ES2523900T3 - Dispositivos para cortar tejido - Google Patents
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- ES2523900T3 ES2523900T3 ES13163446.1T ES13163446T ES2523900T3 ES 2523900 T3 ES2523900 T3 ES 2523900T3 ES 13163446 T ES13163446 T ES 13163446T ES 2523900 T3 ES2523900 T3 ES 2523900T3
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320725—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/32075—Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
- A61B2017/320791—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter with cutter extending outside the cutting window
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Abstract
Un catéter (2) de aterectomía que comprende: un cuerpo (8) que tiene una abertura (6): un vástago giratorio (20) acoplado con el cuerpo (8); un elemento de corte (4; 4A) acoplado con el vástago giratorio (20) para hacer girar el elemento de corte alrededor de un eje longitudinal (LA), teniendo el elemento de corte (4; 4A) una superficie (24; 24A) con forma de copa y un filo de corte (22; 22A), siendo el filo de corte (22; 22A) un filo radialmente exterior del elemento de corte (4; 4A); y una cámara (12) de recogida de tejido acoplada con el cuerpo (8) y posicionada distalmente con respecto al elemento de corte (4); caracterizado por un elemento elevado (26; 26A) que se extiende hacia fuera desde la superficie (24; 24A) con forma de copa del elemento de corte (4; 4A), teniendo el elemento elevado (26; 26A) una primera pared (30, 32) que se extiende hacia fuera y que se prolonga generalmente de manera radial, y una pared distal (38; 38A) que incluye una superficie distal que intersecta con la primera pared (30; 30A) para formar un borde elevado (50), en donde el elemento elevado (26; 26A) está rebajado con respecto al filo de corte (22; 22A) cuando se le ve a lo largo del eje longitudinal (LA).
Description
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DESCRIPCIÓN
Dispositivos para cortar tejido
Antecedentes
Los catéteres de aterectomía se usan para retirar material de un vaso sanguíneo con el fin de abrir el vaso sanguíneo y mejorar el flujo sanguíneo a través del vaso.
Un problema que aparece cuando se elimina material de un vaso sanguíneo es que el material puede ser blando o duro y puede variar durante la intervención de corte. Por tanto, el elemento de corte deberá ser capaz de cortar tejido tanto duro como blando.
La presente invención se dirige a un elemento de corte para un catéter de aterectomía para cortar material de un lumen de flujo sanguíneo usando un elemento de corte giratorio. El documento EP-A-1767159 describe un catéter de aterectomía con las características del preámbulo de la reivindicación 1.
Sumario
La presente invención proporciona un catéter de aterectomía, según la reivindicación 1, que tiene un elemento de corte que es capaz de cortar tejido tanto blando como duro. El elemento de corte tiene un filo de corte afilado que rodea una superficie con forma de copa. La superficie con forma de copa dirige el material que se ha cortado hacia el interior de una cámara de tejido. El filo de corte circunferencial y la superficie con forma de copa están bien adaptados en conjunto para cortar y retirar tejido relativamente blando. Las realizaciones preferidas se describen en las reivindicaciones subordinadas.
En un aspecto de la invención, se proporciona un catéter de aterectomía que tiene uno o más elementos elevados que se extienden desde la superficie con forma de copa. El elemento elevado puede estar rebajado longitudinal y radialmente respecto el filo de corte exterior en una distancia controlada, tal como desde aproximadamente 0,025 hasta aproximadamente 0,05 mm (0,0010-0,0020 pulgadas) pero puede, por supuesto, estar más cerca o más lejos del filo de corte exterior dependiendo de la aplicación. Los elementos elevados ayudan a romper el tejido duro, tal como una placa calcificada. Los elementos elevados están algo rebajados respecto del extremo distal de modo que el filo de corte permanezca expuesto para cortar tejido blando. Cuando el elemento de corte encuentra tejido que es demasiado duro para ser cortado suficientemente por el filo de corte, los elementos elevados ayudan a romper el tejido más duro con una aplicación más roma de la fuerza.
En otro aspecto de la invención, el elemento elevado es algo pequeño de modo que una porción relativamente grande de la superficie con forma de copa es lisa e ininterrumpida. De esta manera, la capacidad del elemento de corte para dirigir tejido hacia el interior de la cámara de tejido con la superficie con forma de copa no se inhibe demasiado por los elementos elevados. Por ejemplo, los elementos elevados pueden ocupar un área menor de 60 grados cuando se les ve a lo largo del eje longitudinal. Dicho de otra manera, la superficie con forma de copa del elemento de corte es lisa e ininterrumpida en la totalidad de al menos 300 grados cuando se la ve a lo largo del eje longitudinal. Dicho aún de otra manera, la superficie con forma de copa puede ser lisa e ininterrumpida en al menos un 95% del área superficial del elemento de corte cuando se la ve a lo largo del eje longitudinal.
Estos y otros aspectos se harán evidentes a partir de la siguiente descripción de las realizaciones preferidas, los dibujos y las reivindicaciones.
Los detalles de una o más realizaciones de la invención se exponen a continuación en los dibujos anexos y en la descripción siguiente. Otras características, objetos y ventajas de la invención serán evidentes a partir de la descripción y dibujos y por las reivindicaciones.
Descripción de los dibujos
La figura 1 muestra un extremo distal de un catéter de aterectomía;
La figura 2 es una vista en sección transversal del catéter de aterectomía con un elemento de corte en una posición almacenada;
La figura 3 es una vista en sección transversal con un elemento de corte en una posición de trabajo;
La figura 4 muestra una realización de un elemento de corte;
La figura 5 muestra una vista extrema de una realización de un elemento de corte;
La figura 6 es una vista en sección transversal de una realización de un elemento de corte;
La figura 7 muestra otra realización de un elemento de corte que puede usarse con el catéter de aterectomía;
La figura 8 muestra la realización del elemento de corte de la figura 7 y la figura 8A muestra uno de los elementos
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elevados de la realización del elemento de corte.
Descripción detallada
Haciendo referencia a las figuras 1-4, se muestra un catéter 2 de aterectomía con un elemento de corte 4, que se usa para cortar material de un lumen de flujo sanguíneo. El elemento de corte 4 es móvil entre una posición almacenada (figura 2) y una posición de corte (figura 3) con respecto a una abertura 6 de un cuerpo 8 del catéter 2. El elemento de corte 4 se mueve hacia fuera con respecto a la abertura 6 de modo que una porción del elemento 4 se extienda hacia fuera desde el cuerpo 8 a través de la abertura 6. El elemento de corte 4 puede posicionarse con respecto al cuerpo 8 y a la abertura 6 de modo que se exponga menos de 90 grados del elemento de corte 4 para cortar tejido. Por supuesto, puede exponerse una extensión mayor del elemento de corte 4 sin apartarse de numerosos aspectos de la invención.
El catéter 2 se mueve distalmente a través de un vaso con el elemento de corte 4 en la posición de trabajo o de corte según se describe con mayor detalle a continuación. Cuando el catéter 2 se mueve a través del vaso sanguíneo, el tejido es cortado por el elemento de corte 4 y es dirigido hacia el interior de una cámara 12 de tejido posicionada distal con respecto al elemento de corte 4. La cámara 12 de tejido puede ser algo alargada para acomodar el tejido que se ha cortado.
El elemento de corte 4 se mueve proximalmente desde la posición almacenada de modo que una superficie 14 de leva en el elemento de corte 4 se acople con una rampa 16 del cuerpo 8 del catéter 2. La interacción entre la superficie 14 de leva y la rampa 16 hace que el elemento de corte 4 se mueva hacia la posición de corte y también hace que una punta 18 se desvíe, lo cual tiende a mover al elemento de corte 4 hacia el tejido que se ha de cortar.
El elemento de corte 4 está acoplado con un vástago 20 que se extiende a través de un lumen 21 del catéter 2. El elemento de corte 4 es hecho girar alrededor de un eje longitudinal LA cuando gira el vástago. El elemento de corte 4 es hecho girar desde aproximadamente 1 hasta 160.000 rpm, pero puede hacerse girar a cualquier otra velocidad adecuada dependiendo de la aplicación particular. Haciendo referencia a las figuras 2, 4 y 5, se muestra el elemento de corte 4 viéndolo a lo largo del eje longitudinal LA. El término “a lo largo del eje longitudinal” según se usa en el presente documento debe significar la vista de la figura 5, que muestra el extremo distal del elemento de corte 4 cuando se le ve en la dirección del eje longitudinal y/o del eje de rotación. El elemento de corte 4 tiene un filo 22 de corte que puede ser un filo con forma circular, ininterrumpido, continuo, aunque también puede incluir rebordes, dientes, estrías u otras características sin apartarse del alcance de la invención. El filo 22 de corte puede estar en un borde radialmente exterior 23 del elemento de corte 4 cuando el elemento de corte 4 está en la posición de corte.
El elemento de corte 4 tiene una superficie 24 con forma de copa que dirige el tejido cortado por el filo 22 de corte hacia el interior de la cámara 12 de tejido. La superficie 24 con forma de copa puede ser una superficie lisa y continua sin agujeros pasantes, dientes, aletas u otras características que interrumpan la naturaleza lisa de la superficie 24 durante al menos la mitad de la distancia desde el eje longitudinal LA hasta el radio exterior en el filo 22 de corte. La superficie 24 con forma de copa también puede estar libre de cualquiera de tales características en toda un área de al menos 300 grados con respecto al eje longitudinal LA.
Haciendo referencia a las figuras 4-6, uno o más elementos elevados 26 se extienden hacia fuera desde la superficie 24 con forma de copa, mostrando la figura 5 dos elementos elevados 26. El elemento elevado 26 es una pequeña cuña de material que se eleva de una manera relativamente abrupta desde la superficie 24 con forma de copa. El elemento elevado 26 tiene una primera pared 30 y una segunda pared 32 que se extiende ambas radialmente y forman un ángulo de aproximadamente 20 grados entre ellas, de modo que los elementos elevados 26 ocupan conjuntamente un área de aproximadamente 40 grados y todos juntos pueden representar menos de 60 grados. Una tercera pared 34 se extiende entre la porción radialmente interior de las paredes primera y segunda 30, 32. El elemento elevado 26 ayuda a romper tejido duro y placa aplicando una fuerza relativamente roma al tejido duro o la placa, dado que el corte de tal tejido con el filo 22 de corte a menudo no es efectivo.
Los elementos elevados 26 ocupan conjuntamente una parte relativamente pequeña de la superficie 24 con forma de copa. Los elementos elevados 26 ocupan conjuntamente menos del 5% de un área superficial del elemento 4 de corte. El término “área superficial del elemento de corte” según se usa en el presente documento debe significar el área superficial que es radialmente interior al filo 22 exterior o de corte y que está expuesta cuando se le ve a lo largo del eje longitudinal LA. Dicho de otra manera, al menos el 95% del área superficial del elemento de corte es una superficie lisa con forma de copa cuando se la ve a lo largo del eje longitudinal. Dimensionando y posicionado el elemento elevado 26 de esta manera, el elemento elevado 26 no interfiere con la capacidad del elemento de corte 4 para cortar y redirigir tejido hacia el interior de la cámara de tejido, al tiempo que proporciona aún la capacidad de romper tejido duro y placa con el elemento elevado 26.
El elemento elevado 26 puede estar rebajado longitudinal y/o radialmente con respecto al filo 22 de corte. El elemento elevado 26 puede estar rebajado longitudinalmente con respecto al filo de corte en aproximadamente 0,025 mm a 0,05 mm (0,0010 hasta 0,0020 pulgadas) y puede estar en aproximadamente 0,038 mm (0,0015 pulgadas). El elemento elevado 26 puede estar rebajado radialmente respecto del filo 22 de corte en aproximadamente la misma cantidad. Una pared distal 38 del elemento de corte 4 forma una superficie plana 40 que
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es perpendicular al eje longitudinal LA, de modo que toda la superficie esté rebajada en la misma distancia respecto del filo de corte. La pared distal 38 puede adoptar cualquiera otra forma, tal como una forma curvada, o puede estar ladeada, inclinada o biselada como ahora se describe.
Haciendo referencia a las figuras 7, 8 y 8A, se muestra otro elemento de corte 4A en el que los mismos o similares números de referencia se refieren a la misma o similar estructura y toda la discusión relativa a las mismas o similares características del elemento de corte 4 es igualmente aplicable aquí. El elemento de corte 4A tiene un filo 22A de corte que puede ser un filo con forma circular continuo, ininterrumpido, aunque también puede incluir rebordes, dientes, estrías u otras características sin apartarse del alcance de la invención. El filo 22A de corte puede estar en un borde 23A radialmente exterior del elemento de corte 4A cuando el elemento de corte 4A está en la posición de corte. El elemento de corte 4A tiene una superficie 24A con forma de copa que dirige el tejido cortado por el filo 22A de corte hacia el interior de la cámara 12 de tejido (véase la figura 2). La superficie 24A con forma de copa puede ser una superficie sustancialmente lisa y continua según se describió anteriormente con respecto al elemento de corte 4.
Uno o más elementos elevados 26A se extienden hacia fuera desde la superficie 24A con forma de copa. La figura 8 muestra cuatro elementos elevados 26A, pero puede incluir cualquier número tal como 2, 3, 4, 6 u 8 elementos elevados. El elemento elevado 26A es una pequeña cuña de material que se eleva de una manera relativamente abrupta desde la superficie 24A con forma de copa. El elemento elevado 26A tiene una primera pared 30A y una segunda pared 32A que se extienden ambas radialmente y forman un ángulo de aproximadamente 1 a 30 grados entre ellas, de modo que los cuatro elementos elevados 26A ocupen conjuntamente un área de aproximadamente 4 a 60 grados y todos juntos pueden representar menos de 60 grados. Una tercera pared 34A se extiende entre la porción radialmente interior de las paredes primera y segunda 30A, 32A. Los elementos elevados 26A pueden ocupar una parte relativamente pequeña de la superficie 24A con forma de copa y pueden estar rebajados respecto del filo 22A de corte de la manera descrita anteriormente con respecto al elemento de corte 4.
Una pared distal 38A del elemento de corte 4A tiene una superficie 40A que forma un ángulo de aproximadamente 30-90 grados con respecto al eje longitudinal LA. Toda la superficie 40A puede aún estar un poco cerca, pero rebajada respecto del filo 22A de corte de modo que toda la superficie 40A esté a aproximadamente 0,025 a 0,13 mm (0,0010 a 0,0050 pulgadas) del filo de corte. Un borde 50 formado en la intersección de la pared 30A y la pared distal 38A está más cerca del filo 22A de corte que un borde 52 formado en la intersección de la pared 32A y la pared distal 38A. El elemento de corte 4A puede hacerse girar en cualquier dirección de modo que el borde elevado 50 pueda ser el borde delantero o trasero. El borde elevado puede estar aproximadamente a una distancia de 0,025 a 0,05 mm (0,0010 a 0,0020 pulgadas) del filo de corte. Todos los elementos elevados 26A pueden estar formados de la misma manera o puede ser diferentes unos de otros. Por ejemplo, algunos de los elementos 26A podrían estar inclinados en diferentes direcciones de modo que dos de los elementos tengan el filo elevado 50 como el filo delantero y dos de los elementos 26A tengan el borde elevado 50 como el filo trasero. Los elementos elevados 26A también pueden subtender diferentes ángulos, pueden ser de alturas diferentes o pueden tener diferentes longitudes radiales sin apartarse de diversos aspectos de la presente invención.
Se describe ahora el uso del catéter 2 en relación con el elemento de corte 4, pero es igualmente aplicable usar el catéter 2 con el elemento de corte 4A. El catéter 2 se introduce dentro del paciente de una manera convencional usando un alambre de guía (no mostrado) o similar. El catéter 2 se hace avanzar con el elemento de corte en la posición almacenada de la figura 2 hasta que el catéter se posiciona en el lugar en el que se ha de retirar material. El elemento de corte 4 se mueve entonces próximalmente de modo que la rampa 16 y la superficie 14 de leva se acoplen entre sí para mover el elemento de corte 4 hacia la posición de corte de la figura 3 y para desviar la punta del catéter 2 con el fin de mover el elemento de corte 4 hacia el tejido que se ha de cortar. El elemento de corte 4 se hace girar alrededor del eje longitudinal LA y el catéter 2 se mueve entonces distalmente a través del vaso de modo que el elemento de corte 4 corte tejido. El tejido que se ha cortado se dirige hacia el interior de la cámara 12 de tejido.
La presente invención se ha descrito en relación con realizaciones preferidas, pero, por supuesto, puede practicarse sin apartarse de las realizaciones antes descritas. Por ejemplo, pueden disponerse tres o más elementos elevados o puede estriarse el filo de corte sin apartarse de numerosos aspectos de la presente invención según se reivindica.
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Claims (15)
- 51015202530354045E1316344613-11-2014REIVINDICACIONES1. Un catéter (2) de aterectomía que comprende:un cuerpo (8) que tiene una abertura (6):un vástago giratorio (20) acoplado con el cuerpo (8);un elemento de corte (4; 4A) acoplado con el vástago giratorio (20) para hacer girar el elemento de corte alrededor de un eje longitudinal (LA), teniendo el elemento de corte (4; 4A) una superficie (24; 24A) con forma de copa y un filo de corte (22; 22A), siendo el filo de corte (22; 22A) un filo radialmente exterior del elemento de corte (4; 4A); yuna cámara (12) de recogida de tejido acoplada con el cuerpo (8) y posicionada distalmente con respecto al elemento de corte (4); caracterizado porun elemento elevado (26; 26A) que se extiende hacia fuera desde la superficie (24; 24A) con forma de copa del elemento de corte (4; 4A), teniendo el elemento elevado (26; 26A) una primera pared (30, 32) que se extiende hacia fuera y que se prolonga generalmente de manera radial, y una pared distal (38; 38A) que incluye una superficie distal que intersecta con la primera pared (30; 30A) para formar un borde elevado (50), en donde el elemento elevado (26; 26A) está rebajado con respecto al filo de corte (22; 22A) cuando se le ve a lo largo del eje longitudinal (LA).
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- 2.
- El catéter (2) según la reivindicación 1, en el que la superficie (24; 24A) con forma de copa está configurada para redirigir tejido cortado por el filo de corte (22; 22A) en una dirección distal cuando la superficie (24; 24A) en forma de copa se mueve en la dirección distal.
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- 3.
- El catéter (2) según la reivindicación 1, en el que:
la superficie (24; 24A) en forma de copa del elemento de corte (4; 4A) es lisa e ininterrumpida en al menos un 95% del área superficial del elemento de corte (4; 4A) cuando se la ve a lo largo del eje longitudinal (LA). -
- 4.
- El catéter según la reivindicación 1, que además comprende:
una pluralidad de elementos elevados (26; 26A), ocupando en conjunto la pluralidad de elementos elevados (26; 26A) un área de menos de 60 grados y de menos del 5% del área superficial cuando se les ve a lo largo del eje longitudinal (LA);siendo lisa e ininterrumpida la superficie (24; 24A) con forma de copa en al menos el 95% del área superficial. -
- 5.
- El catéter según la reivindicación 1, en el que la superficie (24; 24A) con forma de copa es lisa e ininterrumpida con agujeros pasantes y
el elemento elevado (26; 26A) está rebajado respecto del filo (22; 22A) de corte en una distancia longitudinal de 0,025 a 0,05 mm (0,0010-0,0020 pulgadas). -
- 6.
- El catéter según la reivindicación 2 o la reivindicación 5, en el que:
el elemento elevado (26; 26A) está rebajado radialmente hacia dentro respecto del filo (22; 22A) de corte en una distancia radial de 0,025 a 0,05 mm (0,0010-0,0020 pulgadas). -
- 7.
- El catéter según la reivindicación 1 o la reivindicación 5, en el que
la superficie (24; 24A) con forma de copa tiene un radio exterior cuando se la ve a lo largo del eje longitudinal (LA), y la superficie (24; 24A) con forma de copa es continua e ininterrumpida desde el eje longitudinal (LA) hasta al menos la mitad de la distancia al radio exterior. -
- 8.
- El catéter según la reivindicación 1 o la reivindicación 5, en el que:
la superficie (24; 24A) con forma de copa es lisa e ininterrumpida en la totalidad de al menos 300 grados cuando se la ve a lo largo del eje longitudinal (LA). -
- 9.
- El catéter según la reivindicación 5, en el que:
la superficie (24; 24A) con forma de copa es lisa, continua y sin interrupciones en al menos el 95% del área superficial cuando se la ve a lo largo del eje longitudinal (LA), siendo la superficie aquella superficie que está radialmente hacia dentro del filo (22; 22A) de corte cuando se la ve a lo largo del eje longitudinal (LA). -
- 10.
- El catéter según la reivindicación 5, que además comprende:
5E1316344613-11-2014una pluralidad de elementos elevados (26; 26A), que juntos ocupan un área que se extiende en menos de 60 grados cuando se las ve a lo largo del eje longitudinal (LA). - 11. El catéter según la reivindicación 1 o la reivindicación 5, en el queel elemento de corte (4; 4A) tiene menos de 90 grados del elemento de corte (4; 4A) expuesto para cortar tejido con 5 respecto a la abertura en el cuerpo (8).
-
- 12.
- El catéter según la reivindicación 1 o la reivindicación 5, en el que:
una pluralidad de elementos elevados (26; 26A) se extienden hacia fuera desde la superficie (24, 24A) con forma de copa, incluyendo la pluralidad de elementos elevados (26; 26A) de 2 a 6 elementos elevados. -
- 13.
- El catéter según la reivindicación 5, en el que:
10 los bordes elevados (50, 52) del elemento elevado (26, 26A) están rebajados con respecto al filo (22; 22A) de corte en una distancia longitudinal de 0,025 a 0,05 mm (0,0010-0,0020 pulgadas). - 14. El catéter según la reivindicación 1 o la reivindicación 13, en el que:uno de los bordes elevados (50) comprende un borde delantero y el otro de los bordes elevados (52) comprende un borde trasero cuando son hechos girar, estando tanto el borde delantero como el borde trasero a una distancia de 15 0,025 a 0,13 mm (0,0010 a 0,0050 pulgadas) del filo (22; 22A) de corte.
- 15. El catéter según la reivindicación 14, en el que: la superficie distal (38; 38A) forma un ángulo de 30 a 90 grados con el eje longitudinal.6
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US10219824B2 (en) | 2019-03-05 |
US20160374718A1 (en) | 2016-12-29 |
WO2009108489A1 (en) | 2009-09-03 |
CN104490453A (zh) | 2015-04-08 |
US20150018858A1 (en) | 2015-01-15 |
US8784440B2 (en) | 2014-07-22 |
CN102159144A (zh) | 2011-08-17 |
EP2633824B1 (en) | 2014-09-17 |
EP2252220A1 (en) | 2010-11-24 |
CN102159144B (zh) | 2015-01-28 |
US9445834B2 (en) | 2016-09-20 |
EP2633824A1 (en) | 2013-09-04 |
US20090216180A1 (en) | 2009-08-27 |
ES2424451T3 (es) | 2013-10-02 |
EP2252220B1 (en) | 2013-05-08 |
CN104490453B (zh) | 2017-04-12 |
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