JP2009504239A - 挿入型血栓フィルタ及びデリバリシステム - Google Patents
挿入型血栓フィルタ及びデリバリシステム Download PDFInfo
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- A61F2/01—Filters implantable into blood vessels
- A61F2/011—Instruments for their placement or removal
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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
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
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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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
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- 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
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- 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
- A61F2230/0067—Three-dimensional shapes conical
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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
- 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
- A61F2230/0073—Quadric-shaped
- A61F2230/008—Quadric-shaped paraboloidal
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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
- 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
- A61F2230/0093—Umbrella-shaped, e.g. mushroom-shaped
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- 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
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
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Abstract
Description
例えば、ビンカアルカロイド(即ち、ビンブラスチン、ビンクリスチン、及びビンオレルビン)、パクリタクセル、エピジポドフィロトキシン(即ち、エトポシド、テニポシド)、抗生物質(ダクチノマイシン(アクチノマイシンD)ダウノルビシン、ドクソルビシン及びイダルビシン)、アントラシクリン、ミトキサントロン、ブレオマイシン、プリカマイシン(ミトラマイシン)及びマイトマイシン、酵素(Lアスパラギンを全身的に新陳代謝させ、それら自体アスパラギンを合成する容量を有していない細胞を拒否するLアスパラギナーゼ)のような天然物を含む抗増殖/抗分裂剤;
G(GP)IIb/IIIa抑制剤及びビトロネクチンレセプタ拮抗剤のような抗血漿板剤;
ナイトロジェンマスタード(メクロレタミン、シクロホスファミド及び類似体、メルファラン、クロランブシル)、エチレニミン及びメチルメラミン(ヘキサメチルメラミン及びチオテパ)、アルキルスルホン酸・ブスルファン、ニトロソ尿素(カルムスチン(BCNU)及び類似体、ストレプトゾシン)、及びトラゼン−ダカルバジン(DTIC)のような抗増殖/抗分裂アルキル化剤;
葉酸類似体(メトトレキサート)、ピリミジン類似体(フルオロウラシル、フロクスリヂン、及びシタラビン)、プリン類似体及び関連抑制剤(メルカプトプリン、チオグアニン、ペントスタチン、及び2−クロロデオキシアデノシン{クラドリビン})のような抗増殖/抗分裂、抗代謝産物;
白金配位錯体(シスプラチン、カルボプラチン)、プロカルバジン、オキシ尿素、ミトタン、アミノグルテチミド;
ホルモン(即ち、エストロゲン);
抗凝血剤(ヘパリン、合成ヘパリン塩及び他の血栓抑制剤);
繊溶剤(組織プラスミノーゲン活性化剤、ストレプトキナーゼ、及びウロキナーゼのような)、アスピリン、ジピリダモール、チクロピジン、クロピドグレル、アブシキシマブ;
抗遊走剤;
抗分泌剤(例えば、ブレベルジン);
副腎皮質ステロイド(コルチゾール、コルチゾン、フルドロコルチゾン、プレドニゾン、プレドニゾロン、6α−メチルプレドニソロン、トリアムシノロン、ベタメタゾン、及びデクサミタゾーン)、非ステロイド剤(サリチル酸誘導体、即ちアスピリン)のような抗炎症剤;
パラアミノフェノール誘導体、即ちアセトミノフェン;
インドール及びインデン酢酸(インドメタシン、スリンダック、及びエトダラック)、ヘテロアリル酢酸(トルメチン、ジクロフェナック、及びケトロラック)、アリルプロピオン酸(イブプロフェン及び誘導体)、アントラニル酸(メフェナム酸、及びメクロフェナム酸)、エノール酸(ピロキシカム、テノキシカム、フェニルブタゾン、及びオキシフェンタトラゾン)、ナブメトン、金化合物(アウラノフィン、アウロチオグルコース、金ナトリウムチオマラート);
免疫抑制剤:(シクロスポリン、タクロキムス(FK-506)、シロリムス(ラパマイシン)、アザチオプリン、マイコフェノラートモフェチル);
血管内皮発育因子(VEGF)、繊維芽細胞発育因子(FGF)のようなアンギオジェニック剤;
アンギオテンシンレセプタ遮断剤;
酸化窒素ドナー;
抗センスオリギオヌクレオチド及びそれらの組合せ;
mTOR抑制剤のような細胞周期抑制剤、及び発育因子レセプタ信号トランスダクションキナーゼ抑制剤;
レテノイド;
シクリン/CDK抑制剤;
HMGコエンザイム還元酵素抑制剤(スタチン);及び
プロテアーゼ抑制剤。
Claims (33)
- 血液フィルタユニットのための血液フィルタデリバリシステムであって、
細長い概ね管状の部材に接続されている結合ポートを有する導入器と、
前記導入器の結合ポート及びYアダプタに結合されている格納部材と、
前記格納部材内に配置されている第1の端、及び前記Yアダプタを越えて延びている第2の端を有する押し具組立体と、
を備え、
前記押し具組立体は、
前記押し具組立体の縦軸に沿って前記第2の端付近に配置されているハンドルと、
前記押し具組立体の縦軸に沿って前記細長い組立体の前記第1の端付近に配置されている押し具パッドと、
前記縦軸に沿って前記ハンドルと前記押し具との間の前記押し具組立体上に配置され、前記縦軸に沿って離間している第1及び第2のボス部分を有し、これらのボス部分がそれらの間にギャップを形成しているスプライン部材と、
を含み、
前記血液フィルタデリバリシステムは、更に、
前記縦軸の周囲に配置されている複数のアンカー部材を有し、前記各アンカー部材が前記スプライン部材の溝の中に配置される円弧状部分を有するフックを有している血液フィルタ、
を備えていることを特徴とする血液フィルタデリバリシステム。 - 前記導入器の細長い概ね管状の部材は更に、前記結合ポートから遠い方の前記細長い概ね管状の部材上に配置されている放射線不透過マーカーを備えていることを特徴とする請求項1に記載の血液フィルタデリバリシステム。
- 前記結合ポートは開口を有するポートボディを備え、前記開口は前記開口を閉塞するシールを含み、前記ポートボディは、前記開口の周囲に配置されていて急峻な係合を介して前記格納部材の一方の端上に形成されている突起に確保可能な縁を有することを特徴とする請求項2に記載の血液フィルタデリバリシステム。
- 前記格納部材の突起は、前記縦軸の周囲に円周状に配置されている湾曲表面を含むことを特徴とする請求項3に記載の血液フィルタデリバリシステム。
- 前記細長い部材は、前記細長い部材の長さに沿う種々の位置において複数の異なる断面を有する金属ワイヤーからなることを特徴とする請求項3に記載の血液フィルタデリバリシステム。
- 前記金属ワイヤーは、第1の断面積を有するステンレス鋼部材と、前記ステンレス鋼部材に接続されていて前記第1の断面積より小さい第2の断面積を有する形状記憶合金ワイヤーとからなることを特徴とする請求項5に記載の血液フィルタデリバリシステム。
- 前記押し具パッドは、前記細長い組立体の第1の端付近に配置されている概ね円筒形の押し具部材からなり、前記概ね円筒形の押し具部材は前記スプライン部材の最も近い部分から約34mmの距離離間していることを特徴とする請求項1に記載の血液フィルタデリバリシステム。
- 前記スプライン部材の第1のボスは複数の縦方向の突起からなり、前記縦方向の突起は互いに離間し且つ概ね円筒形の主表面の周囲に配置されて複数の縦方向溝を限定していることを特徴とする請求項7に記載の血液フィルタデリバリシステム。
- 前記スプライン部材の第2のボスは前記概ね円筒形の主表面の周囲に配置されている概ね円筒形の部材からなり、前記概ね円筒形の部材は前記概ね円筒形の表面の周囲に配置されている概ね平坦な表面を有し、前記概ね平坦な表面は前記第1のボスの最も近い部分から前記縦軸に沿って約1.3mmの距離離間していることを特徴とする請求項8に記載の血液フィルタデリバリシステム。
- 拡張器組立体を更に備え、前記拡張器組立体は細長い中空部材に結合されている拡張器ハブを有し、前記細長い中空部材は前記拡張器ハブ付近の第1の端と前記第1の端から遠い第2の端とを有し、前記第2の端は前記第2の端から約28mmに配置されている第1の放射線不透過マーカーを有していることを特徴とする請求項1に記載の血液フィルタデリバリシステム。
- 前記第2の端は、前記第1の放射線不透過マーカーから約28mmに配置されている第2の放射線不透過マーカーを含むことを特徴とする請求項10に記載の血液フィルタデリバリシステム。
- 前記細長い中空部材は、通路と、前記中空部材の壁を貫通して前記通路まで延びる複数の流体ポートとを含み、前記複数の流体ポートは、前記第1及び第2の放射線不透過マーカー間の前記細長い部材上で互いにスパイラル状に離間していることを特徴とする請求項11に記載の血液フィルタデリバリシステム。
- 前記フィルタは、
第1の端から第2の端まで縦軸に沿って延び、その上に配置されているフックを有するボディと、
複数のアンカーと、
を備え、
前記複数のアンカーは、前記フィルタが拘束されていない状態では、前記第1及び第2の端から遠ざかるように前記ボディの第2の端から斜めに延び、前記複数のアンカーは前記縦軸に沿う長さを有していて、何れか2つのアンカーの間に前記長さの少なくとも0.9倍の最大幅を限定し、前記フィルタが血管内に配置された時に各アンカーに接続されている前記フックが前記血管の壁に突入するようになっており、
前記ボディの第1及び第2の端から遠ざかるように前記ボディの第2の端から斜めに延びる複数のロケータを更に備え、
前記フィルタが拘束されていない状態では、前記各ロケータの一部分が前記壁と係合する、
ことを特徴とする請求項1に記載の血液フィルタデリバリシステム。 - 大静脈フィルタに使用するための押し具組立体であって、
縦軸に沿って第1の端から第2の端まで延びる細長い部材、
を備え、
前記細長い部材は、前記細長い部材に沿う種々の位置において複数の断面を有し、
前記第1の端付近に配置されているハンドルと、
前記第2の端付近に配置されている押し具パッドと、
前記ハンドルと前記押し具パッドとの間の前記縦軸に沿って配置されている部材と、
を更に備え、
前記部材は主ボディ、及び前記縦軸に沿って離間している第1及び第2のボス部分を有し、前記ボス部分は前記縦軸の周囲にある長さに亘って配置されているギャップを形成している、
ことを特徴とする押し具組立体。 - 前記ギャップは、環状ギャップからなることを特徴とする請求項14に記載の押し具組立体。
- 前記細長い部材は、前記細長い部材の長さに沿う種々の位置において複数の断面を有する金属ワイヤーからなることを特徴とする請求項14に記載の押し具組立体。
- 前記金属ワイヤーは、第1の断面積を有するステンレス鋼部材と、前記ステンレス鋼部材に接続されていて前記第1の断面積より小さい第2の断面積を有する形状記憶合金ワイヤーとからなることを特徴とする請求項16に記載の押し具組立体。
- 前記押し具パッドは、前記細長い組立体の第1の端付近に配置されている概ね円筒形の押し具部材からなり、前記概ね円筒形の押し具部材は前記スプライン部材の最も近い部分から約34mmの距離離間していることを特徴とする請求項17に記載の押し具組立体。
- 前記部材の第1のボスは複数の縦方向の突起からなり、前記縦方向の突起は互いに離間し且つ概ね円筒形の主表面の周囲に配置されて複数の縦方向溝を限定していることを特徴とする請求項18に記載の押し具組立体。
- 前記部材の第2のボスは前記概ね円筒形の主表面の周囲に配置されている概ね円筒形の部材からなり、前記概ね円筒形の部材は前記概ね円筒形の表面の周囲に配置されている概ね平坦な表面を有し、前記概ね平坦な表面は前記第1のボスの最も近い部分から前記縦軸に沿って約1.3mmの距離離間していることを特徴とする請求項19に記載の押し具組立体。
- 前記部材は、スプライン部材からなることを特徴とする請求項14−20の何れか1つに記載の押し具組立体。
- 大静脈フィルタデリバリユニットに使用するための押し具組立体であって、
縦軸に沿って第1の端から第2の端まで延びる細長い部材と、
前記第1の端付近に配置されているハンドルと、
前記第2の端付近に配置されている押し具と、
前記ハンドルと前記押し具との間の前記縦軸に沿って配置されているスプライン部材と、
を備え、
前記スプライン部材は複数の溝を有し、前記各溝は前記溝の長さに沿って複数の幅を限定している、
ことを特徴とする押し具組立体。 - 前記複数の溝の少なくとも1つの中に位置するフィルタの少なくとも1つのアンカー部分を更に備え、前記アンカー部分は前記溝の最小幅より大きい最大幅を有していることを特徴とする請求項21に記載の押し具組立体。
- 縦軸の周囲に複数のアンカーを有する血液フィルタをパッケージする方法であって、前記各アンカーは1つのフック及び少なくとも2つのアンカーを有し、前記少なくとも2つのアンカーは前記縦軸と交叉し且つ前記少なくとも2つのアンカー間に約40mmのスパンを限定し、前記アンカーは前記縦軸に沿って延びるハブと結合され、前記方法は、
前記各フックの湾曲した部分を、支持組立体の2つのボス部分間に位置する環状ギャップ内に配置するステップと、
前記各アンカーの一部分を、前記2つのボス部分の一方を通って延びる縦方向溝内に配置するステップと、
複数のロケータ及びフックを含むフィルタ、及び前記ボス部分を、約10フレンチの外径(直径約3.3mm)を有する概ね管状の部材内に封じ込めるステップと、
を含むことを特徴とする方法。 - 前記配置するステップは、前記フックの円弧部分に沿う断面積が0.04mm2より大きいフックを準備するステップを含むことを特徴とする請求項23に記載の方法。
- 前記外径は、約9フレンチ(直径約2.9mm)であることを特徴とする請求項23に記載の方法。
- 前記概ね管状の部材の内径は、約7フレンチ(直径約2.3mm)であることを特徴とする請求項24に記載の方法。
- 前記封じ込めステップは、手前方向に5ポンド・力より小さい軸方向力が加えられた時に、前記概ね管状の部材に対する前記フィルタの前記縦軸に沿う運動を防ぐことからなることを特徴とする請求項23に記載の方法。
- 前記封じ込めステップは、手前方向に10ポンド・力より小さい軸方向力が加えられた時に、前記概ね管状の部材に対する前記フィルタの前記縦軸に沿う運動を防ぐことからなることを特徴とする請求項23に記載の方法。
- 前記配置するステップは、前記フィルタのハブを、前記概ね管状の部材の開口に向かって遠方へ、且つ前記アンカーが前記ハブから遠去かって手前方向に延びるようにプリロードすることからなることを特徴とする請求項24に記載の方法。
- 生物活性剤を更に備えていることを特徴とする請求項1乃至13の何れか1つに記載の血液フィルタデリバリシステム。
- 前記第2の端付近において前記押し具組立体に結合されている生物活性剤を更に備えていることを特徴とする請求項14乃至20の何れか1つに記載の押し具組立体。
- 前記第2の端付近において前記押し具組立体に生物活性剤を結合するステップを更に含むことを特徴とする請求項23乃至29の何れか1つに記載の方法。
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- 2006-05-09 US US11/997,832 patent/US8062327B2/en active Active
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EP1912696A1 (en) | 2008-04-23 |
US8430903B2 (en) | 2013-04-30 |
US20200085559A1 (en) | 2020-03-19 |
US20120065663A1 (en) | 2012-03-15 |
JP4851522B2 (ja) | 2012-01-11 |
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US8062327B2 (en) | 2011-11-22 |
US10492898B2 (en) | 2019-12-03 |
CA2616818A1 (en) | 2007-02-22 |
CA2616818C (en) | 2014-08-05 |
US9387063B2 (en) | 2016-07-12 |
US11517415B2 (en) | 2022-12-06 |
US20090131970A1 (en) | 2009-05-21 |
US20160317278A1 (en) | 2016-11-03 |
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