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- JP2012513294A5 JP2012513294A5 JP2011543692A JP2011543692A JP2012513294A5 JP 2012513294 A5 JP2012513294 A5 JP 2012513294A5 JP 2011543692 A JP2011543692 A JP 2011543692A JP 2011543692 A JP2011543692 A JP 2011543692A JP 2012513294 A5 JP2012513294 A5 JP 2012513294A5
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関連特許
本PCT国際出願は、2008年12月23日出願の米国特許出願第12/343,374号に基づき優先権を主張する。
本PCT国際出願は、2008年12月23日出願の米国特許出願第12/343,374号に基づき優先権を主張する。
図5および6を参照すると、可動支持部50は、縮小した直径から拡大した直径の構成に遠位部34を拡大するようにして提供される。図示の実施態様において、可動支持部50は、軸方向に可動なコイル52の態様である。コイル52は、軸方向に可動な制御ワイヤ32により、制御部24に機械的に結合されている。制御部24を遠位に進めることで、制御ワイヤ32を、制御ワイヤ管腔30を通って遠位に進め、これにより可動コイル52を近位部33内の位置から、移行部32をわたって、遠位部34中に進める。このことにより、遠位部34は、縮小した直径から拡大した直径構成に移動する。
図7および8を参照すると、軸方向に可動な支持部は、細長い可撓性チューブ56の態様で提供されてもよい。管状要素56の遠位部分58は、半径方向の強度を維持するが横方向の可撓性を与えるための螺旋カットを備える。この遠位部分58の螺旋カット部は、一般に、約1cm〜15cmの範囲、好ましくは約5cm〜約12cmの範囲の長さを有し、具体的な実施態様において、およそ10cmの長さに及ぶ。螺旋カットは、一般に、約0.01インチ〜約0.125インチの範囲のピッチを有し、一実施態様においては、0.06ピッチである。別の実施態様においては、遠位部分58は、長さが約5cmでピッチが約0.06の第一の螺旋カット部と、長さが約5cmでピッチが約0.030の第二の遠位部分を有する。
例えば、管状要素30に好適なもの等のポリテトラフルオロエチレンチューブは、米国サウスカロライナ州OrangeburgのZeus社から購入できる。遠位部分32は、当業者が考案できる任意の様々な技術によるなどして、螺旋カットを備えることができる。一技術に従うと、PTFEまたはその他のチューブをマンドレルに配置する。マンドレルを所定のねじ山を有する機械に装着する。かみそり刃またはその他の鋭利な器具等の切削要素をチューブに交差するように配置し、機械を作動してマンドレルを回転させる。機械(ねじ山)が回転すると、マンドレルは軸方向に移動し、切削を実施して、回転によりチューブを螺旋状に切削する。この機械は、右または左螺旋のいずれかに切削するように設定できる。また、この機械は、連続または可変ピッチ螺旋、あるいは各ゾーンが固有のピッチを有する複数ゾーン螺旋部を切削するようにも設定できる。金属ばねコイル54を当該分野で知られるように、延伸により遠位部分58の開放巻線部を形成した、好適な大きさの回転マンドレルのまわりに巻くこともできる。
あるいは、遠位部分58の管状支持部は、遠位セグメントまたはカテーテル全体の長さにわたって延在する、ワイヤばねの態様であってもよい。一般的には、図5および6を参照。コイルばね52の遠位部36は、コイルの隣接した巻線同士の軸方向の間隔が0.05mm〜約1mmまたはそれを超える範囲内となりうるように、開放巻線構成を作るように軸方向に伸長されている。コイルばね52の近位部分は、コイルの隣接した巻線が互いに接するように、ほとんど最も低い位置に達している(図示せず)。このことは、横方向の可撓性を維持しながら、カテーテル内で遠位に進めることを可能にするカラム強度を与える。あるいは、コイルばねは、その全長にわたって、例えば0.01mm〜1mm間隔で巻かれて開放していてもよい。
図34Aを参照すると、摺動部3412は、溶接、結合部、ピン、ファスナー等の3418により近位メッシュ継輪部3410に取付けられている。継輪結合部3418に対する摺動部は、カテーテル管またはシャフト3402にあるスカイブ、窓部、穿孔部、長穴等3404内に進む。継輪結合部3418に対する近位摺動部は、メッシュの近位端3406を継輪部3410に取付ける。継輪部3410は、カテーテルシャフト3402の外側で摺動可能に配置され、そしてカテーテルシャフト3402の縦軸に沿って移動するが、カテーテルシャフト3402に対する相対的な動きが半径方向で制限されている。メッシュ3406の遠位端は、遠位メッシュ結合部3408によりカテーテル管3402に取付けられている。ハブ(図示せず)は、結合、溶接、またはその他の方法でカテーテルシャフト3402の近位端に取付けられている。拡張可能なメッシュ3406は、ニチノール、ステンレス鋼、コバルト−ニッケル合金、ポリイミド、ポリアミド、ポリエステル、またはその他の高強度材料から製造されている。メッシュ3406を備えるワイヤ直径は、約0.0005〜0.006インチの範囲とすることができ、好ましい範囲は約0.001〜0.004インチである。メッシュ3406は、厚さ約0.0005〜0.004インチの範囲で幅が約0.001〜0.010インチの範囲のフラットワイヤを備えてもよい。好ましい実施態様において、メッシュ3406は、円筒状の直径方向に折りたたまれた配置に向けて設定された形状の、超弾性ニチノールから製造される。遠位メッシュX線非透過性X線非透過性マーカーは、メッシュ3406の遠位端ならびにカテーテルシャフト3402に取付けられ、これらに対して相対的に固定されている。
図39Bに示すように、作動ガイドワイヤ3920は、直径が大きくなるように、あるいはカテーテル3400の摺動部3412の近位端を係合するように一部分を横方向に延伸するように構成されている。リンク機構3922は、リンク機構管腔3926内に摺動可能に配置されており、そして、ガイドワイヤの遠位部分にアンカー3924によって取付けられている。ストラット3928は、ガイドワイヤ3920に対して近位的に引くように、張力がリンク機構3922に加えられている場合に、外側に屈曲する、ガイドワイヤ3920の壁にある薄い部位である。リンク機構3922への近位張力は、ストラット3928に及ぼす圧縮力を生じ、これに応答して外側に屈曲させる。ガイドワイヤ3920およびその成分はすべて、ステンレス鋼、ニチノール、PTFE被覆、FEP被覆、PFA被覆、プラチナ−イリジウム、タンタル等の材料から製造できるが、これらには限られない。ハンドルまたはタブ(図示せず)は、それらの間の相対的な動きを制御可能にするため、リンク機構3922の近位端とガイドワイヤ3920に取付けることができる。ねじジャッキまたはその他の機械効率型制御は、それらの間で動きを生じるための高い力を制御および与えるために、ガイドワイヤハブとリンク機構ハブとの間に配置させることができる。
図41Aは、血管2804の管腔2802内に配置された未拡張の拡張可能なガイドカ
テーテル10を示す。この拡張可能なガイドカテーテル10は、さらに、近位の非拡張可
能な部位33、移行ゾーン32、遠位の拡張可能な部位34、管腔38をさらに備えるス
ライド拡張器50、ガイドワイヤ2614、中央管腔2818をさらに備えるノーズコー
ン2708、およびリブ状カゴ型補強構造4100をさらに備える。
テーテル10を示す。この拡張可能なガイドカテーテル10は、さらに、近位の非拡張可
能な部位33、移行ゾーン32、遠位の拡張可能な部位34、管腔38をさらに備えるス
ライド拡張器50、ガイドワイヤ2614、中央管腔2818をさらに備えるノーズコー
ン2708、およびリブ状カゴ型補強構造4100をさらに備える。
図43は、閉塞物2808を通る経路で送られる血管造影用注入能力を有するマイクロカテーテル4300を示す。マイクロカテーテル4300は、血管2804の管腔2802を通る経路で送られる。X線撮影用色素4304は、遠位排出ポート4302、ならびにマイクロカテーテル4300の遠位部分の長さにわたって分布された、複数の近位色素排出ポート4306から、加圧下で排出されている。色素排出ポート4302および4306は、同一の管腔、またはカテーテル4300のチューブ4308内に備えられている、別の色素注入管腔に操作可能に接続されている。X線透視法下では、色素4304の近位および遠位雲間の間隙は、閉塞物2808の範囲の指標を与える。
図46Cは、ガイドワイヤ4516が除去され、移行拡張器4502を遠位に進めることで、遠位端が半径方向に拡張した、治療用ガイドカテーテル4500を示す(図45Aを参照)。近位カテーテル管4504のポート4508は、カテーテル4500の外部と移行拡張器4502の中央管腔での血液間での流体疎通が確立されている、移行拡張器4502のポート4510に十分に合致している。血液4610は、窓部4508および4510中へ、移行拡張器4502の中央管腔を通り抜け、そして閉塞物4608の遠位の血管腔4604中へと流れている。血液4610は、移行拡張器4502の中央管腔4512に流入し、中央管腔4512を流れ、中央管腔4512の遠位開口部を流れ出て、血管腔4604中に流れて、下流組織を灌流し、それによって組織虚血を緩和する。閉塞物4608は、ガイドカテーテル4500の遠位の拡張可能な部位4506により貫通し、そして、半径方向に拡張している。従って、ガイドカテーテル4500は、血管腔4604に対してシャントを備える。
Claims (17)
- 近位端と遠位端とを有し、その近位端から遠位端へと延びる第1の管腔を有するカテーテルシャフトと、
近位端と遠位端とを有し、カテーテルシャフト内に配設される摺動部と、
近位端と遠位端とを有し、その遠位端を前記カテーテルシャフトの遠位端に固定され、その近位端を前記摺動部に固定される拡張可能部材とからなるマイクロカテーテルとからなり、
前記拡張可能部材が、前記カテーテルシャフトと前記摺動部の相対移動により拡張及び収縮することを特徴とするカテーテルシステム。 - 前記摺動部は、前記カテーテルシャフトの遠位端内の近位で終結することを特徴とする請求項1記載のカテーテルシステム。
- 前記カテーテルシャフトの壁中に、摺動部窓部が配設され、前記拡張可能部材の近位端に近接し、該拡張可能部材の近位端は、前記摺動部窓部を介して前記摺動部に固定されることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記拡張可能部材の近位端に取り付けられ、前記摺動部窓部を介して、前記摺動部を継輪部に取り付けてなることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記カテーテルシャフト内に摺動可能に配設された作動ガイドワイヤからさらになり、前記作動ガイドワイヤは前記摺動部を近位に押すよう作動可能で、前記拡張可能部材の半径方向の拡張を生じさせることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記カテーテルシャフト内に摺動可能に配設されたスリーブからさらになり、前記スリーブは前記摺動部を遠位に押すよう作動可能で、前記拡張可能部材の半径方向の拡張を生じさせることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記スリーブは、前記スリーブの近位端から遠位端へ伸びる管腔を有し、前記管腔は追跡ガイドワイヤを収納する大きさであることを特徴とする請求項6記載のカテーテルシステム。
- 前記摺動部は、前記摺動部の近位端から遠位端へ伸びる管腔を有し、前記管腔は前記追跡ガイドワイヤを収納する大きさであることを特徴とする請求項7記載のカテーテルシステム。
- 前記スリーブは前記カテーテルの近位端へ伸び、前記カテーテルの近位端から作動可能で前記カテーテルシャフト内を摺動することを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記摺動部は、前記摺動部の近位端から遠位端へ伸びる第2の管腔を有することを特徴とする請求項1又は2記載のカテーテルシステム。
- ガイドカテーテルからさらになり、ガイドカテーテルは張り出した遠位部位からさらになることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記ガイドカテーテルからさらになり、前記ガイドカテーテルは張り出した遠位部位からさらになり、前記張り出した遠位口は半径方向拡張可能な形状記憶要素からなることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記拡張可能部材の遠位部分に配設された拡張可能な部材カバーからさらになり、前記拡張可能な部材カバーが液体非浸透性であることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記拡張可能部材の全体に配設された内部メッシュカバーからさらになり、前記内部メッシュカバーが液体非浸透性であることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記摺動部は、管腔から前記摺動部の外面へ連通する側窓部を有し、前記側窓部が前記拡張可能部材内に配設されることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記拡張可能部材は、前記摺動部が前記カテーテルシャフトに対して第1の位置にある時、第1の非拡張構成を取り、前記摺動部が前記カテーテルシャフトに対して第1の位置に近い第2の位置に移動した時、第2の拡張構成を取ることを特徴とする請求項1又は2記載のカテーテルシステム。
- 前記拡張可能部材は自己拡張可能で、遠位狭窄部に挿入されたガイドワイヤによって引っ張られる時、第1の小径構成を有し、前記遠位狭窄部に配設されたガイドワイヤにより引っ張られないとき、第2の大径構成を有することを特徴とする請求項1又は2記載のカテーテルシステム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/343,374 US8425549B2 (en) | 2002-07-23 | 2008-12-23 | Systems and methods for removing obstructive matter from body lumens and treating vascular defects |
US12/343,374 | 2008-12-23 | ||
PCT/US2009/069498 WO2010075565A2 (en) | 2008-12-23 | 2009-12-23 | Systems and methods for removing obstructive matter from body lumens and treating vascular defects |
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JP2012513294A JP2012513294A (ja) | 2012-06-14 |
JP2012513294A5 true JP2012513294A5 (ja) | 2013-10-10 |
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JP2011543692A Pending JP2012513294A (ja) | 2008-12-23 | 2009-12-23 | 体腔から閉塞性物質を除去しそして血管障害を治療するシステムおよび方法 |
Country Status (4)
Country | Link |
---|---|
US (3) | US8425549B2 (ja) |
EP (1) | EP2381997A2 (ja) |
JP (1) | JP2012513294A (ja) |
WO (1) | WO2010075565A2 (ja) |
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2008
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2009
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- 2009-12-23 EP EP09835870A patent/EP2381997A2/en not_active Withdrawn
- 2009-12-23 US US13/141,177 patent/US9078682B2/en not_active Expired - Fee Related
- 2009-12-23 JP JP2011543692A patent/JP2012513294A/ja active Pending
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2015
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