vdyne, Inc. | Ventricular stability elements for side-deliverable prosthetic heart valves and methods of delivery |
US11457922B2 (en) | 2020-01-22 | 2022-10-04 | DePuy Synthes Products, Inc. | Medical device delivery member with flexible stretch resistant distal portion |
US11957354B2 (en) | 2020-02-10 | 2024-04-16 | DePuy Synthes Products, Inc. | Aneurysm implant support device |
US11432822B2 (en) | 2020-02-14 | 2022-09-06 | DePuy Synthes Products, Inc. | Intravascular implant deployment system |
US11944327B2 (en) | 2020-03-05 | 2024-04-02 | Neuravi Limited | Expandable mouth aspirating clot retrieval catheter |
US11633198B2 (en) | 2020-03-05 | 2023-04-25 | Neuravi Limited | Catheter proximal joint |
US11883043B2 (en) | 2020-03-31 | 2024-01-30 | DePuy Synthes Products, Inc. | Catheter funnel extension |
US11759217B2 (en) | 2020-04-07 | 2023-09-19 | Neuravi Limited | Catheter tubular support |
US11717308B2 (en) | 2020-04-17 | 2023-08-08 | Neuravi Limited | Clot retrieval device for removing heterogeneous clots from a blood vessel |
US11871946B2 (en) | 2020-04-17 | 2024-01-16 | Neuravi Limited | Clot retrieval device for removing clot from a blood vessel |
US11730501B2 (en) | 2020-04-17 | 2023-08-22 | Neuravi Limited | Floating clot retrieval device for removing clots from a blood vessel |
US11523831B2 (en) | 2020-04-30 | 2022-12-13 | DePuy Synthes Products, Inc. | Intrasaccular flow diverter |
US11737771B2 (en) | 2020-06-18 | 2023-08-29 | Neuravi Limited | Dual channel thrombectomy device |
US11937836B2 (en) | 2020-06-22 | 2024-03-26 | Neuravi Limited | Clot retrieval system with expandable clot engaging framework |
US11439418B2 (en) | 2020-06-23 | 2022-09-13 | Neuravi Limited | Clot retrieval device for removing clot from a blood vessel |
US11395669B2 (en) | 2020-06-23 | 2022-07-26 | Neuravi Limited | Clot retrieval device with flexible collapsible frame |
US11951026B2 (en) | 2020-06-30 | 2024-04-09 | DePuy Synthes Products, Inc. | Implantable medical device detachment system with flexible braid section |
US11759343B2 (en) * | 2020-07-06 | 2023-09-19 | Venus Medtech (Hangzhou) Inc. | Distal end structure of sheath for delivering interventional instrument and sheath |
US11864781B2 (en) | 2020-09-23 | 2024-01-09 | Neuravi Limited | Rotating frame thrombectomy device |
WO2022098781A1 (en) * | 2020-11-04 | 2022-05-12 | Edwards Lifesciences Corporation | Catheters for implants and medical procedures and methods of use thereof |
US11786698B2 (en) | 2020-12-08 | 2023-10-17 | DePuy Synthes Products, Inc. | Catheter with textured surface |
US11826520B2 (en) * | 2020-12-08 | 2023-11-28 | DePuy Synthes Products, Inc. | Catheter designs for enhanced column strength |
US11937837B2 (en) | 2020-12-29 | 2024-03-26 | Neuravi Limited | Fibrin rich / soft clot mechanical thrombectomy device |
US11872354B2 (en) | 2021-02-24 | 2024-01-16 | Neuravi Limited | Flexible catheter shaft frame with seam |
US11974764B2 (en) | 2021-06-04 | 2024-05-07 | Neuravi Limited | Self-orienting rotating stentriever pinching cells |
US11937839B2 (en) | 2021-09-28 | 2024-03-26 | Neuravi Limited | Catheter with electrically actuated expandable mouth |
US11751881B2 (en) | 2021-11-26 | 2023-09-12 | DePuy Synthes Products, Inc. | Securement wire withstanding forces during deployment of implantable intravascular treatment device using a delivery and detachment system |
US11937824B2 (en) | 2021-12-30 | 2024-03-26 | DePuy Synthes Products, Inc. | Implant detachment systems with a modified pull wire |
US11844490B2 (en) | 2021-12-30 | 2023-12-19 | DePuy Synthes Products, Inc. | Suture linkage for inhibiting premature embolic implant deployment |
WO2023148628A1 (en) * | 2022-02-04 | 2023-08-10 | Medtronic, Inc. | Transcatheter valve recapture devices and methods |
US11937825B2 (en) | 2022-03-02 | 2024-03-26 | DePuy Synthes Products, Inc. | Hook wire for preventing premature embolic implant detachment |
US11937826B2 (en) | 2022-03-14 | 2024-03-26 | DePuy Synthes Products, Inc. | Proximal link wire for preventing premature implant detachment |
Family Cites Families (65)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US39418A (en) * | 1863-08-04 | Improvement in corrugating sheet metal | ||
US4940062A (en) * | 1988-05-26 | 1990-07-10 | Advanced Cardiovascular Systems, Inc. | Guiding member with deflectable tip |
US5480382A (en) * | 1989-01-09 | 1996-01-02 | Pilot Cardiovascular Systems, Inc. | Steerable medical device |
US5383923A (en) * | 1990-10-20 | 1995-01-24 | Webster Laboratories, Inc. | Steerable catheter having puller wire with shape memory |
AU4026793A (en) * | 1992-04-10 | 1993-11-18 | Cardiorhythm | Shapable handle for steerable electrode catheter |
US5396902A (en) * | 1993-02-03 | 1995-03-14 | Medtronic, Inc. | Steerable stylet and manipulative handle assembly |
US5545200A (en) * | 1993-07-20 | 1996-08-13 | Medtronic Cardiorhythm | Steerable electrophysiology catheter |
US5487757A (en) * | 1993-07-20 | 1996-01-30 | Medtronic Cardiorhythm | Multicurve deflectable catheter |
US5395328A (en) * | 1994-01-19 | 1995-03-07 | Daig Corporation | Steerable catheter tip having an X-shaped lumen |
US6302880B1 (en) * | 1996-04-08 | 2001-10-16 | Cardima, Inc. | Linear ablation assembly |
US5904667A (en) * | 1997-03-17 | 1999-05-18 | C.R. Bard, Inc. | Rotatable control mechanism for steerable catheter |
US5944690A (en) * | 1997-03-17 | 1999-08-31 | C.R. Bard, Inc. | Slidable control mechanism for steerable catheter |
US6120476A (en) * | 1997-12-01 | 2000-09-19 | Cordis Webster, Inc. | Irrigated tip catheter |
US7004938B2 (en) * | 2001-11-29 | 2006-02-28 | Medwaves, Inc. | Radio-frequency-based catheter system with improved deflection and steering mechanisms |
US6146338A (en) * | 1999-04-23 | 2000-11-14 | Medtronic, Inc. | Apparatus for deflecting a catheter or lead |
US6468260B1 (en) * | 1999-05-07 | 2002-10-22 | Biosense Webster, Inc. | Single gear drive bidirectional control handle for steerable catheter |
WO2000076570A2 (en) * | 1999-06-15 | 2000-12-21 | Cryocath Technologies, Inc. | Steerable catheter |
US6530897B2 (en) * | 2000-04-28 | 2003-03-11 | Mahase Nardeo | Steerable medical catheter with bendable encapsulated metal spring tip fused to polymeric shaft |
US6579278B1 (en) * | 2000-05-05 | 2003-06-17 | Scimed Life Systems, Inc. | Bi-directional steerable catheter with asymmetric fulcrum |
US6607496B1 (en) * | 2000-09-12 | 2003-08-19 | Medtronic, Inc. | Steerable stylet with enhanced torsional transfer strength |
US6605086B2 (en) * | 2001-05-02 | 2003-08-12 | Cardiac Pacemakers, Inc. | Steerable catheter with torque transfer system |
US7607440B2 (en) * | 2001-06-07 | 2009-10-27 | Intuitive Surgical, Inc. | Methods and apparatus for surgical planning |
US6907298B2 (en) * | 2002-01-09 | 2005-06-14 | Medtronic, Inc. | Method and apparatus for imparting curves in implantable elongated medical instruments |
US7029467B2 (en) * | 2002-07-16 | 2006-04-18 | Edwards Lifesciences Corporation | Multiple lumen catheter having a soft tip |
AU2003290806A1 (en) * | 2002-11-15 | 2004-06-15 | The Government Of The United States As Represented By The Secretary Of The Department Of Health And Human Services | Variable curve catheter |
US7276062B2 (en) * | 2003-03-12 | 2007-10-02 | Biosence Webster, Inc. | Deflectable catheter with hinge |
US7056314B1 (en) * | 2003-05-30 | 2006-06-06 | Pacesetter, Inc. | Steerable obturator |
US7655000B2 (en) * | 2003-09-26 | 2010-02-02 | Tyco Healthcare Group Lp | Urology catheter |
JP5113386B2 (ja) * | 2003-10-27 | 2013-01-09 | ペトルス・アー・ベッセリンク | 自己活動化管腔内デバイス |
US7811277B2 (en) * | 2004-09-30 | 2010-10-12 | Boston Scientific Scimed, Inc. | Steerable device and system |
US7914569B2 (en) | 2005-05-13 | 2011-03-29 | Medtronics Corevalve Llc | Heart valve prosthesis and methods of manufacture and use |
US7623899B2 (en) * | 2005-09-16 | 2009-11-24 | Biosense Webster, Inc. | Catheter with flexible pre-shaped tip section |
US9833595B2 (en) * | 2005-12-30 | 2017-12-05 | Biosense Webster, Inc. | Dual-lever bi-directional handle |
US7740655B2 (en) | 2006-04-06 | 2010-06-22 | Medtronic Vascular, Inc. | Reinforced surgical conduit for implantation of a stented valve therein |
US20070239269A1 (en) | 2006-04-07 | 2007-10-11 | Medtronic Vascular, Inc. | Stented Valve Having Dull Struts |
US20110112563A1 (en) * | 2006-06-30 | 2011-05-12 | Atheromed, Inc. | Atherectomy devices and methods |
US8876895B2 (en) | 2006-09-19 | 2014-11-04 | Medtronic Ventor Technologies Ltd. | Valve fixation member having engagement arms |
US7731706B2 (en) * | 2006-12-29 | 2010-06-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | True angular catheter shaft deflection apparatus |
US8109903B2 (en) * | 2007-05-21 | 2012-02-07 | Smart Medical Systems Ltd. | Catheter including a bendable portion |
US8864675B2 (en) * | 2007-06-28 | 2014-10-21 | W. L. Gore & Associates, Inc. | Catheter |
US8162934B2 (en) * | 2007-12-21 | 2012-04-24 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Medical catheter assembly with deflection pull ring and distal tip interlock |
US8226641B2 (en) * | 2007-12-21 | 2012-07-24 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Medical catheter with deflection pull ring and distal tip attachment apparatus |
US20090264863A1 (en) * | 2008-04-22 | 2009-10-22 | Medtronic Vascular, Inc. | Articulating Tip Tetherless Catheter System |
CN102548508B (zh) * | 2009-09-21 | 2015-06-03 | 麦德托尼克公司 | 带支架的经导管假体心脏瓣膜输送系统及方法 |
US8376991B2 (en) * | 2009-11-09 | 2013-02-19 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Device for reducing axial shortening of catheter or sheath due to repeated deflection |
JP2011172766A (ja) * | 2010-02-24 | 2011-09-08 | Fujifilm Corp | トルク伝達デバイス |
US9795765B2 (en) * | 2010-04-09 | 2017-10-24 | St. Jude Medical International Holding S.À R.L. | Variable stiffness steering mechanism for catheters |
US8998980B2 (en) * | 2010-04-09 | 2015-04-07 | Medtronic, Inc. | Transcatheter prosthetic heart valve delivery system with recapturing feature and method |
US8512401B2 (en) * | 2010-04-12 | 2013-08-20 | Medtronic, Inc. | Transcatheter prosthetic heart valve delivery system with funnel recapturing feature and method |
US9408694B2 (en) * | 2010-08-17 | 2016-08-09 | St. Jude Medical, Inc. | Tip for medical implant delivery system |
CN103282074B (zh) * | 2010-11-03 | 2016-08-10 | 比尔卡地亚股份有限公司 | 可操纵腔内设备和方法 |
MX338973B (es) | 2011-01-14 | 2016-05-06 | Idev Technologies Inc | Sistema de suministro de stent con ensamble empujador. |
AU2012250729B2 (en) * | 2011-05-03 | 2016-12-01 | Shifamed Holdings, Llc | Steerable delivery sheaths |
US9144494B2 (en) | 2011-05-12 | 2015-09-29 | Medtronic, Inc. | Delivery catheter system with micro and macro movement control |
US9486604B2 (en) | 2011-05-12 | 2016-11-08 | Medtronic, Inc. | Packaging and preparation tray for a delivery system |
US11097081B2 (en) * | 2011-07-06 | 2021-08-24 | Boston Scientific Scimed, Inc. | Dual durometer soft/flexible enhanced bond strength guiding tip |
WO2013058962A1 (en) * | 2011-10-18 | 2013-04-25 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US9532871B2 (en) * | 2012-05-04 | 2017-01-03 | St. Jude Medical, Cardiology Division, Inc. | Delivery system deflection mechanism |
US9233225B2 (en) * | 2012-11-10 | 2016-01-12 | Curvo Medical, Inc. | Coaxial bi-directional catheter |
US9387105B2 (en) | 2012-11-12 | 2016-07-12 | W.L. Gore & Associates, Inc | Sleeves for expandable medical devices and methods of making the same |
US9433521B2 (en) * | 2012-11-27 | 2016-09-06 | Medtronic, Inc. | Distal tip for a delivery catheter |
US9636138B2 (en) * | 2012-12-12 | 2017-05-02 | Covidien Lp | Tissue-removing catheter including force-transmitting member for actuating a cutter housing |
US9387106B2 (en) | 2013-02-28 | 2016-07-12 | Medtronic Vascular, Inc. | Medical device delivery systems and methods of use thereof |
US9808311B2 (en) * | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US10118022B2 (en) * | 2014-06-05 | 2018-11-06 | St. Jude Medical, Cardiology Division, Inc. | Deflectable catheter shaft section |
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2015
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US11865000B2 (en) | 2024-01-09 |
AU2016304697A1 (en) | 2018-01-18 |
WO2017027161A1 (en) | 2017-02-16 |
US20190117396A1 (en) | 2019-04-25 |
EP3331474A1 (en) | 2018-06-13 |
US11141269B2 (en) | 2021-10-12 |
US20240115384A1 (en) | 2024-04-11 |
US20170035567A1 (en) | 2017-02-09 |
CN107847332A (zh) | 2018-03-27 |
US10154905B2 (en) | 2018-12-18 |
US20220023041A1 (en) | 2022-01-27 |
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