JP2008534086A - 解剖学的なオリフィス又は内腔の内周を制御するための方法及び装置 - Google Patents
解剖学的なオリフィス又は内腔の内周を制御するための方法及び装置 Download PDFInfo
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Abstract
Description
したがって、本発明の目的は、内部構造又は内腔の形状及びサイズの少なくとも一方を制御するための移植可能な装置を提供することである。
Claims (104)
- 解剖学的な構造又は内腔の形状及びサイズの少なくとも一方を制御するための移植可能な装置であって、
該移植可能な装置の寸法を調整するように構成される調整可能な部材を有する移植可能な装置と、
前記解剖学的な構造又は前記内腔がほぼ正常から正常な生理学的機能を再開する前、再開している間、及び再開した後に、前記調整可能な部材を作動させて調整を行うように構成される調整ツールと
を備える、解剖学的な構造又は内腔の形状及びサイズの少なくとも一方を制御するための移植可能な装置。 - 前記移植可能な装置を前記解剖学的な構造又は前記内腔に移植する前、移植している間、若しくは移植した後に、又は該解剖学的な構造又は該内腔が前記ほぼ正常から正常な生理学的機能に戻った後に、前記解剖学的な構造又は前記内腔の前記形状又は前記サイズを調整する、請求項1に記載の移植可能な装置。
- 前記調整ツールは、前記移植可能な装置に取り付け可能又は再取り付け可能であるように構成される、請求項1に記載の移植可能な装置。
- 前記調整ツールは、前記器官を閉じた後に、前記解剖学的な構造又は前記内腔が前記ほぼ正常から正常な生理学的機能を再開している間に、前記移植可能な装置を調整するために、該移植可能な装置に取り付けられたままであるように構成される、請求項1に記載の移植可能な装置。
- 前記調整ツールは、前記解剖学的な構造又は前記内腔を再び開く必要がないか、又はアクセスする必要なく、該解剖学的な構造又は該内腔の調整が問題ないとみなされた後に、前記移植可能な装置から取り外されるように構成される、請求項1に記載の移植可能な装置。
- 前記調整ツールは、胸部切開部を閉じた後に前記移植可能な装置に再導入されるように構成される、請求項1に記載の移植可能な装置。
- 少なくとも2次元で調整可能である、請求項1に記載の移植可能な装置。
- 3次元で調整可能である、請求項1に記載の移植可能な装置。
- 2次元又は3次元で調整可能である、請求項1に記載の移植可能な装置。
- 少なくとも外層を含む、請求項1に記載の移植可能な装置。
- 前記外層に隣接する中間層をさらに備える、請求項10に記載の移植可能な装置。
- 前記外層に隣接する少なくとも内層又は中間層を含み、該内層は、縫合糸への支持を提供するか又は付加的な部材のための空間をつくる、請求項10に記載の移植可能な装置。
- 前記外層は、発泡体製であるか又はバルク層である、請求項1に記載の移植可能な装置。
- 前記解剖学的な構造又は前記内腔は、前記移植可能な装置が該解剖学的な構造又は該内腔の前記サイズ又は前記形状の少なくとも1つを変えることによって軽減される機能不全を有する、請求項1に記載の移植可能な装置。
- 前記解剖学的な構造又は前記内腔は、心臓弁、食道、胃食道接合部、胃、幽門、腸、及び肛門から選択される、請求項1に記載の移植可能な装置。
- 大動脈弁の配置に用いられる、請求項1に記載の移植可能な装置。
- 腹部大動脈瘤装置の配置に用いられる、請求項1に記載の移植可能な装置。
- 大動脈ステント植え込み用途に用いられる、請求項1に記載の移植可能な装置。
- 大動脈エンドグラフ用途に用いられる、請求項1に記載の移植可能な装置。
- 腹部大動脈瘤ステントグラフに用いられる、請求項1に記載の移植可能な装置。
- 大動脈瘤の治療に用いられる、請求項1に記載の移植可能な装置。
- 食道の治療に用いられる、請求項1に記載の移植可能な装置。
- 肥満を制御するための胃での用途に用いられる、請求項1に記載の移植可能な装置。
- 概ね円形の形状である、請求項1に記載の移植可能な装置。
- 前記解剖学的な構造又は前記内腔の組織への前記移植可能な装置の締結を行うように構成される1つ又は複数の締結装置をさらに備える、請求項1に記載の移植可能な装置。
- 前記1つ又は複数の締結装置は、前記移植可能な装置に組み込まれる、請求項25に記載の移植可能な装置。
- 前記1つ又は複数の締結装置は、縫合糸、ワイヤ、保持針、及びSMAの少なくとも1つから選択される、請求項25に記載の移植可能な装置。
- 前記締結装置はクリップである、請求項27に記載の移植可能な装置。
- 前記クリップは、前記移植可能な装置を前記解剖学的な構造又は前記内腔のまわりの組織に固定する、請求項28に記載の移植可能な装置。
- 前記クリップは、少なくともニチノール又は他の弾性の形状記憶材料製である、請求項28に記載の移植可能な装置。
- 前記クリップは、約4mm〜約10mmの長さである、請求項28に記載の移植可能な装置。
- 後退状態では、前記クリップは、実質的に直線状であり、前記移植可能な装置の下面に密着するか又は場合によっては該移植可能な装置の下面に嵌まり込む、請求項28に記載の移植可能な装置。
- 前記クリップは、縫合、接着、熱融合、アイレット、及び前記移植可能な装置への織り込みの少なくとも1つによって該移植可能な装置に固定される、請求項28に記載の移植可能な装置。
- 後退状態から解放されると、前記クリップ1712は通常な構成をとる、請求項28に記載の移植可能な装置。
- 前記クリップの前記通常な構成では、該クリップの自由端が丸まって重なった針になる、請求項34に記載の移植可能な装置。
- 非展開状態では、前記クリップは、実質的に直線状であり、前記移植可能な装置の下の下面に密着する、請求項28に記載の移植可能な装置。
- 展開縫合糸が、第1のクリップの自由端を通って上方に延び、該第1のクリップに沿って延び、続いて該第1のクリップの反対側の自由端を通って下方に延びる、請求項28に記載の移植可能な装置。
- 前記展開縫合糸は、全てのクリップが前記移植可能な構造の底面に密着するように固定されるまで、後続のクリップの第1の自由端を通って上方に延びる、請求項37に記載の移植可能な装置。
- 前記締結装置は、単一方向に配置されて前記移植可能な装置の外周に結合される、請求項27に記載の移植可能な装置。
- 前記締結装置は、前記移植可能な装置の異なる場所にあり得る、請求項27に記載の移植可能な装置。
- 前記締結装置の前記場所は、前記解剖学的な構造又は前記内腔と並ぶように前記移植可能な装置の外面に戦略的に配置され、異なる用途では前記異なる場所が必要となり得る、請求項27に記載の移植可能な装置。
- 前記締結装置は後退可能である、請求項27に記載の移植可能な装置。
- 前記締結装置は伸張可能である、請求項27に記載の移植可能な装置。
- 前記締結装置は、後退可能且つ伸張可能であり、前記器官に対して前記移植可能な装置が不適当な向きにある場合、適当な向きになるまで伸張されないようにするために用いられる、請求項27に記載の移植可能な装置。
- 前記締結装置は、前記移植可能な装置の移動が該締結装置を係合又は解放させるような向きにされる、請求項27に記載の移植可能な装置。
- 前記締結装置は、前記移植可能な装置の回転移動が該締結装置を係合又は解放させるような向きにされる、請求項27に記載の移植可能な装置。
- 前記移植可能な装置を回転させることによって前記締結装置を係合させるときに円滑に組織を通過できるようにする端子フックを含む、請求項27に記載の移植可能な装置。
- 前記調整ツールに反転可能に結合されるように構成される係合アセンブリを含む、請求項1に記載の移植可能な装置。
- 調整可能な波形部分を含む、請求項1に記載の移植可能な装置。
- 前記調整可能な波形部分と結合される少なくとも1つのグロメット装置をさらに備える、請求項49に記載の移植可能な装置。
- 患者の解剖学的な構造又は内腔が正常な生理学的状態に戻った後に調整されるように構成される、請求項1に記載の移植可能な装置。
- 患者の心臓が正常又はほぼ正常な生理学的状態に戻って血流が再開した後に調整されるように構成される、請求項1に記載の移植可能な装置。
- 前記調整ツールは、ラックアンドピニオン装置を含む、請求項1に記載の移植可能な装置。
- 第1及び第2の調整可能なバンドを含む、請求項1に記載の移植可能な装置。
- 前記第1及び第2の調整可能なバンドは、構造の両端である、請求項54に記載の移植可能な装置。
- ブラケットが、前記第1及び第2のバンドを互いに向かって移動させるように設けられる、請求項54に記載の移植可能な装置。
- 前記第1及び第2のバンドを相対移動させる取り付け構成をさらに備える、請求項54に記載の移植可能な装置。
- 取り付け装置が、グロメット、管、管部材、縫合糸、及びワイヤから選択される、請求項57に記載の移植可能な装置。
- 供給装置に解放可能に取り付けられる、請求項1に記載の移植可能な装置。
- 非展開状態で前記供給装置によって供給される、請求項1に記載の移植可能な装置。
- 前記供給装置は、供給インタフェイスを含む、請求項59に記載の移植可能な装置。
- 前記供給装置は、カテーテル又はトロカールを含む、請求項59に記載の移植可能な装置。
- 前記供給装置は、作動カテーテル及び鞘部を含む、請求項59に記載の移植可能な装置。
- 前記作動カテーテルは、前記移植可能な装置を非展開状態から展開状態にさせる、請求項63に記載の移植可能な装置。
- 少なくとも第1のタッチダウン・センサをさらに備える、請求項1に記載の移植可能な装置。
- 少なくとも3つのタッチダウン・センサをさらに備える、請求項1に記載の移植可能な装置。
- 前記タッチダウン・センサは、回路を完成させるように構成されるか、又は蛍光透視マーカの提供を補助する、請求項65に記載の移植可能な装置。
- 前記タッチダウン・センサは、マイクロスイッチを完成させるように配置され得る、請求項65に記載の移植可能な装置。
- 前記タッチダウン・センサは、該タッチダウン・センサが所望の場所にあることを示すように構成される、請求項65に記載の移植可能な装置。
- 前記タッチダウン・センサは、電気的トレースを検知するように構成される、請求項65に記載の移植可能な装置。
- 前記タッチダウン・センサは、心電図(ECG)の電気的トレースを提供するように構成される、請求項65に記載の移植可能な装置。
- 前記タッチダウン・センサは、遠位部材、中間部材、及び近位部材を含む、請求項65に記載の移植可能な装置。
- 前記遠位部材は、ばねによって取り付けられており、前記近位部材とのシームレス接合を達成するために前記中間部材の上で摺動可能で、入れ子状の移動が可能である、請求項72に記載の移植可能な装置。
- 前記タッチダウン・センサの少なくとも一部は、放射線不透過材料でカバーされる、請求項65に記載の移植可能な装置。
- 前記タッチダウン・センサは、入れ子状又はばね負荷であり得る、請求項65に記載の移植可能な装置。
- 調整停止部を含む、請求項1に記載の移植可能な装置。
- 虚血性環状膨張症及び僧帽弁逆流に用いられる、請求項1に記載の移植可能な装置。
- 展開傘を用いて配置される、請求項1に記載の移植可能な装置。
- 前記展開傘及び前記移植可能な装置は、僧帽弁の領域に対して後方に引かれる、請求項78に記載の移植可能な装置。
- 少なくとも2つのタッチダウン・センサが設けられ、該少なくとも2つのタッチダウン・センサは、前記移植可能な装置の展開が進行され得るときを示す、請求項79に記載の移植可能な装置。
- 前記移植可能な装置の再配置を可能にするために、反対の動きによって前記保持針が再配置される、請求項75に記載の移植可能な装置。
- 前記タッチダウン・センサは、前記移植可能な装置の適当な位置決めに利用される、請求項81に記載の移植可能な装置。
- 前記調整ツールは、カテーテルをベースにしており、経皮的経路又は他の経路を通して連続的に再び挿入されるように構成される、請求項1に記載の移植可能な装置。
- 前記調整ツールは、オペレータによって舵取り可能なように操作可能である、請求項1に記載の移植可能な装置。
- 前記調整ツールは、該調整ツールの結合が可能になるように磁気、電気、電磁気、及びレーザによって案内する装置の少なくとも1つを含む、請求項1に記載の移植可能な装置。
- 前記調整ツールは、遠隔的に制御されるモータ又はシステムによって駆動されるように構成される、請求項1に記載の移植可能な装置。
- 直線、曲線、円形、卵形、多角形、及びその組み合わせの少なくとも1つから選択される外形を有する、請求項1に記載の移植可能な装置。
- 前記内部構造又は内腔の均一若しくは非均一な調整を提供するように構成される、請求項1に記載の移植可能な装置。
- 僧帽弁の平坦な又は非平坦な調整を提供するように構成される、請求項1に記載の移植可能な装置。
- 僧帽弁の優先的な調整を提供するように構成される、請求項1に記載の移植可能な装置。
- 少なくとも一部が、中実な構造、管状の構造、及び実質的な構造である、請求項1に記載の移植可能な装置。
- 外側部材及び内側部材を含む、請求項1に記載の移植可能な装置。
- 前記内側部材は、前記調整ツールに結合され、該調整ツールによって作動されるとき、前記外側部材の形状又はサイズを変更するように構成される調整を提供する、請求項92に記載の移植可能な装置。
- 前記調整ツールは、ねじ、ウォームねじ、摩擦機構、摩擦移動止め機構、歯付き機構、ラチェット機構、及びラックアンドピニオン機構の少なくとも1つと係合されるように構成される、請求項1に記載の移植可能な装置。
- 組織への前記移植可能な装置の縫合糸のない機械的な固定を提供する調整ツールインタフェイスを含む、請求項92に記載の移植可能な装置。
- 組織取り付け部材が、前記移植可能な装置を組織に固定するために該移植可能な装置に固定される、請求項1に記載の移植可能な装置。
- 生物学的に互換性のある物質を用いて、前記移植可能な装置の組織への固定が補助される、請求項1に記載の移植可能な装置。
- 前記外側部材は、電磁エネルギーに露出されたときに剛性が高まる材料製である、請求項69に記載の移植可能な装置。
- トロカール、鞘部、セルディンガー法、針によって皮下的に、及び自然の体のオリフィス、身体内の空所、又は領域を通して内視鏡によって導入される、請求項1に記載の移植可能な装置。
- 引き紐を含む、請求項1に記載の移植可能な装置。
- 前記引き紐は、前記移植可能な装置に沿って自由に摺動可能である、請求項100に記載の移植可能な装置。
- 前記引き紐の端は、前記移植可能な装置に沿った場所に繋がれる、請求項100に記載の移植可能な装置。
- 前記移植可能な装置のうち前記引き紐が位置する部分は、該引き紐のない部分よりも多くの調整を受ける、請求項100に記載の移植可能な装置。
- 前記引き紐と連動する内部整形部材をさらに備える、請求項100に記載の移植可能な装置。
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Also Published As
Publication number | Publication date |
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WO2006105084A2 (en) | 2006-10-05 |
US20060241748A1 (en) | 2006-10-26 |
EP2626039B1 (en) | 2015-10-14 |
JP5149150B2 (ja) | 2013-02-20 |
EP2626039A1 (en) | 2013-08-14 |
EP1861045B1 (en) | 2015-03-04 |
EP2767260A1 (en) | 2014-08-20 |
US20140336756A1 (en) | 2014-11-13 |
US9492276B2 (en) | 2016-11-15 |
AU2006230162B2 (en) | 2011-09-29 |
AU2006230162A1 (en) | 2006-10-05 |
EP1861045A2 (en) | 2007-12-05 |
EP2767260B1 (en) | 2019-07-03 |
EP1861045A4 (en) | 2010-06-30 |
WO2006105084A3 (en) | 2007-11-29 |
JP2012196504A (ja) | 2012-10-18 |
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