JP2009508585A - 終端のための装置および方法 - Google Patents
終端のための装置および方法 Download PDFInfo
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Abstract
Description
本出願は、2003年4月1日に出願された米国特許出願第60/459,735号、2003年4月10日に出願された米国特許出願第60/462,502号および2003年11月24日に出願された米国特許出願第60/524,922号の利益を主張する2004年3月2日に出願された米国特許出願第10/792,681号の一部継続出願であり、そして、2003年12月19日に出願された米国特許出願第10/741,130号の一部継続出願であり、この出願は2003年9月4日に出願された米国特許出願第10/656,797号の一部継続出願および2003年6月13日に出願された米国特許出願第10/461,043号の一部継続出願であり、その後者の出願は、2002年6月13日に出願された米国特許出願第60/388,935号、2002年11月25日に出願された米国特許出願第60/429,288号、2003年2月6日に出願された米国特許出願第60/445,890号、および2003年4月10日に出願された米国特許出願第60/462,502号の利益を主張する。上記出願の全開示は、参照によってここに援用される。
本明細書に記載される方法と装置は、概して医療機器と方法に関し、より具体的には、特に心臓血管弁修復で用いられる、低侵襲手術手技を使用して組織修復を促進するための装置と方法に関する。
最近位アンカーからの滑落を防止するためにテザーが係止されたあと、終了期に除去できるように、余分なテザーを切断しなければならない。一般的に、テザーは係止機構の近位で切断される。多くの場合、係止機構のできるだけ近くでテザーを切断しながら、生じる可能性のあるあらゆる滑脱を見越した十分な余長を残すことが望ましい。以下の例は、余分なテザーを切断するための種々の方法と装置とを提供する。
Claims (40)
- 組織を固定する方法であって、
テザーに固定結合された第一のアンカーと該テザーに摺動自在に結合された第二のアンカーとを該組織に定着することと、
該テザーに血管内で引張力を付加し、該テザーを該第二のアンカーに固定結合させ、該テザーを切断することと
を含む方法。 - 前記組織は心臓組織を含む、請求項1の方法。
- 前記組織は心臓弁輪を含む、請求項1の方法。
- 前記組織は僧帽弁輪を含む、請求項1の方法。
- 前記アンカーを前記組織に定着することは、血管内で実施される、請求項1の方法。
- 前記テザーに付与された引張力に対抗する成分を有する力を前記第二のアンカーに付与することをさらに含む、請求項1の方法。
- 前記第二のアンカーを血管内装置に接触させることにより、前記引張力に対抗する成分を有する力を該第二のアンカーに付与することをさらに含む、請求項6の方法。
- 前記アンカーを前記組織に定着した後に、血管内装置に前記テザーの一部分を装填することをさらに含む、請求項1の方法。
- 前記テザーをループによって捕捉することをさらに含む、請求項8の方法。
- 前記テザーをロッド内の特徴に通すことと、該ロッドを前記血管内装置に挿入することとをさらに含む、請求項8の方法。
- 前記特徴は、開口部、窪み、溝、およびスリットから成る群から選択される、請求項10の方法。
- 前記テザーを前記第二のアンカーに固定結合することは、血管内で実施される、請求項1の方法。
- 前記テザーを前記第二のアンカーに固定結合することは、該第二のアンカーを変形させることを含む、請求項1の方法。
- 前記テザーを前記第二のアンカーに固定結合することは、該テザーを該第二のアンカーに挟着することを含む、請求項1の方法。
- 前記テザーを前記第二のアンカーに固定結合することは、該テザーに係止特徴を提供することを含む、請求項1の方法。
- 前記係止特徴は、前記テザーが通過する前記第二のアンカー上の特徴を前記第一のアンカーの方向に通過できない、請求項15の方法。
- 前記係止特徴を前記テザーに挟着することをさらに含む、請求項15の方法。
- 挟着することは、変形可能なメッシュを拡張させることにより、該メッシュと管の内壁との間に前記テザーを挟着することを含む、請求項17の方法。
- 挟着することは、捩れた管に少なくとも部分的に捩り戻す力を付与することと、前記テザーを該管を通過させることと、該管を再び捩る力を解放することとを含む、請求項17の方法。
- 挟着することは、前記係止特徴の二つの表面を分離する力を付与することと、前記テザーを該表面の間に通過させることと、該テザーを該表面の間に挟着する力を解放することと を含む、請求項17の方法。
- 挟着することは、前記係止特徴の二つの表面を一緒に動かす力を付与し、それによって前記テザーを該二つの面の間に挟着することを含む、請求項17の方法。
- 挟着することは、前記テザーを変形可能な材料の開口部に通すことと、該変形可能な材料を変形させて該開口部の寸法を減少させ、それによって該テザーを挟着することとを含む、請求項17の方法。
- 挟着することは、前記係止特徴を通る前記テザーの経路を変更して、該テザー上の摩擦力を増加させることを含む、請求項17の方法。
- 前記係止特徴は、該係止特徴が前記テザーに沿って一つの方向のみに摺動することを可能にするように適合された突起を備える、請求項15の方法。
- 前記係止特徴は結び目を備える、請求項15の方法。
- 前記係止特徴は、前記テザーが通過するワッシャと、該ワッシャを通過できない該テザー上の結び目とを備える、請求項15の方法。
- 前記係止特徴は、前記第二のアンカー上の特徴を前記第一のアンカーから離れる方向に通過できる、請求項15の方法。
- 前記第二のアンカー上の前記特徴はアイレットを備える、請求項15の方法。
- 前記テザーを前記第二のアンカーに固定結合させることは、該テザーに接着剤をつけることを含む、請求項1の方法。
- 切断するステップは血管内で実施される、請求項1の方法。
- 切断することは前記第二のアンカーの近位で実施される、請求項1の方法。
- 切断することは、二つの同心管の間の前記テザーを剪断するステップを含む、請求項1の方法。
- 前記複数の管の軸に沿って、一方の同心管を他方に対して前進させることをさらに含む、請求項32の方法。
- 前記複数の管の軸の周りを、一方の同心管を他方に対して回転させることをさらに含む、請求項32の方法。
- 切断することは、前記テザーを管の開口部に通過させることと、該管の軸と交差する平面で刃を回転させることとを含む、請求項1の方法。
- 切断することは、前記テザーを切断刃に接触させることを含む、請求項1の方法。
- 切断することは、前記テザーを管に通過させることと、一つ以上の切断刃が取り付けられたバルーンを該管内で膨張させることと、該バルーンを回転させることとを含む、請求項1の方法。
- 切断することは、回転軸を共有する二つの刃の間で前記テザーを剪断することを含む、請求項1の方法。
- 単一の血管内装置が、前記アンカーを展開し、前記テザーに引張力を付与し、該テザーを前記第二のアンカーに固定結合させ、該テザーを切断する、請求項1の方法。
- 同一または異なる血管内装置を使用することにより、各ステップまたはステップの組み合わせを実施し得る、請求項1の方法。
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EP1926438A1 (en) | 2008-06-04 |
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AU2006292531A1 (en) | 2007-03-29 |
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