JP2010505542A - 医療用カテーテル - Google Patents
医療用カテーテル Download PDFInfo
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- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
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- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
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- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
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- A61B2017/22079—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with suction of debris
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Abstract
【解決手段】医療用カテーテルは、固定ブレードカッター組立体と、調節可能ブレードカッター組立体とを有する前進可能かつ回転可能な動作ヘッドを含む。前記動作ヘッドに又はその近傍に、密封された管、吸引装置及び注入装置に接続される吸引ポート及び(又は)注入ポートが設けられている。管腔からの除去中に望ましくない物質の大きさを小さくするために吸引ポートの内側に粉砕組立体が設けられている。駆動シャフトが回転及びトルクを駆動装置からカッター組立体及び前記粉砕組立体に伝える。前記駆動シャフトはベアリングにより前記カッター組立体に取り付けられている。
【選択図】図1
Description
12 コンソールユニット
14 注入ポンプ
15 気泡検出器
16 吸引ポンプ
18 注入管
22 吸引管
30 コントローラー
32、56、96、182 カテーテル
40、170 動作ヘッド
40、100、150、172 カッター組立体
42、72、93、102、152 ブレード
48、154、156、178、185 ポート
70 固定ブレードカッター組立体
80 調節可能ブレードカッター組立体
97、104 ショルダー部分
99、106 切断面
190 粉砕組立体
192 中心部
194 バー
Claims (54)
- 管腔又は体腔の中の目標位置からの閉塞物の除去のための回転可能な動作ヘッドであって、
差別的な切断のための複数のブレードを有し、
前記ブレードの少なくとも1つは段付きブレードである、動作ヘッド。 - 細長いカテーテルに受け入れられた、モーターにより駆動される回転可能かつ移動可能な駆動シャフトに接続されている、請求項1に記載の動作ヘッド。
- 前記段付きブレードは、ショルダー部分に近接する突状の切断面を有する、請求項1に記載の動作ヘッド。
- 前記切断面は、0.00127cmないし0.0254cmの高さ寸法を有する、請求項3に記載の動作ヘッド。
- 前記切断面は、0.00254cmないし0.00762cmの高さ寸法を有する、請求項3に記載の動作ヘッド。
- 前記ショルダー部分は、前記切断面の高さ寸法より大きい幅寸法を有する、請求項3に記載の動作ヘッド。
- 前記ショルダー部分の幅寸法の前記切断面の高さ寸法に対する比は2:1より大きい、請求項6に記載の動作ヘッド。
- 前記段付きブレードは、前記ショルダー部分の前記切断面と反対側の縁部に隣接する、面取りをされた縁部を有する、請求項3に記載の動作ヘッド。
- 前記切断面は、80°と110°との間の傾斜角を有する、請求項3に記載の動作ヘッド。
- 前記切断面及び前記ショルダー部分は、45°と150°との間の角度をなすように交差している、請求項3に記載の動作ヘッド。
- 前記切断面は、湾曲した外形を有する、請求項3に記載の動作ヘッド。
- 前記切断面は、ほぼ扇形の外形を有する、請求項11に記載の動作ヘッド。
- 細長いカテーテルに受け入れられた、モーターにより駆動される回転可能かつ移動可能な駆動シャフトに接続された動作ヘッドを有する、管腔又は体腔からの閉塞物の除去のためのカテーテル組立体であって、
80°より小さい傾斜角を有する、放射状のかつ対称的な、差別的な切断のための複数のブレードを有する遠方カッター組立体と、
80°より大きい傾斜角を有する、放射状のかつ対称的な、差別的な切断のための複数のブレードを有する近方カッター組立体とを含む、カテーテル組立体。 - 前記遠方カッター組立体は固定のブレードを有する、請求項13に記載のカテーテル組立体。
- 前記遠方カッター組立体は、4つの固定のブレードと、前記遠方カッター組立体の内部に連通するポートとを有する、請求項13に記載のカテーテル組立体。
- 前記近方カッター組立体は調節可能なブレードを有する、請求項13に記載のカテーテル組立体。
- 前記遠方カッター組立体及び前記近方カッター組立体は、異なるカッター形状を有する、請求項13に記載のカテーテル組立体。
- 前記遠方カッター組立体の前記ブレード及び前記近方カッター組立体の前記ブレードは、異なる回転方向に動作される、請求項13に記載のカテーテル組立体。
- 細長いカテーテルに受け入れられた、モーターにより駆動される回転可能かつ移動可能な駆動シャフトに接続された動作ヘッドを有する、管腔又は体腔からの閉塞物の除去のためのカテーテル組立体であって、
前記動作ヘッドは、放射状のかつ対称的な、差別的な切断のための複数のブレードを有するカッター組立体と、前記ブレードの少なくともいくつかの間にある複数の吸引ポートとを有し、
各吸引ポートは、ほぼ長円形であり、前記カッター組立体の近方の端部に設けられている、カテーテル組立体。 - 前記吸引ポートは、吸引液及び閉塞物の除去のための真空装置に接続された、密封された管に連通している、請求項19に記載のカテーテル組立体。
- 細長いカテーテルに受け入れられた、モーターにより駆動される回転可能かつ移動可能な駆動シャフトに接続された動作ヘッドを有する、管腔又は体腔からの閉塞物の除去のためのカテーテル組立体であって、
前記動作ヘッドは、ショルダー部分に近接する切断面を有する少なくとも1つの段付きブレードを有する、カテーテル組立体。 - 前記切断面は、0.00127cmないし0.0254cmの高さ寸法を有する、請求項21に記載のカテーテル組立体。
- 前記切断面は、0.00254cmないし0.00762cmの高さ寸法を有する、請求項21に記載のカテーテル組立体。
- 前記ショルダー部分は、前記切断面の高さ寸法より大きい幅寸法を有する、請求項21に記載のカテーテル組立体。
- 前記ショルダー部分の幅寸法の前記切断面の高さ寸法に対する比は、2:1より大きく、5:1より小さい、請求項24に記載のカテーテル組立体。
- カテーテルの端部に取り付けられた、管腔又は体腔の中の目標位置から閉塞物を除去する動作ヘッドと、
前記動作ヘッドの近傍にあって前記カテーテルを貫く少なくとも1つの吸引ポートと、
前記吸引ポートの位置における前記カテーテルの内部に配置された回転部材とを含み、
前記吸引ポートは、前記目標位置から吸引液及び閉塞物の除去する真空装置に接続された第1の密封された管に連通しており、
前記回転部材は、回転可能な駆動部品に設けられた少なくとも1つの直立したバーを有し、
前記バーは、前記カテーテルの長さ方向の軸線に整列された長さ方向の軸線を有し、
前記回転部材は前記真空装置の運転中に回転される、カテーテル組立体。 - 前記回転部材は、前記吸引ポートの位置において前記カテーテルと共通の中心軸線を有する、請求項26に記載のカテーテル組立体。
- 前記吸引ポートは、前記カテーテルの外周の少なくとも15%、少なくとも25%又は少なくとも35%に亘って存在する、請求項26に記載のカテーテル組立体。
- 前記バーは、前記吸引ポートに吸い込まれた閉塞物を破壊するため、前記吸引ポートの少なくとも1つの壁及び前記カテーテルの内面に接する大きさを有する、請求項26に記載のカテーテル組立体。
- 前記回転部材は、前記カテーテルの長さ方向の軸線に関して対称的なかつ放射状の少なくとも2つの直立したバーを有する、請求項26に記載のカテーテル組立体。
- 前記バーは、中心部に設けられており、前記バーの近方の端部における前記中心部の外面からの高さが前記バーの遠方の端部における前記中心部の外面からの高さより高い、請求項26に記載のカテーテル組立体。
- 前記バーは、吸引液及び閉塞物の吸引通路への移動を容易にする壁を有する、請求項26に記載のカテーテル組立体。
- 前記吸引ポートの近傍にあって液体の注入のための第2の密封された管に連通する少なくとも1つの注入ポートを有する、請求項26に記載のカテーテル組立体。
- 前記カテーテルの外面に径方向に間隔を置いて設けられた複数の注入ポートを有する、請求項26に記載のカテーテル組立体。
- 管腔又は体腔の中の目標位置への挿入及び誘導のためのカテーテルと、
前記カテーテルの端部に取り付けられ、前記目標位置から閉塞物を除去する動作ヘッドと、
前記動作ヘッドの近傍の少なくとも1つの吸引ポートと、
前記吸引ポートの近傍にあって前記カテーテルを貫く少なくとも1つの注入ポートとを含み、
前記吸引ポートは、前記目標位置から液体及び閉塞物を除去する第1の密封された管に連通しており、
前記注入ポートは、前記目標位置へ液体を供給する第2の密封された管に連通している、カテーテル組立体。 - 前記吸引ポートは、前記カテーテルの外周の少なくとも10%、少なくとも20%又は少なくとも30%に亘って存在する、請求項35に記載のカテーテル組立体。
- 前記カテーテルに周方向に間隔を置いて設けられた複数の注入ポートを有する、請求項35に記載のカテーテル組立体。
- 前記カテーテルの周囲に、注入された液体を実質的に均等に分配させるため、前記注入ポートは一定の間隔を置かれている、請求項37に記載のカテーテル組立体。
- 前記カテーテルの周囲において、注入された液体の流れを少なくとも1つの所望の方向に向けるため、前記注入ポートは不均一な間隔を置かれている、請求項37に記載のカテーテル組立体。
- 前記動作ヘッドに設けられた少なくとも1つのポートであって液体の吸引又は注入のための密封された管に連通する少なくとも1つのポートを有する、請求項35に記載のカテーテル組立体。
- カテーテルの端部に取り付けられた、管腔又は体腔の中の目標位置から閉塞物を除去する動作ヘッドと、
前記動作ヘッドの近傍にある少なくとも1つの吸引ポートと、
前記目標位置へ注入液を供給する少なくとも1つの注入ポートと、
前記吸引ポートを真空にする吸引装置と、
前記注入ポートに注入液を供給する注入装置とを含み、
前記吸引ポートは、前記目標位置から吸引液及び閉塞物を除去する密封された管に連通しており、
前記注入装置及び前記吸引装置は、注入量の吸引量に対する比率を1:1より大きくかつ2.5:1より小さくするために前記カテーテルの操作時に制御される、カテーテル組立体。 - 前記注入量の前記吸引量に対する比率は、1.5:1より大きく、2.5:1より小さい、請求項41に記載のカテーテル組立体。
- 前記吸引ポートは前記動作ヘッドの近傍にある、請求項41に記載のカテーテル組立体。
- 前記注入ポートは前記吸引ポートの近傍にある、請求項43に記載のカテーテル組立体。
- カテーテルの端部に取り付けられた、管腔又は体腔の中の目標位置から閉塞物を除去する動作ヘッドと、
前記動作ヘッドの近傍にある少なくとも1つの吸引ポートであって前記目標位置から吸引液及び閉塞物を除去する密封された管に連通する少なくとも1つの吸引ポートと、
前記目標位置に注入液を供給する少なくとも1つの注入ポートと、
前記吸引ポートを真空にする吸引装置と、
前記注入ポートに注入液を供給する注入装置とを含み、
前記注入装置及び前記吸引装置は、注入速度を45ml/minないし150ml/minに、吸引速度を20ml/minないし90ml/minにするために前記カテーテルの操作時に制御される、カテーテル組立体。 - 前記吸引ポートは前記動作ヘッドの近傍にある、請求項45に記載のカテーテル組立体。
- 前記注入ポートは前記吸引ポートの近傍にある、請求項46に記載のカテーテル組立体。
- カテーテル組立体の制御装置であって、
動作ヘッドの近傍の液体の吸引のための吸引装置に接続された吸引ポンプと、
管腔又は体腔の中の目標位置への注入液の輸送のための注入装置に接続された注入ポンプと、
前記注入液の中の気泡を検出する検出器とを含み、
前記注入ポンプは前記注入液の中の気泡の検出時に停止される、カテーテル組立体の制御装置。 - 前記動作ヘッドは前記注入液の中の気泡の検出時に停止される、請求項48に記載のカテーテル組立体の制御装置。
- 前記吸引装置及び前記注入装置は前記動作ヘッドの起動時に自動的に起動される、請求項48に記載のカテーテル組立体の制御装置。
- 前記吸引装置及び前記注入装置は、前記動作ヘッドの停止後、選択された時間の経過後に自動的に停止される、請求項48に記載のカテーテル組立体の制御装置。
- オペレーターが、予めプログラム化された吸引及び注入の特性を無効にすることを許すオーバーライド制御機能を有する、請求項48に記載のカテーテル組立体の制御装置。
- 前記注入ポンプにおいて測定された前記注入液の圧力は552kPaないし1379kPaである、請求項48に記載のカテーテル組立体の制御装置。
- カテーテルの端部に取り付けられた、管腔又は体腔の中の目標位置から閉塞物を除去する動作ヘッドと、
前記動作ヘッドの近傍にある少なくとも1つの吸引ポートであって前記目標位置から吸引液及び閉塞物を除去する密封された管に連通する少なくとも1つの吸引ポートと、
前記目標位置に注入液を供給する少なくとも1つの注入ポートと、
前記吸引ポートを真空にする吸引装置と、
前記注入ポートに注入液を供給する注入装置とを含み、
前記吸引装置及び前記注入装置は、前記動作ヘッドの停止後、選択された時間の経過後に自動的に停止される、カテーテル組立体。
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WO2018052121A1 (ja) * | 2016-09-16 | 2018-03-22 | テルモ株式会社 | 医療デバイス |
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