JP2014208126A - 2部品経中隔カニューレ、搬送システム、および搬送方法 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
- A61M1/3659—Cannulae pertaining to extracorporeal circulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/02—Holding devices, e.g. on the body
- A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/148—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/165—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable in, on, or around the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
- A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
- A61M60/865—Devices for guiding or inserting pumps or pumping devices into the patient's body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/02—Holding devices, e.g. on the body
- A61M2025/0213—Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body
- A61M2025/0233—Holding devices, e.g. on the body where the catheter is attached by means specifically adapted to a part of the human body specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/02—General characteristics of the apparatus characterised by a particular materials
- A61M2205/0266—Shape memory materials
Abstract
【解決手段】カニューレ組立体は、近位端、および受容部分を備える遠位端を有する柔軟カニューレ本体(310)と、遠位端、および係合部分を備える近位端を有する経中隔先端(186)とを含む。第1および第2のアンカー(202、206)が、経中隔先端(186)に結合されて、収縮状態から拡張状態に展開されるように構成される。経中隔先端(186)の係合部分(198)は、体内で柔軟カニューレ本体(310)の受容部分に着脱可能に係合するように動作可能である。
【選択図】図1
Description
12 患者
18、22 右および左大腿静脈
24 副切開部位
26、30 左および右鎖骨下静脈
34、38 右および左頸静脈
42 心房内中隔
48 心臓
50 下大静脈
51 イントロデューサ組立体
52 イントロデューサ
53 取り外し可能な拡張器
54 イントロデューサのハブ
55 イントロデューサのシース
56 Oリング
57 拡張器ハブ
58 拡張器シース
60 拡張器シースのテーパ状遠位端
61 イントロデューサセット
62 シースイントロデューサ
63 拡張器
64 案内ワイヤ
65 洗浄側腕口
66 スネア器具
67 上大静脈
68 右心房
69 スネア器具の本体
70 スネアループ
74 経中隔アクセスシステム
78 経中隔アクセスシステムの搬送シース
82 経中隔アクセスシステムの拡張器
84 経中隔アクセスシステムの経中隔針
90 搬送シースの柔軟本体
94 搬送シースのハブ
98 柔軟本体の標識
102 搬送シースのハブの主口
106 搬送シースのハブの側部口
108 配管
110 弁
114 拡張器本体
118 拡張器先端
122 拡張器ハブ
126 中空針先端
130 中空針本体
134 針ハブ
138 穿刺
142 係止案内要素
146 係止案内要素の本体部分
150 係止案内要素の係止部分
158 係止部分の複数の支柱
160 係止部分のハブ
162 ハブの先端移行区間
166 ハブの支柱保持リング
170 ハブの先端
174 係止案内要素用の搬送器具
178 搬送器具のシース先端
182 搬送器具のシース本体
186 経中隔先端
190 経中隔先端の遠位端
194 経中隔先端の近位端
198 経中隔先端の係合部分
202 経中隔先端の第1のアンカー
206 経中隔先端の第2のアンカー
210 経中隔先端用の搬送カテーテル
214 搬送カテーテルの近位端
218 搬送カテーテルの遠位端
222 搬送カテーテルの受容部分
226 搬送カテーテルの金属コイル
230 搬送カテーテルの標識
232 経中隔先端の係合部分のネジ山
234 経中隔先端の内腔
238 経中隔先端のリング
242 経中隔先端の固締具
244 搬送カテーテルのネジ山
246 搬送カテーテルの受容部分のかえし
250 アンカーの複数の支柱
252 アンカーの多孔性高分子構造体
254 装填管
258 搬送シースのハブ内部の止血弁
262 装填管の移行部
266 バルーンカテーテル
270 バルーン
271 膨張流体
274 カテーテル心棒
282 カニューレガイド
286 カニューレガイドの本体
290 カニューレガイドの拡張可能部材
294 カニューレガイドの位置合わせ区間
298 カニューレガイドのテーパ状近位端
302 カニューレガイドのテーパ状遠位端
306 カニューレガイドの本体の標識
310 柔軟カニューレ本体
314 柔軟カニューレ本体の近位端
318 柔軟カニューレ本体の遠位端
322 柔軟カニューレ本体の受容部分
326 柔軟カニューレ本体の金属コイル
330 柔軟カニューレ本体の標識
334 柔軟カニューレ本体の受容部分の雌ネジ山
338 柔軟カニューレ本体の受容部分に対する引込み
342 柔軟カニューレ本体の受容部分の内部シールリング
346 柔軟カニューレ本体の受容部分のリング溝
350 柔軟カニューレ本体の内腔移行部
354 柔軟カニューレ本体の受容部分のかえし
362 移植可能なポンプ
366 流出カニューレ
374、398 右および左鎖骨下動脈
378 制御装置
386 記憶デバイス
390 左心室
394 大動脈
402、410 左および右総頸動脈
406 腕頭動脈
411 蓋
412 案内ワイヤ
413 案内ワイヤの標準的なj字形状
422 閉鎖器具
426 閉鎖器具の遠位端
430 閉鎖器具の近位端
434 閉鎖器具の封止基材
436、438 第1および第2の流体密封シール
444 搬送器具
Claims (13)
- 受容部分を含んでいる遠位端と、近位端と、前記遠位端と前記近位端との間に延在している内腔とを有している柔軟カニューレ本体と、
遠位端と、体内で前記柔軟カニューレ本体の前記受容部分に接続するように動作可能な係合部分を含んでいる近位端と、前記遠位端と前記近位端との間に延在している内腔とを有している経中隔先端であって、前記係合部分が前記受容部分に接続された場合に、血液が前記経中隔先端及び前記柔軟カニューレ本体に流入する、前記経中隔先端と、
前記経中隔先端に結合されており、収縮状態から拡張状態に展開されるように構成されている第1のアンカー及び第2のアンカーであって、前記拡張状態において心臓組織の両側に係合するように構成されている前記第1のアンカー及び前記第2のアンカーと、
を備えていることを特徴とするカニューレ組立体。 - 前記経中隔先端の前記係合部分が、前記柔軟カニューレ本体の前記受容部分に螺合するために、ネジ山が形成された表面を有していることを特徴とする請求項1に記載のカニューレ組立体。
- 前記第1のアンカー及び前記第2のアンカーのそれぞれが、前記柔軟カニューレ本体の長手方向の中心軸線に対して略横方向に延在している複数の支柱を備えていることを特徴とする請求項1に記載のカニューレ組立体。
- 前記複数の支柱が、超弾性材料から形成されており、前記収縮状態にあるときに、前記長手方向の中心軸線に対して略平行とされる所定の位置に折り畳まれ、前記拡張状態あるときに、前記長手方向の前記中心軸線に対して横方向の位置に伸展することを特徴とする請求項3に記載のカニューレ組立体。
- 前記超弾性材料が、管状構造体、ワイヤ、又は平坦なシート素材であることを特徴とする請求項4に記載のカニューレ組立体。
- 前記第2のアンカーの前記複数の支柱が、多孔性高分子構造体を含んでいることを特徴とする請求項3に記載のカニューレ組立体。
- 前記第1のアンカーの前記複数の支柱が、多孔性高分子構造体を含んでいることを特徴とする請求項3に記載のカニューレ組立体。
- 前記柔軟カニューレ本体の前記受容部分が、前記経中隔先端の前記近位端に係合すると共に前記受容部分の内部に流体密封シールを形成する、シールリングを含んでいることを特徴とする請求項1に記載のカニューレ組立体。
- 前記柔軟カニューレ本体の少なくとも一部分が、前記柔軟カニューレ本体のトルク応答を増進させるために、コイル又は編組で補強されていることを特徴とする請求項1に記載のカニューレ組立体。
- 前記柔軟カニューレ本体の前記遠位端および近位端が、補強されていないことを特徴とする請求項9に記載のカニューレ組立体。
- 請求項1に記載のカニューレ組立体と組み合わされたカニューレガイドにおいて、
テーパ状遠位端と、テーパ状近位端と、前記テーパ状遠位端と前記テーパ状近位端との間に配設された位置合わせ区間と、を有している拡張可能部材と、
前記拡張可能部材から近位に延在している本体であって、前記拡張可能部材が、経中隔先端の内面に係合するように構成され、柔軟カニューレ本体の受容部分が前記経中隔先端の係合部分に連結されている間において、前記経中隔先端が心臓組織から移動することを阻むように構成されている、前記本体と、
を備えていることを特徴とするカニューレガイド。 - 前記テーパ状近位端が、前記柔軟カニューレ本体の前記受容部分を前記経中隔先端の前記係合部分に向けるように構成されていることを特徴とする請求項11に記載のカニューレガイド。
- 前記拡張可能部材が、前記経中隔先端の前記内面に係合するための遠位部分と、前記遠位部分の直径よりも小さい直径を有している近位部分と、を含んでいることを特徴とする請求項11に記載のカニューレガイド。
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US16393109P | 2009-03-27 | 2009-03-27 | |
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EP2233165A3 (en) | 2010-12-15 |
US10350384B2 (en) | 2019-07-16 |
JP2014198250A (ja) | 2014-10-23 |
US20140200550A1 (en) | 2014-07-17 |
EP2233165B1 (en) | 2018-03-07 |
JP6161570B2 (ja) | 2017-07-12 |
JP6143707B2 (ja) | 2017-06-07 |
CA2697389C (en) | 2017-06-20 |
JP2010227580A (ja) | 2010-10-14 |
EP2233165A2 (en) | 2010-09-29 |
JP5647805B2 (ja) | 2015-01-07 |
CA2697389A1 (en) | 2010-09-27 |
US20100249491A1 (en) | 2010-09-30 |
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