JP2011005270A - 接近および閉鎖デバイスならびに方法 - Google Patents
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Abstract
【解決手段】長手方向の内腔壁軸を有する内腔壁を有する生物学的内腔に接近するためのデバイス38であって、該デバイスは、長手方向の部材軸を備える細長い部材であって、該部材は、第1の角度42で該内腔に接近するように構造され、該第1の角度は、該長手方向の内腔壁軸と該長手方向の部材軸とによって規定され、該第1の角度は、約19度未満である、部材を備える、デバイス。
【選択図】図6
Description
(項目1)
長手方向の内腔壁軸を有する内腔壁を有する生物学的内腔に接近するためのデバイスであって、該デバイスは、以下:
長手方向の部材軸を備える細長い部材であって、該部材は、第1の角度で該内腔に接近するように構造され、該第1の角度は、該長手方向の内腔壁軸と該長手方向の部材軸とによって規定され、該第1の角度は、約19度未満である、部材を備える、デバイス。
上記第1の角度が、約15度未満である、項目1に記載のデバイス。
上記第1の角度が、約10度未満である、項目2に記載のデバイス。
上記第1の角度が、約5度より大きい、項目3に記載のデバイス。
アンカーをさらに備える、項目1に記載のデバイス。
項目5に記載のデバイスであって、上記アンカーが、上記長手方向の内腔壁軸に対して固定された角度で上記細長い部材を保持するように構造される、デバイス。
項目1に記載のデバイスであって、保持装置をさらに備える、デバイス。
項目7に記載のデバイスであって、上記保持装置が、上記長手方向の内腔軸に対して固定された角度で上記細長い部材を保持するように構造される、デバイス。
内腔壁および長手方向の内腔壁軸を有する生物学的内腔に接近するためのデバイスであって、該デバイスは、以下:
第1の細長い部材軸を備える第1の細長い部材;および
第2の細長い部材軸を備える第2の細長い部材を備える、デバイスであって、
該第2の細長い部材は、該第2の細長い部材軸が、該長手方向の内腔壁軸に平行であるように構造される、デバイス。
上記第2の細長い部材が、保持装置を備える、項目9に記載のデバイス。
上記保持装置が、膨張可能な部材を備える、項目10に記載のデバイス。
上記保持装置が、弾力性のある部材を備える、項目10に記載のデバイス。
上記第2の細長い部材が、上記内腔壁に実質的に隣接して伸びる、項目9に記載のデバイス。
生物学的内腔壁上の開口部を閉じるためのデバイスであって、以下:
長手方向軸、
第1の力を付与する部材、
第2の力を付与する部材、および
弾力性のある部材、を備える、デバイスであって、
該弾力性のある部材は、該長手方向軸に対して外向きの半径方向の力のを、該第1の力を付与する部材および該第2の力を付与する部材に提供する、デバイス。
上記第1の力を付与する部材が、第1の方向に力を付与し、上記第2の力を付与する部材が、第2の方向に力を付与し、該第1の方向が、該第2の方向に対して実質的に反対向きである、項目14に記載のデバイス。
長手方向の壁軸を有する血管壁を介して血管に接近する方法であって、該方法は、以下:
該長手方向の壁軸に対して約19度未満の角度で該血管に入る工程、および
該血管の中に内腔ツールを挿入する工程、を包含する、方法。
上記第1の角度が、約15度未満である、項目16に記載の方法。
上記第1の角度が、約10度未満である、項目17に記載の方法。
上記第1の角度が、約5度より大きい、項目18に記載の方法。
上記入る工程の前に、デバイスと上記内腔壁とを整列させる工程を、さらに包含する、項目16に記載の方法。
内腔壁および長手方向の内腔壁軸を有する生物学的内腔に接近するための方法であって、該方法は、以下:
該生物学的内腔に、第2の細長い部材軸を備える第2の細長い部材を挿入する工程、
該第2の細長い部材軸が、該長手方向の内腔壁軸に実質的に平行であるように、該第2の細長い部材を整列させる工程、および
該生物学的内腔に、第1の細長い部材軸を備える第1の細長い部材を挿入する工程、を包含する、方法。
上記第1の細長い部材軸と上記長手方向の内腔壁軸との間の角度が、約15度未満である、項目21に記載の方法。
上記第1の細長い部材軸と上記長手方向の内腔壁軸との間の角度が、約10度未満である、項目22に記載の方法。
上記第2の細長い部材が、保持装置を備え、該方法が、該保持装置を伸ばす工程、をさらに包含する、項目21に記載の方法。
上記保持装置が、弾力性のある部材を備える、項目24に記載の方法。
項目21に記載の方法であって、上記第2の細長い部材が、膨張可能な部材を備え、該方法が、該膨張可能な部材を膨張させる工程、をさらに包含する、方法。
上記第2の細長い部材が、上記内腔壁に実質的に隣接して伸びる、項目21に記載の方法。
血管の開口部を閉じる方法であって、該血管の開口部が、内側面および長手方向軸を有し、該方法が、以下:
該開口部にデバイスを挿入する工程、
該内側面に力を付与する工程、を包含し、該力が、該長手方向軸から少なくとも1つの半径方向外向きに方向付けられる、方法。
上記力を維持する工程をさらに包含する、項目28に記載の方法。
上記維持する工程が、約120分未満の間維持することを包含する、項目29に記載の方法。
上記力を付与する工程は、上記デバイスが、上記力の少なくとも一部を付与することを包含する、項目28に記載の方法。
上記力を付与する工程は、上記デバイスが、上記力の全てを付与することを包含する、項目31に記載の方法。
血管壁を有する血管に接近して閉じるための方法であって、該血管壁は、内側面および外側面を有し、該方法は、以下:
動脈切開を形成させる工程、
該動脈切開に閉鎖増強デバイスを配置する工程であって、該閉鎖増強デバイスは、該内側面および該外側面に圧力を生じる工程、を包含する、方法。
上記閉鎖増強デバイスが、フィラメントを備え、該フィラメントが、上記動脈切開中に存在する、項目33に記載の方法。
上記閉鎖増強デバイスが、圧力クリップを備える、項目33に記載の方法。
上記閉鎖増強デバイスが、外科用綿撒糸を備える、項目33に記載の方法。
上記閉鎖増強デバイスが、トグルを備える、項目33に記載の方法。
上記閉鎖増強デバイスが、縫合糸を備える、項目33に記載の方法。
血管壁を有する血管に接近するための方法であって、該血管壁は、内側および外側を有し、該方法は、以下:
該血管壁に動脈切開を形成させる工程であって、該動脈切開は、動脈切開幅および動脈切開深さを有し、該動脈切開深さは、動脈切開幅の3分の1とほぼ等しいか、または動脈切開幅の3分の1未満である工程、および
該動脈切開を介して血管ツールを配置する工程、を包含する、方法。
上記動脈切開を形成させる工程が、上記血管壁を介して導入デバイスを配置させる工程をさらに包含し、該導入デバイスが、該血管壁に対して実質的に種々の角度で該血管壁を通過する、項目39に記載の方法。
上記動脈切開を形成させる工程が、上記血管壁を介して導入デバイスを配置させる工程をさらに包含し、該導入デバイスが、上記内腔壁における面を切断する、項目39に記載の方法。
上記面が、上記内腔壁と実質的に平行であり得る、項目41に記載の方法。
上記血管壁が、外膜を有し、上記面が、該外膜に隣接する、項目41に記載の方法。
上記動脈切開が、外側の内腔壁開口部および内側の内腔壁開口部を有し、上記導入幅が、該外側の内腔壁開口部と該内側の内腔壁開口部との間の上記内腔壁と実質的に平行な長さの成分である、項目39に記載の方法。
上記導入深さが、上記外側の内腔壁開口部と上記内側の内腔壁開口部との間の上記内腔壁に対して実質的に垂直な長さの成分である、項目44に記載の方法。
上記動脈切開深さが、上記動脈切開幅の4分の1とほぼ等しいか、または上記動脈切開幅の4分の1未満である、項目39に記載の方法。
上記動脈切開深さが、上記動脈切開幅の5分の1とほぼ等しいか、または上記動脈切開幅の5分の1未満である、項目39に記載の方法。
血管壁を有する血管に接近するための方法であって、該血管壁は、内側および外側を有し、該方法が、以下:
導入デバイスを配置して、動脈切開を形成させる工程、
該血管壁に対して第1の角度で該血管壁を介して該導入デバイスを移動させる工程、
該血管壁に対して第2の角度で該血管壁を介して該導入デバイスを移動させる工程、および
該導入デバイスを該血管壁の内側に入れる工程、を包含する、方法。
上記第1の角度または上記第2の角度が、約5度未満である、項目48に記載の方法。
上記第1の角度または上記第2の角度が、約0度である、項目48に記載の方法。
項目48に記載の方法であって、上記導入デバイスが、上記血管壁の外側に外側開口部を形成し、該導入デバイスが、該血管壁の内側に内側開口部を形成し、該内側の開口部と該外側の開口部との間のベクトルが、導入幅および導入深さを備え、該導入幅に対する該導入深さの比が、約2分の1と等しくなり得るか、または約2分の1未満であり得る、方法。
項目51に記載の方法であって、上記導入幅に対する上記導入深さの比が、約3分の1と等しくなり得るか、または約3分の1未満であり得る、方法。
項目51に記載の方法であって、上記導入幅に対する上記導入深さの比が、約4分の1と等しくなり得るか、または約4分の1未満であり得る、方法。
項目51に記載の方法であって、上記導入幅に対する上記導入深さの比が、約5分の1と等しくなり得るか、または約5分の1未満であり得る、方法。
項目51に記載の方法であって、上記導入幅に対する上記導入深さの比が、約6分の1と等しくなり得るか、または約6分の1未満であり得る、方法。
生物学的内腔に接近するためのデバイスが、開示される。生物学的内腔は、長手方向の内腔壁軸を有する内腔壁を有する。このデバイスは、長手方向の部材軸を有する細長い部材を有する。この部材は、第1の角度で内腔に接近するように構造される。この第1の角度は、長手方向の内腔壁軸および長手方向の部材軸によって規定される。第1の角度は、約19度未満である。
図1〜図3は、生物学的内腔に接近するためのデバイス(例えば、動脈切開デバイス2)を示す。動脈切開デバイス2は、送達ガイド4を有し得る。送達ガイド4は、アンカー6にスライド可能に取り付けられ得る。アンカー6は、剛性、可撓性、またはそれらの組み合わせであり得る。アンカー6は、弾力性、変形可能性またはそれらの組み合わせであり得る。アンカー6は、送達ガイド4から退却可能および拡張可能であり得る。送達ガイド4は、内腔導入器8を有し得る。内腔導入器8は、内腔導入器出口ポート10を有し得る。内腔導入器出口ポート10は、送達ガイド4の表面上に存在し得る。
補助的な閉鎖デバイスを含む、動脈切開デバイス2のエレメントは、例えば、融解、ネジ止め、接着、溶接、または締りばめもしくはプレスばめ(例えば、クリンピング、スナッピング)の使用、またはそれらの組み合わせ方法によって直接的に取り付けられ得る。エレメントは、例えば、成形、打抜き、レーザー切断、放電加工(EDM)または単一の片もしくは材料からのスタンピングによって、一体化され得る。任意の他の方法が、当業者に公知のように使用され得る。
図21は、生物学的内腔114(例えば、大腿動脈のような血管)にアンカー6を挿入する方法を示す。生物学的内腔114は、内腔壁116および内腔壁面118を有し得る。アンカー6は、セルディンガー法、改変セルディンガー法、または当業者に公知の他の方法を用いて生物学的内腔114に挿入され得る。アンカー6は、第1の動脈切開120を作り出し得る。アンカー6は、アンカーアングル部材の第2のサブセクション18が、内腔壁面118と実質的に平行であり得るように内腔114に挿入され得る。アンカー6は、アンカーアングル部材の第2のサブセクション18が、内腔壁面118と実質的に接触し得るように、内腔114に挿入され得る。
Claims (1)
- 本明細書中に記載されるようなデバイス。
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JP5206218B2 (ja) * | 2008-08-20 | 2013-06-12 | 富士通株式会社 | 指紋画像取得装置、指紋認証装置、指紋画像取得方法及び指紋認証方法 |
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2004
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