JP2011067663A - 医療用デバイス - Google Patents
医療用デバイス Download PDFInfo
- Publication number
- JP2011067663A JP2011067663A JP2010269825A JP2010269825A JP2011067663A JP 2011067663 A JP2011067663 A JP 2011067663A JP 2010269825 A JP2010269825 A JP 2010269825A JP 2010269825 A JP2010269825 A JP 2010269825A JP 2011067663 A JP2011067663 A JP 2011067663A
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- JP
- Japan
- Prior art keywords
- stent
- membrane
- item
- aneurysm
- vessel
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
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Classifications
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
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- A—HUMAN NECESSITIES
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
- A61B17/12118—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm for positioning in conjunction with a stent
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- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
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- A61B17/12186—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices liquid materials adapted to be injected
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Abstract
【解決手段】動脈瘤を処置するために身体の血管中への挿入のための医療用デバイスであって:第1の位置から第2の位置まで拡大可能な機械的に拡大可能なデバイス202であって、第2の位置に、このデバイス202の外面が、上記血管を通る流体経路を維持するようにこの血管の内面と係合するように半径方向の外方に拡大されるデバイス202;およびこの機械的に拡大可能なデバイス202の拡大に応答して第1の位置から第2の位置に拡大可能な膜203を備え、この膜203は、第2の位置に拡大されるとき、動脈瘤への血液循環を妨害し、そしてこの膜203の少なくとも一部が、上記デバイス202に固定されて、上記第2の位置に拡大されるとき、上記デバイス202に対してこの膜203の位置を維持する。
【選択図】図5
Description
本発明は、動脈瘤を処置するために身体の血管中に挿入されるための医療用デバイスに関する。
血管の疾患は、出血、血管の閉塞を引き起こすアテローム性動脈硬化症、血管奇形および腫瘍を含む。脳内の血管閉塞または動脈瘤の破裂は、脳卒中を引き起こす。頭蓋内動脈によって供給される動脈瘤は、脳内で、それらの塊およびサイズが、脳卒中または脳卒中の症状を引き起こし、動脈瘤の除去またはその他の治療的介入のために手術を必要とする点まで成長し得る。
第1の好ましい局面では、動脈瘤を処置するために身体の脈管中に挿入される医療用デバイスが提供され、このデバイスは、第1の位置から第2の位置に拡大可能な機械的に拡大可能なデバイスであって、上記第2の位置に、上記機械的に拡大可能なデバイスの外面が、上記脈管を通る流体経路を維持するようにこの脈管の内面と係合するように半径方向の外方に拡大される機械的に拡大可能なデバイス;およびこの機械的に拡大可能なデバイスの拡大に応答して第1の位置から第2の位置に拡大可能な膜であって、この第2の位置に拡大されるとき、上記動脈瘤の血液循環を妨害し、そしてこの膜の少なくとも一部分が上記機械的に拡大可能なデバイスに固定され、この第2の位置に拡大されるとき、上記機械的に拡大可能なデバイスに対するこの膜の位置を維持する膜を備える。
より特定すれば、本願発明は以下の項目に関し得る。
(項目1)
動脈瘤を処置するために身体の脈管中に挿入される医療用デバイスであって:
第1の位置から第2の位置に拡大可能な機械的に拡大可能なデバイスであって、上記第2の位置に、上記機械的に拡大可能なデバイスの外面が、上記脈管を通る流体経路を維持するように上記脈管の内面と係合するように半径方向の外方に拡大される機械的に拡大可能なデバイス;および
上記機械的に拡大可能なデバイスの拡大に応答して第1の位置から第2の位置に拡大可能な膜であって、上記第2の位置に拡大されるとき、上記動脈瘤の血液循環を妨害し、そして上記膜の少なくとも一部分が上記機械的に拡大可能なデバイスに固定され、上記第2の位置に拡大されるとき、上記機械的に拡大可能なデバイスに対する上記膜の位置を維持する膜、を備える、デバイス。
(項目2)
上記機械的に拡大可能なデバイスが、複数の相互連結するストラットであってそれらの間に介在空間を有するストラットによって規定される、ほぼ管状の構造を備える、項目1に記載のデバイス。
(項目3)
上記膜が、生体適合性かつエラストマー性ポリマーから作製される、項目1に記載のデバイス。
(項目4)
上記膜が、約20〜100ミクロンのポアまたは穴サイズを備えた約0.001〜0.005インチの厚みを有する、項目1に記載のデバイス。
(項目5)
上記膜が、ポリマー性材料または生分解性材料から作製される、項目1に記載のデバイス。
(項目6)
上記生分解性材料が、薬物または試薬と混合された複数の下層を形成する、項目5に記載のデバイス。
(項目7)
上記膜が、等方性拡大をし得る、項目1に記載のデバイス。
(項目8)
上記膜が、上記デバイスの外面上に配置される、項目1に記載のデバイス。
(項目9)
上記膜が、上記デバイスを完全に取り囲む、項目1に記載のデバイス。
(項目10)
上記膜が、上記デバイスの一部分を周縁方向に取り囲む、項目1に記載のデバイス。
(項目11)
上記膜が、上記デバイスの一部分を覆う、項目1に記載のデバイス。
(項目12)
上記膜が、非多孔性および非透過性であり、上記動脈瘤への血液循環を防ぐ、項目1に記載のデバイス。
(項目13)
上記膜が、固形ポリマーから作製される、項目12に記載のデバイス。
(項目14)
上記膜が、透過性および多孔性である、項目1に記載のデバイス。
(項目15)
上記膜が、主要脳動脈の穿孔および顕微鏡的分枝への血液供給が許容されるが、上記動脈瘤への血液供給が防がれるように穴またはポアを有する、項目14に記載のデバイス。
(項目16)
上記膜が、サイズが20〜100ミクロンの間のポアを有する、項目15に記載のデバイス。
(項目17)
上記膜が、サイズが20〜100ミクロンの間の製作された穴を有する、項目15に記載のデバイス。
(項目18)
上記穴が、レーザー穿孔によって製作される、項目17に記載のデバイス。
(項目19)
上記ポアまたは穴の間の距離が、100μmより小さい、項目16または17に記載のデバイス。
(項目20)
上記膜が、上記機械的に拡大可能なデバイスに固定される複数のポリマー性ストリップを備える、項目14に記載のデバイス。
(項目21)
上記ストリップが0.075mmより短く、そして隣接するストリップ間の距離が100μmより小さい、項目20に記載のデバイス。
(項目22)
上記膜が、上記機械的に拡大可能なデバイスに固定されるメッシュを備える、項目14に記載のデバイス。
(項目23)
上記メッシュの空間が100μmより短く、そして上記メッシュの幅が0.025〜0.050mmの間である、項目22に記載のデバイス。
(項目24)
上記動脈瘤が、通常サイズ、巨大または広い頸部の動脈瘤である、項目1に記載のデバイス。
(項目25)
上記機械的に拡大可能なデバイスが、自己拡大可能、またはバルーンで拡大可能である、項目1に記載のデバイス。
(項目26)
上記機械的に拡大可能なデバイスが、ステントである、項目1に記載のデバイス。
(項目27)
上記膜が上記ほぼ管状の構造によって支持され、そして少なくとも1つのストラットに取り付けられる、項目2に記載のデバイス。
(項目28)
上記膜が、上記ステントの公証初期直径に類似の直径を有する管状であり、そしてここで、上記膜が、上記ステントの外面に配置されるか、上記ステント間のストラット間に浸漬被覆または噴霧によって導入される、項目26に記載のデバイス。
(項目29)
上記膜が、上記ステントの外面の一部分上に配置された管状構造のセグメントである、項目26に記載のデバイス。
(項目30)
上記少なくとも1つの試薬が、固形錠剤、液体または粉末からなる群から選択される任意の1つの形態である、項目6に記載のデバイス。
(項目31)
少なくとも1つの放射線不透過性マーカーが上記機械的に拡大可能なデバイス上に提供され、挿入の間またはその後に上記デバイスの可視性を改善する、項目1に記載のデバイス。
(項目32)
上記少なくとも1つの放射線不透過性マーカーが、金または白金から作製される、項目31に記載のデバイス。
(項目33)
中央放射線不透過性マーカーおよび端部放射線不透過性マーカーが、上記機械的に拡大可能なデバイス上に提供される、項目31に記載のデバイス。
(項目34)
少なくとも2つの身体の脈管の間の2分枝または3分枝動脈瘤を処置するための医療用デバイスであって:
第1の脈管中に挿入するための第1の機械的に拡大可能なデバイス;
第2の脈管中に挿入するための第2の機械的に拡大可能なデバイス;
ここで、機械的に拡大可能なデバイスの各々は、第1の位置から第2の位置に拡大可能であり、上記第2の位置に、上記機械的に拡大可能なデバイスの外面が、上記脈管を通る流体経路を維持するように上記脈管の内面と係合するように半径方向の外方に拡大される機械的に拡大可能である;および
上記機械的に拡大可能なデバイスの拡大に応答して第1の位置から第2の位置に拡大可能な膜であって、上記第2の位置に拡大されるとき、上記動脈瘤の血液循環を妨害し、そして上記膜の少なくとも一部分が上記機械的に拡大可能なデバイスに固定され、上記第2の位置に拡大されるとき、上記機械的に拡大可能なデバイスに対する上記膜の位置を維持する膜、を備える、デバイス。
(項目35)
項目1に記載の医療用デバイスを作製する方法であって:
ほぼ管状の構造をマンドレル上に配置する工程;および
上記膜を上記機械的に拡大可能なデバイスの外面上に配置する工程、を包含する、項目1に記載の医療用デバイスを作製する方法。
(項目36)
上記方法が:
上記ほぼ管状の構造をマンドレル上に配置する工程;および
上記膜を上記ステントのストラット間に取り込む工程を包含する、項目26に記載の医療用デバイスを作製する方法。
(項目37)
上記配置する工程が:噴霧すること、縫合糸、積層、接着、熱および浸漬被覆からなる群から選択される任意の1つである、項目35または36に記載の方法。
(項目38)
上記ステントが、送達カテーテルによって上記動脈瘤に送達される、項目26に記載の方法。
移植可能な医療用デバイスは、ヒト身体の血管内系内の所望の部位に薬物または試薬を送達するための物理的構造を含む。移植可能な医療用デバイスは、特定の適用に依存して多様化した形状および形態をとり得る。一般的な移植可能な医療用デバイスは、ステント、大静脈フィルター、移植片および動脈瘤コイルを含む。ステントが説明されるけれども、開示される構造および方法は、すべてのその他の移植可能な医療用デバイス適用可能であることを注記する。
− 頭蓋内ステント202は、圧縮された送達モードで0.020インチのプロフィールを有する。
− 頭蓋内ステント202は、ステントプロフィール0.020インチ〜0.022イントを有する低0.014インチ〜0.016インチのようなプロフィールをもつ送達カテーテル上に圧縮されるように設計される。頭蓋内ステント202は、一様な材料分布および壁適用範囲を有し、必要な脈管支持を生成する。材料比は、展開直径に依存して10〜17%の範囲である。
− 頭蓋内ステント202は、0.0028インチよりは大きくないストラット厚みおよび幅を有する。ストラット寸法は、最も少ない侵入性ステント材料容量を生成し、そして脈管損傷スコアを減少するように選択される。
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JP2015518394A (ja) * | 2012-04-06 | 2015-07-02 | マーリン エムディー プライベート リミテッド | 動脈瘤を治療するためのデバイスおよび方法 |
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Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
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JP2015518394A (ja) * | 2012-04-06 | 2015-07-02 | マーリン エムディー プライベート リミテッド | 動脈瘤を治療するためのデバイスおよび方法 |
JP2018149308A (ja) * | 2012-04-06 | 2018-09-27 | マーリン エムディー プライベート リミテッド | 動脈瘤を治療するためのデバイスおよび方法 |
JP2020179216A (ja) * | 2012-04-06 | 2020-11-05 | マーリン エムディー プライベート リミテッド | 動脈瘤を治療するためのデバイスおよび方法 |
US10987208B2 (en) | 2012-04-06 | 2021-04-27 | Merlin Md Pte Ltd. | Devices and methods for treating an aneurysm |
Also Published As
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JP2007530213A (ja) | 2007-11-01 |
US9585668B2 (en) | 2017-03-07 |
JP5046919B2 (ja) | 2012-10-10 |
US20070100430A1 (en) | 2007-05-03 |
JP2017023876A (ja) | 2017-02-02 |
US8915952B2 (en) | 2014-12-23 |
JP2019048106A (ja) | 2019-03-28 |
JP2014195733A (ja) | 2014-10-16 |
JP2015062831A (ja) | 2015-04-09 |
CN101394808A (zh) | 2009-03-25 |
EP1734897A1 (en) | 2006-12-27 |
JP7222462B2 (ja) | 2023-02-15 |
JP2021000552A (ja) | 2021-01-07 |
JP2013066749A (ja) | 2013-04-18 |
US20070191924A1 (en) | 2007-08-16 |
JP2023041948A (ja) | 2023-03-24 |
EP1732467A1 (en) | 2006-12-20 |
WO2005094725A1 (en) | 2005-10-13 |
EP1734897A4 (en) | 2010-12-22 |
WO2005094726A1 (en) | 2005-10-13 |
JP2020114545A (ja) | 2020-07-30 |
EP1732467A4 (en) | 2010-09-15 |
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