JP2015500681A - 罹患脈管を横断して、遠位場所までデバイスを展開するためのシステム - Google Patents
罹患脈管を横断して、遠位場所までデバイスを展開するためのシステム Download PDFInfo
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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
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Abstract
Description
Claims (46)
- 罹患脈管を横断して、遠位場所までデバイスを展開するためのシステムであって、
それを通して管腔を画定し、シート状部材に連結される、2つ以上の長手方向レール構造を備える、レール付き拡張可能シースであって、前記シースが、第1の断面外径および第1の管腔内径を有する、圧潰構成と、前記シースが、第2の断面外径および第2の管腔内径を有する、拡張構成とを有する、シースを備え、
前記圧潰構成では、前記シースの第1の断面外径と前記罹患脈管の管腔の内径プロファイルとの間の実質的サイズ干渉を伴わずに、前記シースは、前記罹患脈管の少なくとも一部を横断して、前記遠位場所に隣接する位置まで前進されるように構成され、
前記圧潰構成の前記遠位場所に対する所望の位置への位置付けに応じて、前記デバイスによって前記シースに付与される荷重が、前記レールに伝達され、分散され、表面を傷つけない様式において、前記罹患脈管の近傍部分に分布されるように、前記シースは、前記管腔を通した長手方向のデバイスの漸増押動に伴って、前記拡張構成に拡張され得る、
システム。 - 前記レール構造およびシート状部材は、同一の材料を備える、請求項1に記載のシステム。
- 前記レール構造およびシート状部材は、同時に形成される、請求項2に記載のシステム。
- 前記レール構造は、前記シート状部材の内側表面に連結される、請求項1に記載のシステム。
- 前記レール構造は、前記シート状部材の外側表面に連結される、請求項1に記載のシステム。
- 前記レール構造は、少なくとも部分的に、前記シート状部材によって封入される、請求項1に記載のシステム。
- 前記レール構造は、実質的に、長手方向に均一形状である、請求項1に記載のシステム。
- 前記レール構造は、長手方向に非均一形状である、請求項1に記載のシステム。
- 前記2つ以上のレール構造は、実質的に、相互に対して均一である、請求項1に記載のシステム。
- 前記2つ以上のレール構造のうちの少なくとも1つは、実質的に、その他のうちの少なくとも1つに対して非均一である、請求項1に記載のシステム。
- 前記2つ以上のレール構造のうちの少なくとも1つは、楕円形形状、長方形形状、および円形形状から成る群から選択される、断面形状を備える、請求項1に記載のシステム。
- 前記シート状構造は、前記シースが、前記拡張構成にあるとき、実質的に、円筒形である、請求項1に記載のシステム。
- 前記シート状構造は、前記レール構造に対して折畳され、前記圧潰構成を形成する、請求項1に記載のシステム。
- 前記レール構造は、前記管腔に暴露される様式において、シート状構造に連結される、請求項1に記載のシステム。
- 前記レール構造のうちの少なくとも1つの長手方向軸は、前記シースの長手軸に平行である、請求項1に記載のシステム。
- 前記レール構造のうちの少なくとも1つは、前記少なくとも1つのレール構造の長手軸が、前記シースの長手軸に平行ではないような構成を有する、請求項1に記載のシステム。
- 前記シースは、前記シート状部材に連結された2つの直径方向に対向するレール構造を備える、請求項1に記載のシステム。
- 前記シースは、円周方向に等距離で分布される3つのレール構造を備える、請求項1に記載のシステム。
- 前記シースは、円周方向に等距離で分布される4つのレール構造を備える、請求項1に記載のシステム。
- 前記第1の管腔内径は、約0mm〜約3mmに等しい、請求項1に記載のシステム。
- 前記第2の管腔内径は、約6mm〜約8mmに等しい、請求項1に記載のシステム。
- 前記シースに連結され、蛍光透視下で観察しているオペレータが、前記シースを罹患動脈に対して位置付けるのを補助するように構成される、1つ以上の放射線不透過性マーカーをさらに備える、請求項1に記載のシステム。
- 前記シート状部材は、概して、血液に不浸透性である、材料を備える、請求項1に記載のシステム。
- 前記シート状部材は、血液が、前記管腔内の位置から、前記シート状部材を横断して、前記シースの外側の位置に流動することを可能にするように構成される、1つ以上の多孔性領域を備える、請求項1に記載のシステム。
- 前記1つ以上の多孔性領域は、頸動脈内への血液の流動を支援するように選択される、多孔率流速を備える、請求項24に記載のシステム。
- 前記多孔性領域は、前記シート状部材を横断して生成される、1つ以上の孔を備える、請求項24に記載のシステム。
- 前記孔は、直径約100ミクロンを有する、請求項26に記載のシステム。
- 前記1つ以上の多孔性領域は、それを通して流動する血液を濾過し、前記管腔内に存在し得る、塞栓の通過を防止するように構成される、請求項24に記載のシステム。
- 前記シースは、前記1つ以上の多孔性領域に隣接して位置し、オペレータが、蛍光透視法を使用して、1つ以上の解剖学的特徴に対する前記1つ以上の多孔性領域の相対的位置付けを可視化することを可能にするように構成される、1つ以上の放射線不透過性マーカーを備える、請求項24に記載のシステム。
- 前記レール構造は、ポリエチレン、超高分子量ポリエチレン、テレフタル酸ポリエチレン、ポリオキシメチレン、ポリテトラフルオロエチレン、およびそれらのコポリマーから成る群から選択される、材料を備える、請求項1に記載のシステム。
- 前記レール構造は、ニチノール合金を備える、請求項1に記載のシステム。
- 前記レール構造は、潤滑性コーティングでコーティングされる、請求項1に記載のシステム。
- 前記シート状部材は、ポリエチレン、ポリテトラフルオロエチレン、およびそれらのコポリマーから成る群から選択される、材料を備える、請求項1に記載のシステム。
- 前記管腔の少なくとも一部を通して挿入され、前記罹患脈管を通した前記シースの誘導を補助するように構成される、ガイドワイヤをさらに備える、請求項1に記載のシステム。
- 前記罹患脈管の支流脈管への塞栓の通過を防止するように選択される構成において前記罹患脈管内に位置付けられる、濾過デバイスをさらに備える、請求項1に記載のシステム。
- 前記シースが前記罹患脈管内に挿入される、アクセス点に近位の場所において、前記罹患脈管内に位置付けられる、濾過デバイスであって、前記シースの場所の近位の位置への塞栓の通過を防止するように構成される、濾過デバイスをさらに備える、請求項1に記載のシステム。
- 前記圧潰構成から前記拡張構成への前記レール付き拡張可能シースの再構成を完了するように構成される、バルーン拡張プローブをさらに備える、請求項1に記載のシステム。
- 前記レール付き拡張可能シースは、前記圧潰構成から前記拡張構成に自己拡張する、請求項1に記載のシステム。
- 前記レール付き拡張可能シースを前記圧潰構成に保定するように構成される、可撤性拡張保定部材をさらに備える、請求項38に記載のシステム。
- 前記拡張保定部材は、コルセットおよび引張部材アセンブリを備え、前記引張部材は、近位に張力がかけられ、前記コルセットを解放し、前記拡張構成に拡張することを可能にし得る、請求項38に記載のシステム。
- 前記レール構造の1つ以上の部分は、強磁性材料を備える、請求項1に記載のシステム。
- 前記拡張構成の管腔を通して通過され、前記圧潰構成に戻る前記シースの確実な圧潰を補助し得る、磁気式圧潰プローブをさらに備える、請求項36に記載のシステム。
- 前記拡張構成の管腔を通して位置付けられ、前記プローブが抜去され得る、前記拡張構成への再構成が所望されるまで、前記圧潰構成を維持するのを補助し得る、磁気式圧潰プローブをさらに備える、請求項36に記載のシステム。
- 前記デバイスは、前記罹患脈管を横断して、前記遠位場所まで、前記レール付き拡張可能シースを通して通過されるように選択される、埋込型プロテーゼを備える、請求項1に記載のシステム。
- 前記埋込型プロテーゼは、心臓弁プロテーゼを備える、請求項38に記載のシステム。
- 前記レール付き拡張可能シースは、長手方向に捻転されると、前記圧潰構成を形成し、長手方向に捻転が戻されると、前記拡張構成を形成するように構成される、請求項1に記載のシステム。
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US10874511B2 (en) | 2011-11-10 | 2020-12-29 | Medtronic, Inc. | System for deploying a device to a distal location across a diseased vessel |
US10959844B2 (en) | 2011-11-10 | 2021-03-30 | Medtronic, Inc. | System for deploying a device to a distal location across a diseased vessel |
US11213318B2 (en) | 2011-11-10 | 2022-01-04 | Medtronic Vascular, Inc. | Expandable introducer sheath and method |
US11672564B2 (en) | 2011-11-10 | 2023-06-13 | Medtronic, Inc. | Expandable introducer sheath and method |
US11751994B2 (en) | 2011-11-10 | 2023-09-12 | Medtronic, Inc. | System for deploying a device to a distal location across a diseased vessel |
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US20130138201A1 (en) | 2013-05-30 |
EP2776114A1 (en) | 2014-09-17 |
CA2855387A1 (en) | 2013-05-16 |
CA3082091C (en) | 2023-01-31 |
AU2012335016B2 (en) | 2017-07-20 |
JP6324550B2 (ja) | 2018-05-16 |
BR112014012352A2 (pt) | 2017-07-18 |
WO2013071179A1 (en) | 2013-05-16 |
CA3082091A1 (en) | 2013-05-16 |
EP3449969A1 (en) | 2019-03-06 |
US20160338828A1 (en) | 2016-11-24 |
EP2776114A4 (en) | 2015-06-24 |
IL232542B (en) | 2019-11-28 |
CN104039381A (zh) | 2014-09-10 |
EP2776114B1 (en) | 2018-10-24 |
US11751994B2 (en) | 2023-09-12 |
EP4190387A1 (en) | 2023-06-07 |
US10959844B2 (en) | 2021-03-30 |
US10874511B2 (en) | 2020-12-29 |
IL232542A0 (en) | 2014-06-30 |
CA2855387C (en) | 2020-08-04 |
CA3183330A1 (en) | 2013-05-16 |
US20210068953A1 (en) | 2021-03-11 |
US20130131787A1 (en) | 2013-05-23 |
US9370438B2 (en) | 2016-06-21 |
AU2012335016A1 (en) | 2014-05-29 |
EP2776114B8 (en) | 2019-04-17 |
EP3449969B1 (en) | 2023-02-01 |
JP2017080514A (ja) | 2017-05-18 |
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