JP2008504941A - 挿入装置および使用方法 - Google Patents
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Abstract
Description
本出願は、2000年4月7日出願の米国特許仮出願第60/195,207号の利益を主張する、2001年4月6日出願の、発明の名称「Insertion Devices and Method of Use」の同時係属中の米国特許出願第09/828,470号の一部継続出願である。
本発明は、膨張可能構造体の膨張を、所望の方向および/または動物またはヒトの体内領域に向けて、またはその方向または領域から離れる方向に案内することができる挿入装置に関する。本発明は、医療用バルーンなどの膨張可能構造体をヒトまたは動物の体内領域に挿入するための挿入装置であって、その先端部が膨張可能な装置にさらに関する。本発明は、折れた骨および/または罹病した骨の修復、増強、および/または処置において、開示されている装置を使用する方法にさらに関する。
バルーン切開装置およびバルーンカテーテルなどの膨張可能構造体は、医療の分野においてさまざまな外科的手順およびさまざまなリハビリ目的に使用される。血管形成術においては、血管を膨張させるために、バルーンカテーテルが一般に静脈および動脈に挿入される。この最も一般的な目的は、血管を拡張させ、そして/または血管内の閉塞を解消する(たとえば、血管を閉塞し、心臓発作または脳卒中を引き起こしうる狭窄を解消する)ことにある。他のタイプの外科用バルーンは、手術中の特定の臓器に外科医がアクセスするのを助けるために、通常は以前の通気技術の代わりに使用されてきた。このようなバルーンは通常、しぼませた状態で、カニューレ、カテーテルチューブ、または他の同様の装置を備えた挿入装置を通して挿入され、臓器の下に位置付けられる。次にバルーンを膨らませて所望の臓器を持ち上げ、周囲の臓器および組織から離すことによって、手術中に所望の臓器の側面にアクセスしやすいようにする。他の臓器および組織を持ち上げて分離するためにバルーンを配置して膨らませることもあり、この場合は手術対象の臓器がバルーンの下側で露出される。
本発明は、バルーンカテーテルなどの膨張可能構造体の膨張を所望の方向に、またはそこから離れるように方向付けるために、膨張可能構造体と併用しうる挿入装置を提供する。膨張可能構造体の方向付けられた膨張によって、医師は海綿質骨の圧縮および骨内での空洞の形成をかなり制御できるばかりでなく、皮質骨の移動も制御できる。また、膨張可能構造体の膨張を制御することによって、医師は空洞の形状および寸法を調整できるため、そこに収容する充填材料の塊の形状および寸法を調整できる。さらに、膨張可能構造体の膨張を方向付けることによって、医師は処置手順中に健康な海綿および/または皮質骨の破壊を最小限に抑えられるので、処置後の骨の治癒をさらに向上させることができる。したがって、本願明細書に開示されている各装置および方法によって、医師は圧縮力に対する骨の耐久力を最適化でき、さらに/または手順の完了後にできるだけ速く治癒させることができる。
本発明は、医療用バルーンなどの膨張可能構造体と併用される挿入装置の現行の方法およびデザインに伴う問題および欠点を克服する。特に、本発明は、膨張可能構造体の膨張を方向付けるばかりでなく、ヒトまたは動物の体内領域への膨張可能構造体の挿入および取り出しを助けるために、膨張可能構造体と併用しうる挿入装置を提供する。このような処置に適した方法および器具は、米国特許第4,969,888号、同第5,108,404号、同第5,827,289号、同第5,972,015号、同第6,048,346号、および同第6,066,154号により詳細に記載されている。これらの各明細書は本明細書中に参考として援用される。
Claims (19)
- 骨処置装置であって、
膨張可能構造体と、
前記膨張可能構造体を収容するシースであって、前記膨張可能構造体の膨張を方向付けるために前記シースの軸線に沿って、かつ前記シースの軸線を中心として延在する開口部と、前記膨張可能構造体を前記シース内に固定する少なくとも1つの固定要素とを含むシースと、を備える装置。 - 請求項1に記載の装置であって、
前記固定要素がタブである装置。 - 請求項2に記載の装置であって、
前記タブが先細りになっている装置。 - 請求項1に記載の装置であって、
前記開口部が前記シースの軸線に沿って、かつ前記シースの軸線を中心として360°未満の範囲にわたって延在する装置。 - 請求項1に記載の装置であって、
前記膨張可能構造体が海綿質骨を圧縮するようになっている装置。 - 請求項1に記載の装置であって、
遠位端を有するスタイレットであって、前記膨張可能構造体を貫通して延在するサイズと構成とを有し、前記スタイレットの遠位端が少なくとも部分的に前記シースの遠位端を越えて延在するスタイレットをさらに備える装置。 - 請求項6に記載の装置であって、
前記スタイレットの遠位端が尖っていない装置。 - 皮質骨壁プローブであって、
軸線に沿って延在し、遠位端を有するシースと、
遠位端を備え、前記シースを貫通する形状と構成とを有するシャフトと、
尖っていない遠位端を備え、前記シャフトを貫通するサイズと構成とを有するスタイレットであって、前記尖っていない遠位端が少なくとも部分的に前記シースの遠位端および前記シャフトの遠位端を越えて延在するスタイレットと、を有する皮質骨壁プローブ。 - 請求項8に記載の皮質骨壁プローブであって、
前記シャフトによって担持される膨張可能構造体をさらに備え、
前記膨張可能構造体の膨張を方向付けるために、前記シースが前記シースの軸線に沿って、かつ前記シースの軸線を中心として延在する開口部を含む皮質骨壁プローブ。 - 請求項9に記載の皮質骨壁プローブであって、
前記膨張可能構造体が、前記開口部の外側に、前記シースを越えて膨張するようになっている皮質骨壁プローブ。 - 請求項9に記載の皮質骨壁プローブであって、
前記膨張可能構造体の膨張を方向付けるために、前記開口部が前記シースの軸線に沿って、かつ前記シースの軸線を中心として360°未満の範囲にわたって延在する皮質骨壁プローブ。 - 請求項9に記載の皮質骨壁プローブであって、
前記膨張可能構造体が海綿質骨を圧縮するようになっている皮質骨壁プローブ。 - 請求項9に記載の皮質骨壁プローブであって、
前記シースが、前記シース内での前記シャフトの移動を防ぐ固定要素を少なくとも1つ含む皮質骨壁プローブ。 - 請求項13に記載の皮質骨壁プローブであって、
前記固定要素がタブである皮質骨壁プローブ。 - 骨処置装置であって、
内部を貫通する管腔と遠位端とを有するシャフトによって担持される膨張可能構造体と、
尖っていない遠位先端部を備えたスタイレットであって、バルーンカテーテル組み立て体を形成するために、前記尖っていない遠位先端部の少なくとも一部を前記シャフトの遠位端より先に延在させるために、前記管腔を貫通するサイズと構成とを有するスタイレットと、
遠位端を備え、前記カテーテル組み立て体を通過させるサイズと構成とを有するシースであって、前記膨張可能構造体を受け入れるための開口部と、前記シースを前記シャフトの遠位端に固定するための少なくとも1つの固定要素とを含むシースと、を備える装置。 - 請求項15に記載の装置であって、
前記スタイレットの遠位先端部が少なくとも部分的に前記シースの遠位端を越えて延在する装置。 - 骨の処置方法であって、
挿入装置を皮質骨領域を通して前記骨の海綿質骨領域に導入するステップと、
バルーンカテーテル組み立て体を前記挿入装置を通して導入するステップであって、前記バルーンカテーテル組み立て体が膨張可能構造体と、前記膨張可能構造体を収容するシースとを備え、前記シースが前記シースの軸線に沿って、かつ前記シースの軸線を中心として延在する、前記膨張可能構造体の膨張を方向付けるための開口部と、前記膨張可能構造体を前記シース内に固定する少なくとも1つの固定要素とを含むステップと、
空洞を前記骨内に形成するために、前記膨張可能構造体を前記開口部の外側に、前記シースを越えて膨張させるステップと、を含む方法。 - 請求項17に記載の方法であって、
前記膨張可能体の膨張によって海綿質骨を圧縮する方法。 - 請求項17に記載の方法であって、
前記空洞に骨充填材を充填するステップをさらに含む方法。
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AU2005262796A1 (en) | 2006-01-19 |
CN101384223A (zh) | 2009-03-11 |
JP4904271B2 (ja) | 2012-03-28 |
WO2006007090A3 (en) | 2008-11-20 |
US7815649B2 (en) | 2010-10-19 |
EP1768737A4 (en) | 2011-11-30 |
AU2005262796B2 (en) | 2011-03-31 |
US20050090852A1 (en) | 2005-04-28 |
KR20070023740A (ko) | 2007-02-28 |
WO2006007090A2 (en) | 2006-01-19 |
CN101384223B (zh) | 2012-07-04 |
CA2567381A1 (en) | 2006-01-19 |
EP1768737A2 (en) | 2007-04-04 |
KR101179856B1 (ko) | 2012-09-04 |
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