JP2013500748A - ワンピース分岐グラフト - Google Patents
ワンピース分岐グラフト Download PDFInfo
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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Abstract
【選択図】 図7
Description
(a)第1の分岐血管から前記展開システムを血管分岐部内に導入するステップと、
(b)管腔内プロテーゼを解放するために第1の拘束シースを開くまたは引き戻すステップと、
(c)胴体部分を血管分岐部の血管内に前進させるステップとを含む。
Claims (24)
- ワンピース・グラフト・スリーブ(32)を備えた、血管分岐部(10)で展開される管腔内プロテーゼであって、前記グラフト・スリーブ(32)が、
第1のプロテーゼ・ルーメン(30)を画定する分岐部分(28)であって、展開された状態では第1の直径(39)を有し、ステント要素(33)によって補強されている、分岐部分(28)と、
前記第1のプロテーゼ・ルーメン(30)に流体連通した第2のプロテーゼ・ルーメン(31)を画定する胴体部分(29)であって、展開された状態では第2の直径(40)を有する、胴体部分(29)とを備え、
前記胴体部分(29)が、補強用ステント材料を実質的に含まないことを特徴とする、管腔内プロテーゼ。 - 前記分岐部分(28)が、自己拡張型ステント要素(33)によって補強されていることを特徴とする、請求項1に記載の管腔内プロテーゼ。
- 前記胴体部分(29)が、複数のひだ(34)を有することを特徴とする、請求項1または2に記載の管腔内プロテーゼ。
- 前記胴体部分(29)が、その遠位端部で、構造要素(36)によって周方向に補強されていることを特徴とする、請求項1〜3のいずれか1項に記載の管腔内プロテーゼ。
- 前記構造要素(36)が、少なくとも部分的に自己拡張型ステントであることを特徴とする、請求項4に記載の管腔内プロテーゼ。
- 前記構造要素(36)が、ガイドワイヤまたはカテーテルに取り外し可能に接続することができる接続要素(38)を有することを特徴とする、請求項4または5に記載の管腔内プロテーゼ。
- 請求項1〜6のいずれか1項に記載の管腔内プロテーゼ(27)が装着され、前記管腔内プロテーゼ(27)を血管分岐部(10)に配置するように構成されたカテーテルであって、前記カテーテル(18)が、
ガイドワイヤ(16)を収容するためのガイドワイヤ・ルーメン(22)およびグラフト・アクチュエータ・ルーメン(23)を有するカテーテル本体(21)と、
前記装着された管腔内プロテーゼ(27)を内部で径方向に圧縮して維持する拘束シース(26)と、
前記グラフト・アクチュエータ・ルーメン(23)内に収容されたグラフト・アクチュエータ(24)とを備え、
前記カテーテル(18)が、前記装着された管腔内プロテーゼ(27)が胴体部分(29)を有する領域(20)で捻るまたは曲げることができるように構成され、かつ
前記グラフト・アクチュエータ・ルーメン(23)が、前記領域(20)またはその近位側の開口(24)で終端していることを特徴とする、カテーテル。 - 前記グラフト・アクチュエータ(24)が、その遠位端部に、前記胴体部分(29)の遠位端部に取り外し可能に係合するように調節された接続部分(37)を有することを特徴とする、請求項7に記載のカテーテル。
- 展開システムであって、
請求項7または8に記載のカテーテル(18)と、
前記カテーテル(18)に装着された、請求項1〜6のいずれか1項に記載の管腔内プロテーゼ(27)とを備え、
前記カテーテル(18)の前記グラフト・アクチュエータ(24)が、前記装着された管腔内プロテーゼ(27)の前記胴体部分(29)の遠位端部に取り外し可能に接続されていることを特徴とする、展開システム。 - 前記グラフト・アクチュエータ(24)が、接続部分(37)を介して前記管腔内プロテーゼ(27)の前記胴体部分(29)の遠位端部に取り外し可能に係合していることを特徴とする、請求項9に記載の展開システム。
- 前記グラフト・アクチュエータ(24)が、前記胴体部分(29)の遠位端部の構造要素(36)に取り外し可能に係合していることを特徴とする、請求項9または10に記載の展開システム。
- 前記装着された管腔内プロテーゼ(27)の前記胴体部分(29)が、その長手方向軸(35)に沿って圧縮されていることを特徴とする、請求項9〜11のいずれか1項に記載の展開システム。
- 胴体補強ステント(44)が装着された第2のカテーテル(41)をさらに備えることを特徴とする、請求項9〜12のいずれか1項に記載の展開システム。
- 前記胴体補強ステント(44)が、首部分(45)を有し、前記首部分(45)が、前記ステント(44)が完全に拡張すると、前記首部分(45)の遠位端部および近位端部の直径よりも小さい直径を有することを特徴とする、請求項13に記載の展開システム。
- 請求項9〜14のいずれか1項に記載の展開システム(17)を用いて、血管分岐部(10)で請求項1〜6のいずれか1項に記載の管腔内プロテーゼ(27)を展開する方法であって、
(a)第1の分岐血管(12)から前記展開システムを前記血管分岐部(10)内に導入するステップと、
(b)前記管腔内プロテーゼ(27)を解放するために第1の拘束シース(26)を開くまたは引き戻すステップと、
(c)胴体部分(29)を前記血管分岐部(10)の血管内に前進させるステップとを含み、
ステップ(a)の際に、前記展開システムが、前記第1の分岐血管(12)および第2の分岐血管(13)に支持されて、主血管(11)に近接した前記胴体部分(29)の位置で捻れまたは湾曲を形成するように前記展開システムを導入し、
ステップ(c)の際に、前記胴体部分(29)を主血管(11)内に前進させることを特徴とする、方法。 - ステップ(a)の際に、前記展開システム(17)を、ガイドワイヤ(16)を使用して前記血管分岐部(10)内に導入することを特徴とする、請求項15に記載の方法。
- ステップ(c)の際に、前記胴体部分(29)を、グラフト・アクチュエータ(24)を前方に押すことによって前進させることを特徴とする、請求項15または16に記載の方法。
- ステップ(c)の後、さらなるステップ(d)で、胴体補強ステント(44)が、前記管腔内プロテーゼ(27)を前記主血管(11)に固定し、前記管腔内プロテーゼ(27)を前記胴体部分(29)に沿って補強するように、前記胴体補強ステント(44)を前記胴体部分(29)および前記主血管(11)の領域に配置して拡張させることを特徴とする、請求項15〜17のいずれか1項に記載の方法。
- 遠位固定部分(52)、近位密封部分(53)、およびこれらの間に位置する首部分(54)を有する、管状グラフトを血管内に固定するためのステントであって、前記首部分(54)が、前記ステントの展開された状態では、前記ステント(50)の前記遠位固定部分(52)および前記近位密封部分(53)の直径よりも小さい直径を有する、ステント。
- 前記管状グラフトを補強するための、前記近位密封部分(53)の近位側の補強部分を備えることを特徴とする、請求項19に記載のステント。
- 請求項1〜6のいずれか1項に記載の管腔内プロテーゼ(27)および請求項19または20に記載のステント(50)を含むキット。
- 側血管の開口の下の血管に管状グラフトを固定する方法であって、前記グラフトを適切な位置に配置するステップと、前記グラフトを請求項19または20に記載のステントを使用して固定するステップとを含む、方法。
- 前記管状グラフトが、請求項1〜6のいずれか1項に記載の管腔内プロテーゼ(27)であることを特徴とする、請求項22に記載の方法。
- 前記グラフトを適切な位置に配置するステップと前記グラフトを固定するステップとを、請求項15〜18のいずれか1項に記載の方法の後に行うことを特徴とする、請求項23に記載の方法。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/EP2009/005552 WO2011012147A1 (en) | 2009-07-31 | 2009-07-31 | One-piece bifurcation graft |
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FR2975000B1 (fr) * | 2011-05-10 | 2013-06-14 | Guro Bjoernstad | Endoprothese vasculaire |
US9005270B2 (en) | 2012-03-27 | 2015-04-14 | Medtronic Vascular, Inc. | High metal to vessel ratio stent and method |
US8911490B2 (en) | 2012-03-27 | 2014-12-16 | Medtronic Vascular, Inc. | Integrated mesh high metal to vessel ratio stent and method |
US9993330B2 (en) * | 2013-03-13 | 2018-06-12 | Cook Medical Technologies Llc | Endoluminal prosthesis system |
CH710439A1 (de) * | 2014-12-18 | 2016-06-30 | Intellistent Ag | Einstellbarer mehrlumiger Stent. |
US10512533B1 (en) | 2016-02-23 | 2019-12-24 | W. L. Gore & Associates, Inc. | Branched graft assembly method in vivo |
ITUA20163080A1 (it) * | 2016-05-02 | 2017-11-02 | Kardia S R L | Dispositivo di trattamento degli aneurismi preferibilmente di tipo aortico |
CN107320216B (zh) * | 2017-08-01 | 2020-03-06 | 上海长海医院 | 一种用于主髂动脉的一体式支架 |
AU2020242051A1 (en) | 2019-03-20 | 2021-11-04 | inQB8 Medical Technologies, LLC | Aortic dissection implant |
EP3982877A1 (en) * | 2019-06-17 | 2022-04-20 | Boston Scientific Scimed, Inc. | Covered endoprosthesis with improved branch access |
US11311397B2 (en) * | 2019-10-23 | 2022-04-26 | Medtronic Vascular, Inc. | Branch stent graft and delivery method for endovascular treatment of the iliac artery aneurysms |
EP4225133A1 (en) | 2020-10-07 | 2023-08-16 | Canary Medical Switzerland AG | Providing medical devices with sensing functionality |
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- 2009-07-31 WO PCT/EP2009/005552 patent/WO2011012147A1/en active Application Filing
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BR112012000762A2 (pt) | 2016-11-16 |
US9603697B2 (en) | 2017-03-28 |
CN102470029A (zh) | 2012-05-23 |
BR112012000762B1 (pt) | 2020-05-05 |
JP5503001B2 (ja) | 2014-05-28 |
EP2459121A1 (en) | 2012-06-06 |
US20120150273A1 (en) | 2012-06-14 |
BR112012000762B8 (pt) | 2021-06-22 |
WO2011012147A1 (en) | 2011-02-03 |
EP2459121B1 (en) | 2016-05-04 |
CN102470029B (zh) | 2015-06-17 |
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