JP2014508598A - 組織切除のためのハイブリッドカテーテル - Google Patents
組織切除のためのハイブリッドカテーテル Download PDFInfo
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- JP2014508598A JP2014508598A JP2013554976A JP2013554976A JP2014508598A JP 2014508598 A JP2014508598 A JP 2014508598A JP 2013554976 A JP2013554976 A JP 2013554976A JP 2013554976 A JP2013554976 A JP 2013554976A JP 2014508598 A JP2014508598 A JP 2014508598A
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Abstract
【選択図】なし
Description
血管インターベンションのためのレーザアブレーション技術における現行の最先端技術は、Spectraneticsの CVX−300(登録商標)レーザおよびTURBO−Booster(登録商標)カテーテルなどの専用のカテーテルを有するエキシマレーザの使用に基づく。これらの技術は、例えば米国特許第6,673,064号、同第7,811,281号、および同第7,572,254号に記載される。技術および安全性を考慮すれば、用いられるエキシマレーザは一般に、パルス幅が100ナノ秒の範囲内であり308nmで操作される塩化キセノンレーザであることが多い。これらの技術は、理想的ではなく、幾らかの限定を有する。例えば、重度の石灰化プラークを取り扱う場合、壊死組織片/プラーク断片による穿孔および損傷のリスクがある。それゆえ、その手順は、複雑で大規模でコストのかかるシステムを必要とし、広範な臨床使用を制限すると思われる手法により、手順の長さが極めて著しい。加えて、末梢動脈疾患(PAD)の管理に非常に重要で、4〜5mmを超える口径の血管および長い病変を処置することになるSFA(表面大腿動脈)などの大血管の処置において、その技術は困難を有する。
Claims (17)
- 血管壁、血管内に留置されたステントおよび体腔のうちの少なくとも1つの内表面から望ましくない堆積物をデバルキングする方法であって、
レーザ光学部品と、
カッターと、
を含み、
前記レーザ光学部品が望ましくない堆積物の領域を改変するためにレーザ光を伝送し、それにより前記領域を前記カッターの進入のために準備するよう構成されており、前記カッターが前記改変された領域を切断し、それにより望ましくない堆積物の少なくとも一部をデバルキングするよう構成されている、カテーテル。 - 前記先端部が、挿入対象の体腔の典型的な解剖学的構造に適合するように構成されている、請求項1に記載のカテーテル。
- 前記先端部が、円筒形または円筒扇形の形状である、請求項1に記載のカテーテル。
- 前記カッターが、円形または円筒扇形の形状である、請求項1に記載のカテーテル。
- 前記望ましくない体積物の前記領域を改変することが、前記領域を機械的に弱化することを含む、請求項1に記載のカテーテル。
- 前記レーザ光学部品が、先端部の第一の壁に沿って配置された複数の光ファイバーを含む、請求項1に記載のカテーテル。
- 前記カッターが、前記第一の壁を形成する、請求項6に記載のカテーテル。
- 前記第一の壁が、鋭利な遠位エッジを有する、請求項7に記載のカテーテル。
- 前記カッターが、前記複数の光ファイバーに対して内方もしくは外方に、前記第一の壁の内表面もしくは外表面に沿って配置されたブレードを含む、または前記カッターが、前記複数の光ファイバーに対して内方もしくは外方に、前記先端部の前記第一の壁に沿って回転可能なブレードを含む、請求項6に記載のカテーテル。
- 前記レーザが、パルスレーザ、固体トリプルNd:YAGレーザ、パルスツリウムレーザ、パルスツリウムファイバーレーザ、Er:YAGレーザ、およびダイオード励起ホルミウムファイバーレーザからなる群より選択される、請求項1に記載のカテーテル。
- 前記レーザが、ファイバーレーザおよびパルスレーザから選択され、2.8〜3ミクロンの範囲内のレーザを射出するように構成されている、請求項1に記載のカテーテル。
- 望ましくない堆積物が無茎性ポリープ、平坦型ポリープおよびNP−CRN(非ポリープ様結腸直腸新生物)を含み、この場合の体腔が結腸の内壁表面を含む、または望ましくない堆積物が平坦型病変を含み、この場合の体腔が胃の内壁を含む、または前記望ましくない堆積物がバレット組織であり、この場合の体腔が食道を含み、前記先端部が食道の典型的な解剖学的構造に適合するように構成されている、請求項1に記載のカテーテル。
- 血管壁および/または体腔の内表面から望ましくない堆積物をデバルキングする方法であって、
カテーテルを用いることと、
円周方向に向いたレーザ光学部品を用いて望ましくない堆積物の領域を照射し、それにより前記領域を改変することと、
カッターを用いて前記改変された領域を切断し、それにより前記望ましくない堆積物の少なくとも一部をデバルキングすることと、
を含む方法。 - 前記照射することと前記切開することとが、同時に実施される、請求項13に記載の方法。
- 前記照射することと前記切開することとが、間欠的に実施される、請求項13に記載の方法。
- カテーテルを送り込んで改変された望ましくない堆積物を切断し、それにより前記望ましくない堆積物の少なくとも一部をデバルキングすることを更に含む、請求項13に記載の方法。
- 望ましくない堆積物をデバルキングすることが、血管壁もしくは心臓からペースメーカおよびICDリードを脱離することを含む、または望ましくない堆積物をデバルキングすることが、血管内のプラークおよび体積物をデバルキングすることを含む、または望ましくない堆積物をデバルキングすることが、植え込まれたステント内のプラークおよび/もしくは堆積物をデバルキングすることを含む、請求項1に記載のカテーテル。
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US61/521,523 | 2011-08-09 | ||
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CN103491892B (zh) | 2017-06-09 |
AU2012221758A2 (en) | 2013-11-14 |
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