JP2013511335A - ステントグラフト及び導入器アッセンブリ - Google Patents
ステントグラフト及び導入器アッセンブリ Download PDFInfo
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- JP2013511335A JP2013511335A JP2012539958A JP2012539958A JP2013511335A JP 2013511335 A JP2013511335 A JP 2013511335A JP 2012539958 A JP2012539958 A JP 2012539958A JP 2012539958 A JP2012539958 A JP 2012539958A JP 2013511335 A JP2013511335 A JP 2013511335A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/89—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
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- A—HUMAN NECESSITIES
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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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
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- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
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- A—HUMAN NECESSITIES
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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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
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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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
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- A—HUMAN NECESSITIES
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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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
- A61F2002/9665—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
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- A—HUMAN NECESSITIES
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- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
Abstract
Description
本出願は、2009年11月19日出願の米国仮特許出願第61/262,839号、及び2009年11月18日出願のイギリス特許出願第GB0920235.9号並びに2009年11月19日出願の同第GB0920327.4号に対する優先権を主張し、前記特許出願それぞれをここに参考文献としてそっくりそのまま援用する。
12 下行大動脈
14 大動脈弓
16 腕頭動脈
18 左総頚動脈
20 左鎖骨下動脈
22 上行大動脈
23 大動脈洞
24 心臓開口部
26、28 冠状動脈
30、32 A型解離の輪郭線
40 ステントグラフト
42 グラフト管
44、46、48、50、52 ステントリング (44と52は裸)
54 ステント頂端
56、58、60 縮径縫合糸ループ
56’、58’、60’ 拘束点
62、64 球状領域
70 遠位ステント
72 ステントリング
74 スレッド
80 亀裂
100 導入器
112 外部操作部区間
114 遠位取付部領域
116 近位取付部領域
118 インプラント、人工器官、ステントグラフト
120 拡張器先端
122 ガイドワイヤ受け入れ用の孔
124 ガイドワイヤカテーテル
126 接続装置
128 拡張器先端の開口
130 押出器部材、押出器ロッド
132 シース
134 シースマニピュレータ及び止血シールユニット
136 側管
138 ルアロック
140 118の遠位端
142、144 トリガーワイヤ
146、150 トリガーワイヤ解放機構
148 本体
154 ピン万力
156 ねじ込み口金
160、162 スロット
Claims (31)
- 近位端と遠位端の設けられているグラフト材料の管状部分と、前記グラフト管に取り付けられている複数のステントリングと、少なくとも第1と第2の直径拘束装置とを有し、前記第1の直径拘束装置は前記グラフト管の前記近位端に又は前記近位端に近接して置かれており、少なくとも1つの前記第2の直径拘束装置は前記グラフト管に沿った中間の位置に置かれているステントグラフト。
- 前記第2の直径拘束装置は、前記グラフト管に沿った実質的に半分の地点に置かれている、請求項1に記載のステントグラフト。
- 前記拘束装置は、前記グラフト管の周りに周方向に配置されている直径収縮ループである、請求項1又は2に記載のステントグラフト。
- 前記グラフト管上に置かれている1つのステント又は前記グラフト管に沿った中間の位置に配置されている複数のステントの近位端と遠位端を拘束する働きをする少なくとも2つの第2の直径拘束装置が設けられている、上記請求項1乃至3の何れか一項に記載のステントグラフト。
- 前記グラフト管の近位端から延びる裸ステントを含んでいる、上記請求項1乃至4の何れか一項に記載のステントグラフト。
- 前記裸ステントは、前記グラフト管に対して外向きに張り出すように設計されている、請求項5に記載のステントグラフト。
- 前記裸ステントは、グラフト管材料の周りに周方向に配設されていて、湾曲した頂端を有している一連の指状部分を提供する波状のステント構造で形成されている、請求項6に記載のステントグラフト。
- 前記グラフト管の前記近位端と前記遠位端の両方に裸ステントが設けられている、上記請求項1乃至7の何れか一項に記載のステントグラフト。
- 前記遠位の裸ステントは、前記グラフト管材料に対して外向きに張り出す、請求項8に記載のステントグラフト。
- それぞれの裸ステントは、前記グラフト管材料の周りに周方向に配設されていて湾曲した頂端を有している一連の指状部分を提供する波状ステント構造で形成されている、請求項8に記載のステントグラフト。
- 前記グラフト管は長さが65mm程度である、上記請求項1乃至10の何れか一項に記載のステントグラフト。
- 前記ステントグラフトには、前記グラフト管材料の前記遠位端から延びるステント区間が設けられている、上記請求項1乃至11項の何れか一項に記載のステントグラフト。
- 前記ステント区間は、前記グラフト区間と一体化されているものと別体構成要素のうちの一方である、請求項12に記載のステントグラフト。
- 請求項1に記載のステントグラフトを配備するための導入器アッセンブリにおいて、前記ステントグラフトを担持するための担持体と、前記担持体を覆う位置から当該担持体を露出する引き込み位置へ動かせる外シースと、を含んでおり、且つ前記シースの引き込み後に前記ステントグラフトの前記拘束装置を半径方向に圧縮された形態に維持するための複数の拘束要素を含んでいる、導入器アッセンブリ。
- 前記拘束要素は、1つ又はそれ以上のトリガーワイヤを含んでいる、請求項14に記載の導入器アッセンブリ。
- 前記トリガーワイヤは、前記ステントグラフトの近位の裸ステント並びに拘束装置を拘束するように、そして前記拘束ワイヤが引き込まれるとそれらを最近位位置から最遠位位置へ向かって解放してゆくように、配設されている、請求項15に記載の導入器アッセンブリ。
- 前記拘束ワイヤは、前記ステントグラフトの前記遠位端も保持する、請求項16に記載の導入器アッセンブリ。
- トリガーワイヤの複数のセットを含んでいる、請求項15に記載の導入器アッセンブリ。
- 前記配備処置時に患者の心臓弁を通過させることのできる柔軟な拡張器先端を含んでいる、請求項14に記載の導入器アッセンブリ。
- 上行大動脈の欠陥を治療するためのステントグラフトにおいて、近位端と遠位端の設けられているグラフト材料の管状部分と、前記グラフト管に取り付けられている複数のステントリングと、前記グラフト管の前記近位端から延びていて、使用時に患者の大動脈洞の腔に係合させるために当該グラフト管に対して外向きに張り出すように設計されている、少なくとも1つの裸ステントと、を含んでいるステントグラフト。
- 前記グラフト管の前記近位端と前記遠位端の両方に裸ステントが設けられている、請求項20に記載のステントグラフト。
- 前記遠位の裸ステントは、前記グラフト管材料に対して外向きに張り出す、請求項21に記載のステントグラフト。
- 前記裸ステントは、前記グラフト管材料の周りに周方向に配設されていて湾曲した端又は頂端を有している一連の指を提供するように波状のステント構造で形成されている、請求項20に記載のステントグラフト。
- 前記グラフト管材料は、長さが65mm程度である、請求項20乃至23の何れか一項に記載のステントグラフト。
- 前記裸ステントは、前記グラフト管材料から約10mm延びている、請求項20乃至24の何れか一項に記載のステントグラフト。
- 少なくとも第1と第2の直径拘束装置であって、前記第1の直径拘束装置は前記グラフト管の前記近位端に又は前記近位端に近接して置かれており、前記又は少なくとも1つの第2の直径拘束装置は前記グラフト管に沿った中間の位置に置かれている、第1と第2の直径拘束装置を含んでいる、請求項20乃至25の何れか一項に記載のステントグラフト。
- 前記第2の直径拘束装置は、前記グラフト管に沿った実質的に半分の地点に置かれている、請求項26に記載のステントグラフト。
- 前記拘束装置は、前記グラフト管の周りに周方向に配置されている直径収縮ループである、請求項26又は27に記載のステントグラフト。
- 前記グラフト管上に置かれている1つのステント又は前記グラフト管に沿った中間の位置に配置されている複数のステントの近位端と遠位端を拘束する働きをする少なくとも2つの第2直径拘束装置が設けられている、請求項26、27、又は28に記載のステントグラフト。
- 前記ステントグラフトには、前記グラフト管材料の前記遠位端から延びるステント区間が設けられている、請求項20乃至29の何れか一項に記載のステントグラフト。
- 前記ステント区間は、前記グラフト区間と一体化されているものと別体構成要素のうちの一方である、請求項30に記載のステントグラフト。
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JP2013511335A true JP2013511335A (ja) | 2013-04-04 |
JP2013511335A5 JP2013511335A5 (ja) | 2013-08-15 |
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EP (1) | EP2387379B1 (ja) |
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