JP2000279532A - Intraluminal indwelling object - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an intraluminal indwelling object capable of performing the treatment arranging a stent graft actively even in aneurysm in the vicinity of renal artery. SOLUTION: This intraluminal indwelling object (stent graft) 1 is arranged in a lumen and has a cylindrical stent 21 expansible in the radial direction, a cover member 4 covering at least a part is formed, a side hole 30 is formed in at least a part of a side wall of the cover member 4, and an imaging marker 3 is provided in a side hole part.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an intraluminal indwelling device which is inserted and indwelled in a lumen such as a blood vessel, and more particularly to a lumen which is disposed in a lesion site such as an abdominal aortic aneurysm Related to in-place objects.

[0002]

2. Description of the Related Art Conventionally, when treating an abdominal aortic aneurysm, the aneurysm is surgically excised and an artificial blood vessel (a tube made of an artificial material) is transplanted into the area, or a bypass operation is performed. Another new vascular flow path, called blood flow, has been used to treat blood. But,
Patients who develop such symptoms are generally more than 65 years of age, and such major surgery increased the risk of intraoperative and postoperative complications and was associated with danger.

However, in a subsequent improvement, a cylindrical artificial blood vessel called a stent graft is percutaneously introduced into the blood vessel from the thigh or the like using a catheter under local anesthesia, and is transported to a treatment site. There is a technique that is used to cover the aneurysm with a graft and treat the thrombus. This has made it possible to greatly reduce the burden on the patient.

FIG. 8 shows a schematic view of the abdominal aorta and an example of arrangement of a conventional stent graft. In the abdominal aorta 100, renal arteries 101 and 102 branch right and left, and there are common iliac arteries 103 and 104 branching left and right legs. This is an example in which an aortic aneurysm 105 has developed in the vicinity of the aortic aneurysm, in which the stent graft 90 is placed as a treatment for the aneurysm 105.

[0005]

However, in such a conventional technique, the site where the stent graft can be placed is limited. This is due to the complicated structure of the aorta, as shown in FIG. 8, and a large amount of aortic aneurysm occurs near the renal artery and the site having a bifurcation leading to the foot. In this case, the stent graft can be placed at a position that does not cover the renal artery. Therefore, it is customary that this treatment cannot be applied.

SUMMARY OF THE INVENTION The present invention has been made in view of the above problems, and has as its object to provide a treatment for positively placing a stent graft (intraluminal indwelling device) even in an aneurysm near a renal artery. .

[0007]

The above object is achieved by a cylindrical graft to be placed in a body cavity, wherein a side hole is formed in at least a part of a side wall of the graft, and the side hole is formed in the side hole. This is an intraluminal indwelling object provided with a contrast marker.

In order to achieve the above object, a stent graft to be placed in a body cavity, which has a cylindrical stent expandable in a radial direction and covers at least a part of the stent graft, An intraluminal indwelling object in which a side hole is formed in at least a part of a side wall, and a contrast marker is provided in the side hole portion.

It is preferable that at least two side holes are provided.

[0010] The indwelling object may have a branch portion.

Preferably, the cover member is formed of a flexible resin.

[0012] Preferably, the contrast marker is bordered by a gold wire around the side hole.

Further, it is preferable that a nonwoven fabric is further provided around the side hole portion.

Further, it is preferable that at least a skeleton structure is arranged in the side hole portion.

[0015]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view showing an intraluminal indwelling device according to the present invention. Note that the upper side in the drawing of this embodiment is described as “upper” or “upper”, and the lower side is described as “lower” or “lower end”.

FIG. 1 is a view showing an embodiment in which the indwelling object of the present invention is applied to a stent graft. As shown in FIG. 1, a stent graft 1 of the present invention is inserted and placed in an aorta, and has a structure 2 having a cylindrical or tubular contour.

The structure 2 includes a main body tube 21 and two branch tubes 22 and 23 branched from the main body tube 21 into two branches. Branch tube 22, 2
The outer diameter of 3 is smaller than the outer diameter of the main body tube 21.

At the upper end of the main body tube 21 and at the lower end of both branch tubes 22, 23, openings 24,
25 and 26 are formed.

The structure 2 is mainly composed of a plurality of struts (linear bodies) 27 wound spirally. In this case, the spiral of one strut 27 and the other strut 27 are wound in opposite directions. These struts 27 form the skeleton of the structure 2.

The shape and form of the strut 27 are not limited to a spiral shape, but may be, for example, a ring shape (in particular, a shape in which a plurality of rings are connected), a net shape, or a zigzag structure. .

As described above, the structure includes the cover member (film) 4.
Or a role as a fixing means for fixing the cover member (membrane) at the place where the cover member is arranged.

The cover member (film) 4 is coated on the inner surface and / or outer surface of the structure.

As a feature of the present invention, side holes 30 and 31 are provided in the side wall of the main body 21 of the stent graft.
This side hole is preferably provided at a position matching the renal arteries 101 and 102. Basically, two side holes are formed at positions facing each other.

However, it is known that the position of the renal artery varies among individuals, and that the arrangement position is not always constant. Therefore, it is necessary to confirm in advance the position of the side hole with respect to the target patient. Further, it is preferable to set the positions of the side holes in several patterns and select a pattern suitable for the patient. Alternatively, it is also possible to form a side hole after examining the arrangement position of each individual in advance.

The shape of the stent graft may be a shape in which a treatment site is closed and a side hole is formed, such as a shape in which a branch portion is formed as shown in FIG. 1 or a shape 50 of only a main body portion as shown in FIG. If there is, it is not limited to these.

In this embodiment, two side holes are provided. However, depending on the arrangement of the renal artery and the treatment site, the stent graft may be applied to only one of the renal arteries. In that case, one side hole may be formed.

The size of the side hole depends on the size of the renal artery, but is preferably about 1 to 20 mm in diameter, and more preferably about 3 to 10 mm.

FIG. 3 is a partially enlarged view of the side hole forming portion. A stitch bordered by the gold wire 3 is formed at the edge of the side hole. This serves as a contrast marker for confirming the position of the side hole at the time of contrast, which is a feature of the present invention. In addition, fraying of the cover member 4 in the side hole is prevented. This enables accurate positioning while confirming the position of the renal artery and the position of the side hole when the stent graft is placed.

In this embodiment, the material of the contrast marker is bordered using a gold wire. However, the material is not particularly limited as long as the position of the side hole can be confirmed, and is selected from the metal group of silver, platinum, iridium, and palladium. It is preferable that the material is arranged, and that the wire material is woven or knitted in the film at the end portion, that which is integrally formed into a sheet, that which is formed by mixing powdered metal into a sheet, or that has a side hole opening Coating or plating on the stent skeleton corresponding to the part,
It may be deposited.

It is preferable to further attach a soft resin, fluffy fiber, fluffy fiber, or the like to the side edge portion, and it is particularly preferable to provide the nonwoven fabric 5. This is effective in increasing the adhesion of the side hole edge portion to the living body and further preventing blood flow from leaking.

The cover member 4 may be, for example, any of a fibrous porous membrane such as a woven or knitted fabric, a nonwoven fabric, and a paper material, a non-fibrous porous membrane, and a dense membrane such as a polymer sheet.

Examples of the material (fiber) of the cover member 4 include cellulose fiber, cotton, linter, kapok, flax, hemp, natural fibers such as ramie, silk, wool, nylon (polyamide), tetron, rayon, cupra, and the like. Chemical fibers such as acetate, vinylon, acrylic, polyethylene terephthalate (polyester), and polypropylene;
Alternatively, a combination of two or more of these natural and chemical fibers (such as a blended fiber) can be mentioned.

Other examples of the material (polymer sheet) of the cover member 4 include, for example, polyesters such as polyethylene, polypropylene, polyurethane, polyethylene terephthalate, polybutylene terephthalate, polyvinyl chloride, polytetrafluoroethylene, and natural materials. Examples include various rubbers such as rubber, isoprene rubber, silicone rubber, styrene-butadiene rubber, latex rubber, and various thermoplastic elastomers such as polyamide, polyester, and polyurethane.

The cover member 4 may be a laminate of two or more layers made of the same or different materials.

The installation location of the cover member 4 with respect to the structure 2 may be the whole or a part of the structure 2, but is preferably a central portion in the longitudinal direction of the main body tube 21, more preferably substantially the entirety of the main body tube 21. Preferably, the inner or outer surface is coated.

The method of fixing the cover member 4 to the structure 2 is not particularly limited, and the cover member 4 is pressed against the structure 2 by the contraction force of the cover member 4 and is bonded to the strut 27 with an adhesive and fused (heat). Fusion, ultrasonic fusion, etc.), suture,
It can be fixed at a plurality of places by a method such as ligation.

Next, an embodiment of the skeletal structure of the stent graft of the present invention will be described in detail.

Although the skeletal structure is not particularly limited as described above, the skeletal structure of the stent graft 1 of the present invention is formed spirally by struts 27 as shown in FIG.

The strut 27 is preferably made of a material having a certain degree of biocompatibility, for example, stainless steel, Ni-Ti alloy, superelastic alloy, Cu-Zn alloy, Ni-A
Various metals such as l-alloy, tungsten, tungsten alloy, titanium, titanium alloy, tantalum or tantalum alloy are exemplified, and particularly preferred are superelastic alloys and high-tensile stainless steel for springs.

The wire diameter of the strut 27 is not particularly limited, but can be preferably about 0.03 to 2 mm. More preferably, it can be about 0.1 to 1 mm.

The outer diameter of the main body tube 21 of the structure 2 is changed by the action of an external force. That is, the diameter of the main body tube 21 is reduced by the external force, and when the external force is removed, the main body tube 21 assumes an expanded state (natural state).

In this case, it is preferable to select a stent graft whose body tube 21 is sufficiently close to the inner wall of the aorta and whose diameter in the natural state is slightly larger than that of the aorta.

The branch tubes 22 and 23 can be similarly selected according to the diameter of the blood vessel.

FIG. 4 shows a modified example 60 of the skeletal structure.
This is one in which a stent 28 having a zigzag structure is arranged at the end of the cover member (gufft) 4. The graft itself may be formed of the above-described material. The end portion has a fixing means in a stent graft arrangement.

In FIG. 4, the skeleton structure is further arranged so as to be located at the edge of the side hole. It is also preferable to further attach a soft resin, fluffy fiber, fluffy fiber, or the like around the side hole portion, and it is particularly preferable to form the nonwoven fabric 5. These are effective in further improving the adhesion between the side hole portion and the living body and preventing leakage of blood flow.

FIG. 5 shows a seventh modification of the stent graft.
Indicates 0. In FIG. 4, skeletal structures are arranged at several places. However, as shown in FIG. 5, a zigzag stent may be formed in a ring shape and fixed to a membrane to have a skeletal structure as a whole.

In FIG. 5, the stent has a skeleton structure also in the side hole opening, and the contrast marker 301 is provided on the skeleton structure corresponding to this opening by gold plating.

In this embodiment, the self-expanding stent is shown. However, the present invention can be applied to a balloon-expandable stent. However, the self-expanding type is more preferable in terms of simplicity of operation.

Next, the arrangement of the stent graft 1 of the present invention in the lumen is shown in FIG. Thus, the renal arteries 101, 1
The stent graft 1 is arranged so as to cover the site of the aneurysm 105 related to 02. Thus, the side holes 30, 31
The stent graft can be fixed to the renal artery, and the stent graft can be fixed at the normal site (above the renal artery). Is possible.

In the present embodiment, a stent graft having a skeleton structure having a cover member or an end fixing means in the cover member has been described in detail. As shown in FIG. Side hole 3
It is needless to say that even those formed with 0 and 31 are within the scope of the present invention.

[0051]

As described above, in the intraluminal indwelling device according to the present invention, a side hole is formed in the side wall to allow blood flow to the renal artery, and a contrast marker is provided in the side hole to accurately correct the blood flow. The possibility of accurate position confirmation and placement makes it possible to use a minimally invasive intraluminal indwelling object (stent graft) even at a treatment site involving the renal artery, which is currently considered difficult.

Further, since the side hole is provided with a border by a gold wire, it is also effective in preventing the film material from fraying.

Further, by providing a fiber such as a nonwoven fabric around the side hole portion, the adhesion to the living body can be further improved.

[Brief description of the drawings]

FIG. 1 is a view showing a stent graft of the present invention.

FIG. 2 illustrates another form of a stent graft of the present invention.

FIG. 3 is a partially enlarged view of a side hole forming portion of the present invention.

FIG. 4 is a view showing a stent graft having another skeletal structure according to the present invention.

FIG. 5 is a view showing a stent graft having another skeletal structure according to the present invention.

FIG. 6 is a view in which the stent graft of the present invention is placed in a lumen.

FIG. 7 is a diagram showing another embodiment of the present invention.

FIG. 8 is a view showing a conventional placement of a stent graft in a lumen.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Stent graft 2 Structure 21 Main body tube 22, 23 Branch tube 24-26 Opening 27 Strut 28 Strut (Zigzag line) 3, 301 Contrast marker 4 Membrane 5 Nonwoven fabric 100 Aorta 101 Left renal artery 102 Right renal artery 103 Left iliac artery 104 Right iliac artery 105 Aortic aneurysm

Claims (8)

[Claims] 1. A cylindrical graft disposed in a body cavity, wherein a side hole is formed in at least a part of a side wall of the graft, and a contrast marker is provided in the side hole. Intraluminal indwelling object. 2. A stent graft for placement within a body cavity, said stent graft having a radially expandable cylindrical stent.
An intraluminal indwelling object, characterized in that a cover member that covers at least a part thereof, a side hole is formed in at least a part of a side wall of the cover member, and a contrast marker is provided in the side hole portion. 3. The in-lumen indwelling device according to claim 1, wherein at least two side holes are provided. 4. The intraluminal indwelling device according to claim 1, wherein the intraluminal indwelling object has a branch portion. 5. The in-lumen indwelling device according to claim 2, wherein said cover member is formed of a flexible resin. 6. The imaging marker according to claim 1, wherein the periphery of the side hole is bordered by a gold wire.
An indwelling indwelling device according to the above. 7. The intraluminal indwelling device according to claim 1, wherein a nonwoven fabric is further provided around the side hole portion. 8. The in-lumen indwelling device according to claim 2, wherein at least a skeletal structure is arranged in said side hole portion.