JP2010172712A - 血管の創傷をふさぐ装置および方法 - Google Patents
血管の創傷をふさぐ装置および方法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/085—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound with adhesive layer
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
-
- 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
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- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04N—PICTORIAL COMMUNICATION, e.g. TELEVISION
- H04N7/00—Television systems
- H04N7/08—Systems for the simultaneous or sequential transmission of more than one television signal, e.g. additional information signals, the signals occupying wholly or partially the same frequency band, e.g. by time division
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- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04N—PICTORIAL COMMUNICATION, e.g. TELEVISION
- H04N7/00—Television systems
- H04N7/08—Systems for the simultaneous or sequential transmission of more than one television signal, e.g. additional information signals, the signals occupying wholly or partially the same frequency band, e.g. by time division
- H04N7/087—Systems for the simultaneous or sequential transmission of more than one television signal, e.g. additional information signals, the signals occupying wholly or partially the same frequency band, e.g. by time division with signal insertion during the vertical blanking interval only
- H04N7/088—Systems for the simultaneous or sequential transmission of more than one television signal, e.g. additional information signals, the signals occupying wholly or partially the same frequency band, e.g. by time division with signal insertion during the vertical blanking interval only the inserted signal being digital
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00491—Surgical glue applicators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3439—Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00637—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for sealing trocar wounds through abdominal wall
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00646—Type of implements
- A61B2017/0065—Type of implements the implement being an adhesive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00646—Type of implements
- A61B2017/00654—Type of implements entirely comprised between the two sides of the opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00646—Type of implements
- A61B2017/00659—Type of implements located only on one side of the opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
Abstract
【解決手段】止血材が、外科手術器具上を前進させられ創傷を囲む血管の領域に接触させられる。外科手術器具は取り外される。血液が止血材に染み込み、材内において止血薬により血液凝固が促進される。接着剤からなる密封層が、止血材に加えられ、止血材へ血流を閉じこめることができる。従って、血管穿刺創傷は、自然な血液の凝血塊形成により封じられる。
【選択図】図27
Description
Claims (20)
- 止血材を収容できるように形成されたチャンバーを画定している送達管であって、近位端および遠位端を有する前記送達管と、
血管創傷近傍の前記送達管の前記遠位端に位置するように形成された装置と、
少なくとも一部が前記送達管を変形させることなく前記送達管の前記近位端に適合するように形成された遠位端を有するプッシャーメンバーであって、前記送達管の少なくとも一部分の直径より大きな直径を有する部分を備えたプッシャーメンバーとを備え、
前記止血材は、前記チャンバー内において運ばれ、
前記プッシャーメンバーおよび前記送達管は、前記プッシャーメンバーが前記送達管に関して遠位に動かされるように形成され、前記プッシャーメンバーは、止血材がチャンバーから出るように少なくとも1つの開口が作られるために、止血材の少なくとも一部に隣接する前記送達管と係合しおよび前記送達管を変形させる血管創傷閉鎖アセンブリー。 - 前記装置は、テーパーが付いた遠位部と前記遠位部に近位の少なくとも一つのカテーテル孔を有するカテーテルを備える請求項1に記載のアセンブリー。
- 前記カテーテルは、前記送達管の中を通って延びている請求項2に記載のアセンブリー。
- 前記止血材は、前記カテーテルと前記送達管の間に配置されている請求項3に記載のアセンブリー。
- 前記カテーテルの表面のまわりに配置された停止部材と、
前記カテーテルと前記プッシャーメンバーを取り外し可能に連結させるために、前記カテーテルのまわりに可動に配置され、前記停止部材と係合するように形成され、前記プッシャーメンバー上の近位の連結部材と係合するように形成された連結部材とをさらに備える請求項2に記載のアセンブリー。 - 前記プッシャーメンバーは、また、前記プッシャーメンバーと前記送達管を取り外し可能に連結するために形成された、遠位の連結部材を備える請求項5に記載のアセンブリー。
- 前記送達管、前記装置および前記プッシャーメンバーが互いに固定された関係において取り外し可能かつ同時に連結するための手段をさらに備える請求項1に記載のアセンブリー。
- 前記送達管は、略円錐形である請求項1に記載のアセンブリー。
- 前記止血剤は、Hemadex(登録商標)を含む請求項1に記載のアセンブリー。
- 前記送達管は、前記プッシャーメンバーが前記送達管に関して遠位に移動された時に、優先的に破壊されるように形成された少なくとも一つの軟化させた部分を備える請求項1に記載のアセンブリー。
- 前記少なくとも一つの軟化させた部分は、厚さが減少した壁部を含む請求項10に記載のアセンブリー
- 前記少なくとも一つの軟化させた部分は、刻み目のついた壁部を含む請求項10に記載のアセンブリー。
- 前記送達管は、半分に分割され互いに結合されている二つの部分を含む請求項1に記載のアセンブリー。
- 前記送達管は、弾性材料を含む請求項1に記載のアセンブリー。
- 前記送達管は、互いに可動するように連結された少なくとも二つのレトラクタアームを備え、前記アームは、開放位置と閉鎖位置の間を移動するように形成され、各前記レトラクタアームは、内面を画定しており、前記内面は、前記アームが閉鎖位置にある時、前記レトラクタアームを通る管を画定しており、前記管は、前記カテーテルを収容するために形成され、前記管の少なくとも一方の部分は、前記閉鎖位置にある前記アームと関連した固定された位置に前記カテーテルを保持するための前記カテーテルの前記表面と係合する大きさであり、前記管の少なくとももう一方の部分は、前記内面と前記カテーテルの間のスペースを画定するために形成されている請求項2に記載のアセンブリー。
- 前記スペース内に前記止血材が配置された請求項15に記載のアセンブリー。
- 前記送達管に関して近位または遠位に移動しないように、前記送達管と前記プッシャーメンバーを取り外し可能に連結するために形成された第一の連結手段をさらに備える請求項1に記載のアセンブリー。
- 前記第1と第2の連結手段が前記カテーテルと係合された時、前記プッシャーメンバーと前記送達管が互いに関して近位または遠位に移動しないように、前記カテーテルを前記プッシャーメンバーと取り外し可能に連結するために形成された前記第2の連結手段をさらに備える請求項17に記載のアセンブリー。
- 前記送達管内を通って延びるカテーテルをさらに備え、
前記送達管は、相互に可動に結合された少なくとも2つのレトラクタアームを有し、
前記レトラクタアームは、開放位置と閉鎖位置との間を動くよう構成され、
前記レトラクタアームは、各々テーパー状の内面を画定しており、
前記内面は、前記レトラクタアームが閉鎖位置にある状態で前記レトラクタアーム内を通るチャネルを画定し、
前記チャネルの遠位端は前記カテーテルの表面に係合し、
前記チャンバーは前記チャネルと前記チャネルの遠位端に隣接するカテーテルとの間に画定されている、請求項1に記載のアセンブリー。 - 前記プッシャーメンバー及び送達管は、前記プッシャーメンバーの遠位端が前記チャンバー内に配置されるとともに取り外し可能に連結されている、請求項19に記載のアセンブリー。
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US38923902P | 2002-06-14 | 2002-06-14 | |
US60/389,239 | 2002-06-14 |
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JP2004512612A Division JP4544991B2 (ja) | 2002-06-14 | 2003-06-16 | 血管の創傷をふさぐ装置および方法 |
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JP2010062985A Expired - Fee Related JP5132702B2 (ja) | 2002-06-14 | 2010-03-18 | 血管の創傷をふさぐ装置および方法 |
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US (4) | US7780699B2 (ja) |
EP (1) | EP1513456B1 (ja) |
JP (2) | JP4544991B2 (ja) |
CN (1) | CN1306910C (ja) |
AT (1) | ATE342000T1 (ja) |
AU (1) | AU2003276105A1 (ja) |
CA (1) | CA2488751C (ja) |
DE (1) | DE60309030T2 (ja) |
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EP1513456B1 (en) | 2006-10-11 |
US20040054346A1 (en) | 2004-03-18 |
AU2003276105A1 (en) | 2003-12-31 |
CA2488751C (en) | 2012-04-17 |
EP1513456A1 (en) | 2005-03-16 |
JP4544991B2 (ja) | 2010-09-15 |
DE60309030D1 (de) | 2006-11-23 |
US8491628B2 (en) | 2013-07-23 |
DE60309030T2 (de) | 2007-05-16 |
ES2274253T3 (es) | 2007-05-16 |
WO2003105697A1 (en) | 2003-12-24 |
ATE342000T1 (de) | 2006-11-15 |
US20110046664A1 (en) | 2011-02-24 |
CN1306910C (zh) | 2007-03-28 |
JP2005529674A (ja) | 2005-10-06 |
CA2488751A1 (en) | 2003-12-24 |
JP5132702B2 (ja) | 2013-01-30 |
US9101731B2 (en) | 2015-08-11 |
CN1674829A (zh) | 2005-09-28 |
US20150320422A1 (en) | 2015-11-12 |
US20130281785A1 (en) | 2013-10-24 |
US7780699B2 (en) | 2010-08-24 |
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