FR2677872A1 - Device for assisting in the positioning of a filter for trapping thrombi - Google Patents

Device for assisting in the positioning of a filter for trapping thrombi Download PDF

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Publication number
FR2677872A1
FR2677872A1 FR9107531A FR9107531A FR2677872A1 FR 2677872 A1 FR2677872 A1 FR 2677872A1 FR 9107531 A FR9107531 A FR 9107531A FR 9107531 A FR9107531 A FR 9107531A FR 2677872 A1 FR2677872 A1 FR 2677872A1
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Prior art keywords
filter
vein
mark
positioning
assisting
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Granted
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FR9107531A
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FR2677872B1 (en
Inventor
Cottenceau Jean-Philippe
Chevillon Gerard
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B Braun Medical SAS
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Celsa LG SA
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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
    • A61F2/01—Filters implantable into blood vessels
    • A61F2/0105—Open ended, i.e. legs gathered only at one side
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • 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
    • A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters
    • 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
    • A61F2/01—Filters implantable into blood vessels
    • A61F2/011—Instruments for their placement or removal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • 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
    • A61F2/01—Filters implantable into blood vessels
    • A61F2002/016—Filters implantable into blood vessels made from wire-like elements
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/005—Rosette-shaped, e.g. star-shaped
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • 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
    • 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
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Dentistry (AREA)
  • Pathology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Pulmonology (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention relates to a device for assisting in the positioning of a filter for trapping thrombi. According to the invention, the dilator guide (1) has, in the vicinity of its free end, several radiopaque markings (A, B, C) distinct from one another, by means of which it is possible to determine the exact position of the head and foot of the filter after positioning in the vein (3), and to check whether the filter is compatible with the diameter of the vein receiving it. The invention applies in particular to the introduction of vena cava filters by the percutaneous route.

Description

L'invention a pour objet un dispositif d'aide à la pose d'un filtre de piégeage des thrombus. The subject of the invention is a device for assisting with the installation of a thrombus trapping filter.

L'invention intéresse le domaine des filtres à veine cave. The invention relates to the field of vena cava filters.

On utilise les filtres à veine cave pour la prévention des embolies pulmonaires. Vena cava filters are used to prevent pulmonary embolism.

Il s'agit d'un piège de forme adéquate placé dans le flux sanguin de la veine cave, ce piège arrête les thrombus circulant dans le retour veineux et les empêche de venir obstruer l'artère pulmonaire. It is an appropriately shaped trap placed in the blood flow of the vena cava, this trap stops the thrombi circulating in the venous return and prevents them from coming to obstruct the pulmonary artery.

La mise en place de ces filtres se fait soit par voie chirurgicale, soit par voie percutanée. The placement of these filters is done either surgically or percutaneously.

Dans le cas d'une pose en percutané, on ponctionne la voie d'abord et l'on met en place un introducteur qui permet d'amener le filtre à l'endroit voulu dans la veine cave. In the case of percutaneous placement, the line is first punctured and an introducer is put in place which allows the filter to be brought to the desired location in the vena cava.

Cependant, une mise en place adéquate du filtre dans la veine cave pose deux problèmes précis difficiles à résoudre. However, proper placement of the filter in the vena cava poses two specific problems that are difficult to solve.

Le premier problème qui se pose concerne la localisation précise du filtre. The first problem that arises concerns the precise location of the filter.

La localisation précise du filtre à veine cave avant son largage est un des problèmes importants qui se posent lors de la pose des filtres par voie percutanée. The precise location of the vena cava filter before it is released is one of the major problems which arise when the filters are applied percutaneously.

Pour être parfaitement fonctionnel, le filtre doit être situé juste en dessous de l'abouchement des veines rénales dans la veine cave. To be fully functional, the filter must be located just below the mouth of the renal veins in the vena cava.

Un filtre placé trop haut risque d'avoir une partie de ses branches prises dans une veine rénale ou bien de se trouver dangereusement situé à proximité de l'entrée de l'oreillette droite. A filter placed too high may have part of its branches caught in a renal vein or be dangerously located near the entrance to the right atrium.

Un filtre placé trop bas laisse une partie de la veine cave inférieure non protégée contre la création et la remontée de thrombus pouvant entraîner une récidive d'embolie pulmonaire. A filter placed too low leaves part of the inferior vena cava unprotected against the creation and ascent of thrombi which can lead to a recurrence of pulmonary embolism.

Il est par conséquent très important de savoir situer la position du filtre avant de l'éjecter de sa gaine d'introduction. It is therefore very important to know how to locate the position of the filter before ejecting it from its introduction sheath.

Le deuxième problème qui se pose est relatif à la conformation de la veine cave, notamment en ce qui concerne son diamètre. The second problem which arises relates to the conformation of the vena cava, in particular as regards its diameter.

La remontée du filtre dans la veine cave est empêchée par un système d'accrochage qui le fixe aux parois de ladite veine. The ascent of the filter in the vena cava is prevented by an attachment system which fixes it to the walls of said vein.

L'efficacité d'un tel système n'est possible que si le filtre est en appui sur les parois, autrement dit que si la veine cave n'est pas surdimensionnée par rapport au filtre utilisé. The effectiveness of such a system is only possible if the filter is supported on the walls, in other words if the vena cava is not oversized compared to the filter used.

Par exemple le diamètre maximal admissible pour un type de filtre déterminé est de 28 mm ; il est absolument interdit de poser un tel filtre sur une veine dont le diamètre de passage serait supérieur à cette dimension. For example, the maximum admissible diameter for a given type of filter is 28 mm; it is absolutely forbidden to place such a filter on a vein whose passage diameter would be greater than this dimension.

Enfreindre cette règle conduit à prendre un risque majeur pour le malade dont le filtre peut se décrocher et migrer dans l'oreillette droite. Breaching this rule leads to taking a major risk for the patient whose filter can come off and migrate into the right atrium.

Il est par conséquent très important de savoir déterminer avec précision si la veine est d'une dimension convenable ou non avant le larguer le filtre. It is therefore very important to know how to accurately determine whether the vein is of a suitable size or not before dropping the filter.

L'évaluation du diamètre de la veine se fait généralement en prenant sa mesure sur le cliché de la cavographie en utilisant des opacifiants introduits dans le sang avant prise du cliché. The evaluation of the diameter of the vein is generally done by taking its measurement on the X-ray of the cavography using opacifiers introduced into the blood before taking the X-ray.

Il faut savoir que le matériel de radiographie crée des modifications d'échelle qui doivent être prises en compte en utilisant les facteurs de correction appropriés. Ces facteurs changent à chaque fois que l'on modifie l'angulation du cliché. Si l'on ajoute à celà les erreurs dues aux phénomènes de paralaxe, on comprend que la mesure exacte du diamètre de la veine cave est difficile. Be aware that x-ray equipment creates scale changes that must be taken into account using the appropriate correction factors. These factors change each time the angle of the image is changed. If we add to this the errors due to the phenomena of paralaxis, we understand that the exact measurement of the diameter of the vena cava is difficult.

Ceci est d'autant plus gênant que le diamètre de la veine cave s'approche de la limite autorisée. This is all the more annoying as the diameter of the vena cava approaches the authorized limit.

L'invention a pour objet de permettre de résoudre ces difficultés.  The object of the invention is to make it possible to resolve these difficulties.

A cet effet, un dispositif d'aide à la pose d'un filtre de piégeage des thrombus pour son positionnement précis dans le système veineux, du type comprenant un introducteur pour la mise en place du filtre composé d'une gaine et d'un guide dilatateur se caractérise selon l'invention en ce que le guide dilatateur présente au voisinage de son extrémité libre, plusieurs repères radio-opaques distants les uns des autres notamment un repère correspondant à une extrémité (de tête ou de pied) du filtre après son largage par l'introducteur. To this end, a device for assisting with the placement of a thrombus trapping filter for its precise positioning in the venous system, of the type comprising an introducer for the placement of the filter composed of a sheath and a The dilator guide is characterized according to the invention in that the dilator guide has, in the vicinity of its free end, several radiopaque markers distant from each other, in particular a mark corresponding to one end (head or foot) of the filter after its released by the introducer.

Avantageusement, un deuxième repère précité donne la position de la seconde extrémité du filtre après son largage (pied ou tête), tandis qu'un troisième repère précité donne en conjugaison avec l'un des deux autres repères précités une longueur de référence, laquelle peut par exemple correspondre à la dimension du diamètre maximal autorisé de la veine dans laquelle le filtre doit être posé. Advantageously, a second aforementioned mark gives the position of the second end of the filter after its release (foot or head), while a third aforementioned mark gives in conjunction with one of the two other aforementioned marks a reference length, which can for example correspond to the dimension of the maximum authorized diameter of the vein in which the filter must be placed.

Avec les moyens de l'invention, on comprend que le chirurgien va disposer d'un cliché radiographique en grandeur réelle qui lui permettra de déterminer précisément la hauteur à laquelle le filtre va être largué dans la veine et parallèlement lui permettra de déterminer par comparaison directe sans avoir à effectuer aucun calcul et aucune correction si le diamètre de la veine cave n'est pas trop grand et autorise la position effective du filtre sans risque pour le patient. With the means of the invention, it is understood that the surgeon will have a full-size radiographic image which will allow him to determine precisely the height at which the filter will be released into the vein and in parallel will allow him to determine by direct comparison without having to carry out any calculation and no correction if the diameter of the vena cava is not too large and allows the effective position of the filter without risk for the patient.

L'invention et sa mise en oeuvre apparaîtront plus clairement à l t aide de la description qui va suivre faite en référence aux dessins annexés illustrant à titre d'exemple non limitatif un mode de mise en oeuvre. The invention and its implementation will appear more clearly with the aid of the description which follows, made with reference to the appended drawings illustrating by way of nonlimiting example an embodiment.

Dans ces dessins
La figure 1 montre en vue extérieure l'extrémité d'un guide dilatateur comportant les moyens de l'invention.In these drawings
Figure 1 shows in external view the end of a dilator guide comprising the means of the invention.

La figure 2 montre de façon schématique le positionnement dans une veine de l'introducteur comportant le guide dilatateur et la gaine, expliquant le principe de localisation que le dispositif de l'invention permet d'obtenir.  Figure 2 shows schematically the positioning in a vein of the introducer comprising the dilator guide and the sheath, explaining the principle of localization that the device of the invention allows to obtain.

La figure 3 montre en référence à la figure 2 l'endroit où le filtre serait largué dans la veine pour la position de l'introducteur retenue à la figure 2. FIG. 3 shows with reference to FIG. 2 the place where the filter would be released into the vein for the position of the introducer retained in FIG. 2.

En se référant tout d'abord à la figure 1, l'organe dilatateur repéré 1 comporte trois repères référencés A, B, C radio-opaques. Referring first of all to FIG. 1, the dilator member identified 1 comprises three references referenced A, B, C radio-opaque.

Ces repères sont constitués par exemple par trois fines bagues d'acier serties sur le dilatateur en matière plastique convenable. These marks consist for example of three thin steel rings crimped onto the suitable plastic dilator.

Le principe du dilatateur comportant un repère radio-opaque est connu et classique. The principle of the dilator comprising a radiopaque marker is known and conventional.

L'invention est relative à l'emploi en combinaison de plusieurs repères radio-opaques disposés à écartement convenable les uns des autres. The invention relates to the use in combination of several radiopaque markers arranged at a suitable spacing from one another.

Avantageusment, la distance séparant les repères A et C d'extrémités correspond précisément à la longueur du filtre qui sera largué dans la veine. Advantageously, the distance separating the marks A and C of ends corresponds precisely to the length of the filter which will be released in the vein.

Ceci se comprend plus facilement par comparaison des figures 2 et 3 auxquelles on va se reporter maintenant. This is easier to understand by comparing Figures 2 and 3 to which we will now refer.

La figure 2 illustre le dilatateur 1 autour duquel a été mis en place la gaine 2 qui permettra l'introduction du filtre dans la veine 3. FIG. 2 illustrates the dilator 1 around which the sheath 2 has been placed, which will allow the introduction of the filter into the vein 3.

La gaine 2 et le dilatateur 1 sont conçus de façon que lorsqu'un repère 4 du dilatateur vient au droit de l'extrémité 5 libre de la gaine 2 (c'est-à-dire l'extrémité qui est apparente à l'extérieur du système veineux) l'autre extrémité 6 de la gaine, c'est-à-dire celle par laquelle le filtre va être largué, se trouve exactement au droit du repère
C.The sheath 2 and the dilator 1 are designed so that when a mark 4 of the dilator comes to the right of the free end 5 of the sheath 2 (that is to say the end which is visible on the outside of the venous system) the other end 6 of the sheath, that is to say the end by which the filter will be released, is located exactly to the right of the mark
vs.

Le chirurgien qui opère sait donc exactement ou se trouvera l'extrémité correspondante du filtre lorsqu'il sera largué, cette extrémité étant la tête ou le pied du filtre, selon que le filtre a été introduit par voie jugulaire ou par voie fémorale. The operating surgeon therefore knows exactly where the corresponding end of the filter will be when it is released, this end being the head or the foot of the filter, depending on whether the filter has been introduced by jugular or femoral route.

Dans l'exemple illustré, on a supposé comme indiqué à la figure 3 que c'était l'extrémité de pied 8 du filtre 7 qui se trouverait larguée au niveau de l'extrémité 6 de la gaine 2. In the example illustrated, it has been assumed as indicated in FIG. 3 that it was the foot end 8 of the filter 7 which would be released at the end 6 of the sheath 2.

Si la distance entre les repères A et C a été choisie précisément égale à la longueur du filtre 7, alors on sait que l'extrémité de tête 9 du filtre 7 va se trouver positionnée au niveau du repère A du guide 1. If the distance between the marks A and C has been chosen to be precisely equal to the length of the filter 7, then we know that the head end 9 of the filter 7 will be positioned at the mark A of the guide 1.

Le chirurgien a donc sur le cliché radiographique de la figure 2 une image parfaitement précise de l'endroit où va être positionné le filtre dans la veine 3 ; il peut donc résoudre parfaitement les problèmes susmentionnés de localisation du filtre. The surgeon therefore has on the radiographic image of FIG. 2 a perfectly precise image of the place where the filter will be positioned in the vein 3; it can therefore perfectly solve the aforementioned problems in locating the filter.

D'autre part, si la distance entre les repères A et
B a été choisie, par exemple égale à 28 mm, diamètre supposé maximal admissible pour la veine 3 devant recevoir le filtre d'un type correspondant, alors il suffit au chirurgien de comparer la dimension du diamètre 10 de la veine 3 à l'endroit où le filtre va être posé à la dimension de la longueur A - B pour savoir si la pose est admissible ou non.On the other hand, if the distance between the marks A and
B has been chosen, for example equal to 28 mm, the diameter assumed to be the maximum admissible for the vein 3 which must receive the filter of a corresponding type, then it suffices for the surgeon to compare the dimension of the diameter 10 of the vein 3 at the location where the filter will be placed at the dimension of the length A - B to know if the installation is admissible or not.

Si des déformations de paralaxe ou d'angles de vue existent, ces déformations se répercutant de la même façon sur les dimensions du segment A - B et du diamètre 10 se compenseront. If deformations of paralaxis or angles of view exist, these deformations having the same effect on the dimensions of segment A - B and of diameter 10 will compensate for each other.

Si la distance A - B supposée dans cet exemple choisi égale à 28 mm ne correspondant pas au diamètre maximal d'une veine autorisé pour la pose d'un filtre d'un type donné, alors il suffit au chirurgien de faire une simple règle de trois pour savoir si le filtre qu'il a l'intention de poser est adapté ou non au diamètre de la veine du patient considéré. If the distance A - B assumed in this chosen example equal to 28 mm does not correspond to the maximum diameter of a vein authorized for the installation of a filter of a given type, then it is enough for the surgeon to make a simple rule of three to find out if the filter he intends to install is suitable or not for the diameter of the patient's vein.

Mais là encore, le problème du dimensionnement de la veine cave pour l'utilisation d'un filtre de type convenable est immédiatement et simplement résolu.  But here again, the problem of dimensioning the vena cava for the use of a suitable type of filter is immediately and simply resolved.

Claims (5)

REVENDICATIONS 1 - Dispositif d'aide à la pose d'un filtre de piégeage des thrombus pour son positionnement précis dans le système veineux, du type comprenant un introducteur pour la mise en place du filtre composé d'une gaine et d'un guide dilatateur, caractérisé en ce que le guide dilatateur (1) présente au voisinage de son extrémité libre plusieurs repères radio-opaques (A, B, C) distants les uns des autres, et notamment un repère (A, C) correspondant à une extrémité (de tête ou de pied) du filtre après son largage par l'introducteur. 1 - Device for assisting with the placement of a thrombus trapping filter for its precise positioning in the venous system, of the type comprising an introducer for the placement of the filter composed of a sheath and a dilator guide, characterized in that the dilator guide (1) has, in the vicinity of its free end, several radiopaque markers (A, B, C) distant from each other, and in particular a mark (A, C) corresponding to one end (of head or foot) of the filter after it has been released by the introducer. 2 - Dispositif selon la revendication 1 caractérisé en ce qu'un deuxième repère précité (C, A) donne la position de la seconde extrémité du filtre après largage (pied ou tête).  2 - Device according to claim 1 characterized in that a second aforementioned mark (C, A) gives the position of the second end of the filter after release (foot or head). 3 - Dispositif selon la revendication 1 ou la revendication 2 caractérisé en ce qu'un troisième repère (B) précité donne en conjugaison avec l'un des deux autres repères précités (A) une longueur de référence. 3 - Device according to claim 1 or claim 2 characterized in that a third mark (B) above gives in conjunction with one of the other two above marks (A) a reference length. 4 - Dispositif selon la revendication 3 caractérisé en ce que le troisième repère précité (B) est formé entre les deux autres, (A, C). 4 - Device according to claim 3 characterized in that the aforementioned third mark (B) is formed between the other two, (A, C). 5 - Dispositif selon la revendication 3 ou la revendication 4 caractérisé en ce que la longueur de référence entre les deux repères précités (A, B) correspond au diamètre maximal de la veine pour lequel la pose d'un filtre est autorisé.  5 - Device according to claim 3 or claim 4 characterized in that the reference length between the two aforementioned marks (A, B) corresponds to the maximum diameter of the vein for which the installation of a filter is authorized.
FR9107531A 1991-06-19 1991-06-19 Device for assisting in the positioning of a filter for trapping thrombi Granted FR2677872A1 (en)

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US5603721A (en) * 1991-10-28 1997-02-18 Advanced Cardiovascular Systems, Inc. Expandable stents and method for making same
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EP0679372A2 (en) * 1994-04-25 1995-11-02 Advanced Cardiovascular Systems, Inc. Radiopaque stent markers
US6174329B1 (en) 1996-08-22 2001-01-16 Advanced Cardiovascular Systems, Inc. Protective coating for a stent with intermediate radiopaque coating
US7094243B2 (en) 1999-01-28 2006-08-22 Salviac Limited Catheter with an expandable end portion
US7837692B2 (en) 1999-01-28 2010-11-23 Salviac Limited Catheter with an expandable end portion
US6464723B1 (en) 1999-04-22 2002-10-15 Advanced Cardiovascular Systems, Inc. Radiopaque stents
US6585757B1 (en) 1999-09-15 2003-07-01 Advanced Cardiovascular Systems, Inc. Endovascular stent with radiopaque spine
WO2001021258A1 (en) * 1999-09-22 2001-03-29 Advanced Cardiovascular Systems, Inc. Methods and apparatuses for radiation treatment
WO2004030576A1 (en) * 2002-10-01 2004-04-15 Scimed Life Systems, Inc. Embolic protection device with lesion length assessment markers
US8475518B2 (en) 2003-12-22 2013-07-02 Advanced Cardiovascular Systems, Inc. Stent with anchors to prevent vulnerable plaque rupture during deployment
US7763198B2 (en) 2005-04-12 2010-07-27 Abbott Cardiovascular Systems Inc. Method for retaining a vascular stent on a catheter
US7947207B2 (en) 2005-04-12 2011-05-24 Abbott Cardiovascular Systems Inc. Method for retaining a vascular stent on a catheter
US8221112B2 (en) 2005-04-12 2012-07-17 Abbott Cardiovascular Systems, Inc. Method for retaining a vascular stent on a catheter
US10130465B2 (en) 2016-02-23 2018-11-20 Abbott Cardiovascular Systems Inc. Bifurcated tubular graft for treating tricuspid regurgitation
US11583399B2 (en) 2016-02-23 2023-02-21 Abbott Cardiovascular Systems Inc. Bifurcated tubular graft for treating tricuspid regurgitation

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