JP2014042832A - 歪み集中ブリッジを備えた管腔内医療装置 - Google Patents
歪み集中ブリッジを備えた管腔内医療装置 Download PDFInfo
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- JP2014042832A JP2014042832A JP2013209031A JP2013209031A JP2014042832A JP 2014042832 A JP2014042832 A JP 2014042832A JP 2013209031 A JP2013209031 A JP 2013209031A JP 2013209031 A JP2013209031 A JP 2013209031A JP 2014042832 A JP2014042832 A JP 2014042832A
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Abstract
【解決手段】軸方向隣接セグメント1000は目的治療部位への送達時には連結したままである。送達後、装置が配された領域内で十分な運動負荷が加えられると、少なくとも一つの歪み集中ブリッジ1500は折れて少なくとも二つの軸方向隣接セグメントを離す。理想的には、管腔内医療装置を生体適合性金属材料で構成し、少なくとも一つのブリッジも生体適合性金属材料で構成し、少なくとも一つの歪み集中ブリッジは軸方向隣接セグメントの歪み閾値レベルよりも低い歪み閾値レベルを有する。少なくとも一つの歪み集中ブリッジの構成材料あるいは寸法を変えることで、少なくとも一つのブリッジの歪み閾値レベルを変えることができる。理想的には、所定の負荷が加えられると少なくとも一つの歪み集中ブリッジは折れて軸方向隣接セグメントを分離する。歪み集中ブリッジは薄肉部1700を含んでもよい。
【選択図】図3B
Description
〔発明の分野〕
本発明は管腔内医療装置に関する。また更に特定すれば、本発明はステントに関し、特定の閾値を超える荷重条件を受けるとステントの隣接するセグメントを離脱可能に連結する少なくとも一つの歪み集中ブリッジ(strain concentrating bridge)を有するステントに関する。
経皮経管血管形成術(PTA)は動脈の血流を増すために用いられる治療医療処置である。この処置においては、血管形成バルーンを狭窄した血管あるいは内腔(body passageway)内で膨らませて血管の壁成分を剪断し破壊して血管を拡げる。しかし、下にある組織の切開皮弁(dissection "flap")が発生することがあり、好ましくないことに折り重なって血管を塞いでしまうことがある。その結果、直ちに矯正手術が必要となる。
本発明のシステムおよび方法のさまざまな態様は、軸方向に隣接するセグメントを少なくとも一つの歪み集中ブリッジ(strain concentrating bridge)で連結した管腔内医療装置を含み、軸方向隣接セグメントは装置の所望治療部位への送達時には連結されたままとなっている。上記少なくとも一つの歪み集中ブリッジは、装置が患者の体内で十分大きな運動負荷が加わる領域に置かれると折れて、軸方向に隣接するセグメントを分離する。勿論、運動負荷が最小または小さい領域に装置が置かれた時には、装置はそのままである。この医療装置は少なくとも二つの軸方向隣接セグメントを含むステントであるのが好ましい。
図1A〜図1Cは一連の軸方向隣接セグメント100を含むステント50を示す。これらのセグメント100は、コーディス・コーポレイション(Cordis Corporation)製のパルマズ(商標)(Palmaz)ステントあるいはパルマズ‐シャッツ(商標)(Palmaz-Schatz)ステントまたは同じくコーディス・コーポレイション製のスマートステント(商標)(Smart Stent)におけるようにステンレス鋼あるいはニチノールで構成することができる。これらのセグメント100は体内に配置されたときには半径方向の強度が大きいものとしている。セグメント100は自己拡張するものでもよいし、または拘束がなくなると塑性拡張するものでもよく、あるいはバルーンカテーテル(図示せず)を使って拡張させることもできる。いずれにしても、ステントを目的どおり患者の血管内あるいは他の内腔内に配置したときにセグメント100が拡張するのが理想的である。
(1)管腔内医療装置において、
解剖学的内腔への配置時は連続的に連結している一連の少なくとも二つの軸方向隣接セグメントと、
2つの前記一連の少なくとも二つの軸方向隣接セグメントを連結している少なくとも一つの金属製歪み集中ブリッジであって、各ブリッジは歪み閾値レベルを超える局所化した負荷が加わると折れる(yielding)、金属製歪み集中ブリッジと、
を具備する、管腔内医療装置。
(2)実施の態様1に記載の管腔内医療装置において、
前記少なくとも一つの金属製歪み集中ブリッジのそれぞれは、
第1脚部と、
第2脚部と、
前記第1脚部を前記第2脚部に接続する歪み発生部であって、前記歪み閾値レベルが超えた場合に折れる(yield)脆弱点を有する、歪み発生部と、
をさらに有する、管腔内医療装置。
(3)実施の態様2に記載の管腔内医療装置において、
前記歪み発生部は、前記脆弱点が存在する円弧を含む、管腔内医療装置。
(4)実施の態様3に記載の管腔内医療装置において、
前記歪み発生部の前記歪み閾値レベルは、前記第1脚部あるいは前記第2脚部の長さに応じて変化する、管腔内医療装置。
(5)実施の態様3に記載の管腔内医療装置において、
前記歪み閾値レベルは、前記歪み発生部の前記円弧の長さに応じて変化する、管腔内医療装置。
(6)実施の態様3に記載の管腔内医療装置において、
前記軸方向隣接セグメントは、前記少なくとも一つの金属製歪み集中ブリッジを構成する金属材料とは異なる金属材料で構成されている、管腔内医療装置。
(7)実施の態様6に記載の管腔内医療装置において、
前記軸方向隣接セグメントは、チタン、バナジウム、アルミニウム、ニッケル、タンタル、ジルコニウム、クロム、銀、金、シリコン、マグネシウム、ニオブ、スカンジウム、プラチナ、コバルト、パラジウム、マンガン、モリブデン、およびそれらの合金のうち少なくとも一つからなる生体適合性材料で構成されている、管腔内医療装置。
(8)実施の態様7に記載の管腔内医療装置において、
前記少なくとも一つの金属製ブリッジは、チタン、バナジウム、アルミニウム、ニッケル、タンタル、ジルコニウム、クロム、銀、金、シリコン、マグネシウム、ニオブ、スカンジウム、プラチナ、コバルト、パラジウム、マンガン、モリブデン、およびそれらの合金のうち少なくとも一つからなる生体適合性材料で構成されている、管腔内医療装置。
(9)実施の態様1に記載の管腔内医療装置において、
前記少なくとも一つの金属製ブリッジのそれぞれは、溝穴付き部材を含み、
軸方向に整列した対になった一連の前記軸方向隣接セグメントは、対応する溝穴付き部材に受け入れられた突起をさらに含む、管腔内医療装置。
(10)実施の態様9に記載の管腔内医療装置において、
各前記溝穴付き部材は、チタン、バナジウム、アルミニウム、ニッケル、タンタル、ジルコニウム、クロム、銀、金、シリコン、マグネシウム、ニオブ、スカンジウム、プラチナ、コバルト、パラジウム、マンガン、モリブデン、およびそれらの合金のうち少なくとも一つからなる生体適合性金属材料で構成されている、管腔内医療装置。
前記突起は、前記生体適合性材料のうちの一種類以上を含んでいる、管腔内医療装置。
(12)実施の態様1に記載の管腔内医療装置において、
ステント、
をさらに具備する、管腔内医療装置。
(13)実施の態様1に記載の管腔内医療装置において、
前記少なくとも一つの金属製ブリッジのそれぞれの少なくとも一部内に含ませたか、あるいは前記少なくとも一部上に塗布した、放射線不透過性材料、
をさらに含む、管腔内医療装置。
(14)実施の態様13に記載の管腔内医療装置において、
前記少なくとも一つの金属製ブリッジのそれぞれの少なくとも一部内に含ませたか、あるいは前記少なくとも一部上に塗布した、一種類以上の薬物あるいは生体活性剤、
をさらに含む、管腔内医療装置。
(15)管腔内医療装置において、
一連の少なくとも二つの軸方向隣接セグメントと、
前記少なくとも二つの軸方向隣接セグメントを連結している少なくとも一つの歪み集中ブリッジと、
前記少なくとも一つのブリッジの薄肉部であって、前記薄肉部の耐荷力を超える局所化した負荷が加わると折れる(yield)、薄肉部と、
を具備する、管腔内医療装置。
(16)実施の態様15に記載の管腔内医療装置において、
前記少なくとも一つのブリッジは、U字形である、管腔内医療装置。
(17)実施の態様16に記載の管腔内医療装置において、
前記薄肉部は、前記少なくとも一つのブリッジのU字形の頂点に在る、管腔内医療装置。
(18)実施の態様16に記載の管腔内医療装置において、
ステント、
を具備する、管腔内医療装置。
(19)実施の態様18に記載の管腔内医療装置において、
前記少なくとも二つの軸方向隣接セグメント、前記少なくとも一つのブリッジ、および前記ブリッジのそれぞれの前記薄肉部のうち少なくとも一つの中あるいは表面に含ませた放射線不透過性材料、薬物あるいは他の物質(agent)、
をさらに含む、管腔内医療装置。
(20)実施の態様18に記載の管腔内医療装置において、
前記少なくとも二つの軸方向隣接セグメント、前記少なくとも一つのブリッジ、および前記少なくとも一つのブリッジのそれぞれの前記薄肉部は、チタン、バナジウム、アルミニウム、ニッケル、タンタル、ジルコニウム、クロム、銀、金、シリコン、マグネシウム、ニオブ、スカンジウム、プラチナ、コバルト、パラジウム、マンガン、モリブデン、およびそれらの合金のうち少なくとも一つからなる生体適合性金属材料で構成されている、管腔内医療装置。
前記少なくとも一つのブリッジのそれぞれの前記薄肉部は、前記少なくとも二つの軸方向隣接セグメントのセグメント幅より狭い薄肉部幅を含む、管腔内医療装置。
(22)実施の態様20に記載の管腔内医療装置において、
前記少なくとも一つのブリッジのそれぞれの前記薄肉部は、前記少なくとも二つの軸方向隣接セグメントのセグメント幅に等しいか、あるいはほぼ等しい薄肉部幅を含む、管腔内医療装置。
(23)実施の態様21に記載の管腔内医療装置において、
前記少なくとも一つのブリッジのそれぞれの前記薄肉部は、前記少なくとも二つの軸方向隣接セグメントのセグメント幅より均一に狭い薄肉部幅を含む、管腔内医療装置。
Claims (3)
- ステントにおいて、
一連の少なくとも二つの軸方向に隣接するセグメントと、
前記少なくとも二つの軸方向隣接セグメントを連結しているU字形の少なくとも一つの歪み集中ブリッジと、
前記少なくとも一つのブリッジの薄肉部であって、前記薄肉部の耐荷力を超える局所化した負荷が加わると折れる、薄肉部と、
を具備し、
前記少なくとも二つの軸方向隣接セグメント、前記少なくとも一つのブリッジ、および前記少なくとも一つのブリッジのそれぞれの前記薄肉部は、チタン、バナジウム、アルミニウム、ニッケル、タンタル、ジルコニウム、クロム、銀、金、シリコン、マグネシウム、ニオブ、スカンジウム、プラチナ、コバルト、パラジウム、マンガン、モリブデン、およびそれらの合金のうち少なくとも一つからなる生体適合性金属材料で構成されており、
前記少なくとも一つのブリッジのそれぞれの前記薄肉部は、前記少なくとも二つの軸方向隣接セグメントのセグメント幅より均一に狭い薄肉部幅を含む、管腔内医療装置。 - 請求項1に記載のステントにおいて、
前記薄肉部は、前記少なくとも一つのブリッジのU字形の頂点に在る、管腔内医療装置。 - 請求項1に記載のステントにおいて、
前記少なくとも二つの軸方向隣接セグメント、前記少なくとも一つのブリッジ、および前記ブリッジのそれぞれの前記薄肉部のうち少なくとも一つの中あるいは表面に含ませた放射線不透過性材料、薬物あるいは他の物質、
をさらに含む、管腔内医療装置。
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ATE499084T1 (de) | 2011-03-15 |
US20070100431A1 (en) | 2007-05-03 |
EP1782766A2 (en) | 2007-05-09 |
CA2566021C (en) | 2014-10-21 |
JP2007125394A (ja) | 2007-05-24 |
DE602006020220D1 (de) | 2011-04-07 |
EP1782766B1 (en) | 2011-02-23 |
EP1782766A3 (en) | 2008-10-22 |
JP5917470B2 (ja) | 2016-05-18 |
US20130211499A1 (en) | 2013-08-15 |
CA2566021A1 (en) | 2007-05-03 |
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