JP2014533584A - 心筋薬剤送達装置および方法 - Google Patents
心筋薬剤送達装置および方法 Download PDFInfo
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- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
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- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
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- A61M5/14244—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body
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- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
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- A61B5/4839—Diagnosis combined with treatment in closed-loop systems or methods combined with drug delivery
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- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
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- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6867—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive specially adapted to be attached or implanted in a specific body part
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- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0526—Head electrodes
- A61N1/0529—Electrodes for brain stimulation
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36014—External stimulators, e.g. with patch electrodes
- A61N1/36025—External stimulators, e.g. with patch electrodes for treating a mental or cerebral condition
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- A—HUMAN NECESSITIES
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
- A61N1/36064—Epilepsy
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- A—HUMAN NECESSITIES
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
- A61N1/36082—Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
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- A—HUMAN NECESSITIES
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
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- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3629—Heart stimulators in combination with non-electric therapy
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
- A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
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- A—HUMAN NECESSITIES
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
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- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
- A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
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Abstract
Description
本出願は、共に2011年11月21日に出願された「Myocardial Drug Delivery Apparatus for Treatment of Cardiac Rhythm Disorders」という題名の仮出願第61/629,599号および61/629,609号の優先権の利益を主張する。上記文献は、全ての目的のために、参照することによって本願明細書において完全に援用される。
本発明の実施形態は、薬剤送達デバイスおよびその使用方法に関する。より具体的には、本発明の実施形態は、固体形態の薬剤および他の治療薬の送達のための薬剤送達装置に関する。さらにより具体的には、本発明の実施形態は、心房細動の治療のために心筋に固体形態の薬剤を送達するための薬剤送達装置に関する。
心臓は、右心房および左心房、ならびに右心室および左心室といった、4つの心腔を有する。心房は、心室へのプライマポンプとしての機能を果たし、ひいては、心室は、血液を肺(右心室)または大動脈および身体の残りの部分(左心室)に送出する。心臓は、本質的に、一連の伝導経路を通して時限的に心房から心室へ広がる脱分極波を用いて、収縮して血液を送出する、電気機械ポンプである。心不整脈は、心臓が罹患する症状であり、心組織内の異常な伝導パターンによって特徴付けられる。これらの異常な伝導パターンは、ひいては、1つ以上の心腔内のポンプ効率に影響を及ぼし得る。これは、心房、心室、または両方の中で起こり得る。特定の種類の心房不整脈は、心房のポンプ効率が損なわれる、心房細動(AF)として知られる症状を引き起こし得る。協調的に収縮する代わりに、左心房または右心房は、ほとんどまたは全くポンプ効率を伴わずに粗動する。
本明細書で記述される全ての出版物、特許、および特許出願は、各個別出版物、特許、または特許出願が、参照することにより組み込まれるように具体的かつ個別に示された場合と同一の程度に、参照することにより本明細書に組み込まれる。
ペレットはまた、ペレットの崩壊状態の指示を提供するように構成されるパターン、サイズ、または形状のうちの1つ以上を有する、種々の光学指標を含んでもよい。
Claims (20)
- 患者の体内の送達部位への薬物の送達のための装置であって、前記装置は、
前記患者の体内に埋め込まれるように構成された薬剤貯蔵デバイスであって、前記貯蔵デバイスは、複数の固体形態の薬物要素を貯蔵するように構成され、各薬物要素が薬剤を含む、薬剤貯蔵デバイスと、
薬液を形成するように、体液とともに少なくとも1つの固体形態の薬物要素を溶解または懸濁させるための手段と、
前記薬液を前記送達部位に送達するための手段と
を備える、装置。 - 薬液を形成するように、前記少なくとも1つの固体形態の薬物要素を溶解または懸濁させるための前記手段は、
近位および遠位端を有する可撓性送達部材であって、前記近位端は、前記薬剤貯蔵デバイスに連結され、前記送達部材は、前記送達部材を通した前記薬物要素の前進のための管腔を含む、可撓性送達部材と、
前記送達部材管腔を通して前記薬物要素を前進させるように構成された前進部材と、
前記送達部材の前記遠位端に連結された捕捉チャンバであって、前記捕捉チャンバは、前記薬物要素を受容するための内部容積を有する筐体を含み、前記筐体は、組織液が前記チャンバに流入し、前記チャンバから流出することを可能にする少なくとも1つの多孔質区画を含む、捕捉チャンバと
を備え、
前記チャンバは、i)前記送達部材から受容された薬物要素を保持し、ii)前記内部容積内で組織液に前記薬物要素を溶解または懸濁させて薬液を形成するように構成され、
前記薬液を送達するための前記手段は、前記薬液を前記送達部位に送達するように構成される、前記捕捉チャンバの少なくとも1つの多孔質区画を備え、
前記送達部位は、固体組織を含む、請求項1に記載の装置。 - 前記少なくとも1つの多孔質区画は、前記薬液を前記送達部位に送達するよう、組織に接触するように構成された組織接触多孔質区画を含み、前記送達部位は、心臓の表面を含む、請求項2に記載の装置。
- 前記少なくとも1つの多孔質区画はさらに、非組織接触多孔質区画を備え、前記組織接触多孔質区画は、第1の多孔性を有し、前記非組織接触多孔質区画は、第2の多孔性を有する、請求項3に記載の装置。
- 前記組織液は、血液または間質液を含む、請求項2に記載の装置。
- 前記心臓表面は、心臓の心房表面である、請求項3に記載の装置。
- 前記組織接触表面は、鼓動を打っている心臓の壁運動を妨げないよう、屈折および屈曲するように構成されている、請求項3に記載の装置。
- 前記捕捉チャンバは、鼓動を打っている心臓の壁運動を妨げないように構成されている、請求項2に記載の装置。
- 前記捕捉チャンバは、鼓動を打っている心臓の壁運動を妨げないように構成される輪郭、可撓性、または質量のうちの少なくとも1つを有する、請求項8に記載の装置。
- 前記捕捉チャンバは、前記捕捉チャンバが配置される、心腔を通る血流を妨げないように構成された輪郭を有する、請求項2に記載の装置。
- 前記前進部材は、金属ワイヤを備える、請求項2に記載の装置。
- 前記前進部材は、前記薬物要素に係合するように構成された球状先端を有する、請求項2に記載の装置。
- 前記前進部材は、前記薬物要素との接触を感知するように構成された先端を有する、請求項2に記載の装置。
- 前記前進部材を前進させるための前記前進部材に連結された駆動手段をさらに備える、請求項2に記載の装置。
- 前記捕捉チャンバは、前記捕捉チャンバを組織表面に固定するための固定デバイスを含む、請求項2に記載の装置。
- 前記固定デバイスは、成形コイル、螺旋形コイル、または金属螺旋形コイルを備える、請求項15に記載の装置。
- 前記固定デバイスはさらに、前記心臓の電気的活動を感知するか、または電気信号を前記心臓に送達する電極として機能するように構成されている、請求項15に記載の装置。
- 前記固定デバイスは、少なくとも1本の導線に電気的に連結され、
前記少なくとも1本の導線は、電気刺激装置またはペースメイキングデバイスのうちの少なくとも1つに電気的に連結されている、請求項15に記載の装置。 - 前記送達部材は、カテーテルを備える、請求項2に記載の装置。
- 薬液を形成するように少なくとも1つの固体形態の薬物要素を溶解させ、前記薬液を前記送達部位に送達するための前記手段はさらに、前記送達部材の前記遠位端に連結された再密閉可能な隔膜であって、前記隔膜は、開放し、前記捕捉チャンバの中への前記薬物要素の通過を可能にし、次いで、閉鎖し、前記送達部材の中への流体の流入を防止するように構成されている、隔膜を備え、
前記隔膜は、前記薬物要素の通過のための再密閉可能なスリットを含む、請求項2に記載の装置。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161629599P | 2011-11-21 | 2011-11-21 | |
US201161629609P | 2011-11-21 | 2011-11-21 | |
US61/629,609 | 2011-11-21 | ||
US61/629,599 | 2011-11-21 | ||
PCT/US2012/066156 WO2013078256A1 (en) | 2011-11-21 | 2012-11-20 | Myocardial drug delivery apparatus and methods |
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JP2017163500A Division JP6533811B2 (ja) | 2011-11-21 | 2017-08-28 | 心筋薬剤送達装置および方法 |
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CN104159636A (zh) | 2014-11-19 |
EP2782632A4 (en) | 2015-04-01 |
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EP2782632B1 (en) | 2016-10-19 |
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AU2012340751A1 (en) | 2014-06-19 |
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ES2611405T3 (es) | 2017-05-08 |
AU2017219161A1 (en) | 2017-09-21 |
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