JP2015504328A - 経皮的な血管内アクセスおよびガイドワイヤ配置用のシステムおよび方法 - Google Patents
経皮的な血管内アクセスおよびガイドワイヤ配置用のシステムおよび方法 Download PDFInfo
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- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A61M25/00—Catheters; Hollow probes
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
- A61B2017/00252—Making holes in the wall of the heart, e.g. laser Myocardial revascularization for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
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- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections
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- 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
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
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- 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
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3454—Details of tips
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Abstract
Description
本発明は、主血管から隣接した副血管にガイドワイヤを通過させる器具を含む。器具は、主ルーメンおよび副ルーメンを有する本体、並びに副ルーメンに配置されるとともに副ルーメンから遠位側に移動され、且つ遠位側に移動される間に組織を貫通するように構成される穿刺部材を含む。穿刺部材内に配置される第3のルーメンは、主血管から隣接した副血管までガイドワイヤを配置させるように構成される。
本発明の別の態様において、血管内のアクセス形成およびガイドワイヤ輸送の方法が開示される。方法は、主血管内の器具の本体を位置決めする工程と、主血管の内壁部と係合するように器具の遠位端を操作し、主血管を隣接する副血管に押し込み嵌合させる工程とを含む。さらなる工程は、穿刺部材を本体から遠位側に、主血管壁を介して、且つ副血管の隣接した壁部を介して延ばし、これにより、主血管および副血管の対向する壁部に連通孔を形成するように穿刺部材の端を副血管内に配置する工程を含む。
方法は、穿刺部材のルーメンを通してガイドワイヤを主血管から副血管内に遠位側に前進させる工程と、血管から器具を後退させ、これによりガイドワイヤを所定位置に保持し、主血管から連通孔を通して副血管に交差させる工程とをさらに含む。
Claims (14)
- 血管内のアクセス形成およびガイドワイヤ配置用の器具であって、
第1のルーメンを有する本体と、
前記第1のルーメンに配置され、且つ前記第1のルーメンから遠位側に移動するとともにこの遠位側への移動時に組織を貫通するように構成される穿刺部材と、
前記本体に取り付けられるとともに、前記穿刺部材を移動させるためのアクチュエータを有する取っ手と、
前記穿刺部材内の第2のルーメンと、
前記第2のルーメンの遠位端から所望の部位に輸送するための、前記第2のルーメン内に配置されるガイドワイヤとを備えることを特徴とする血管内のアクセス形成およびガイドワイヤ配置用の器具。 - 前記穿刺部材は、その一端に尖端を有することを特徴とする請求項1に記載の器具。
- 前記本体内且つ前記第1のルーメンの外側に第3のルーメンをさらに備えることを特徴とする請求項1に記載の器具。
- 前記穿刺部材は、前記第1のルーメン内に格納可能であることを特徴とする請求項2に記載の器具。
- 前記第3のルーメンは、形状記憶特性を有する針ガイドによって形成され、同針ガイドは、該針ガイドに漸増的に調整可能な曲率半径を形成するように前記本体の位置を調整することによって湾曲した配向に駆動可能であることを特徴とする請求項4に記載の器具。
- 穿刺部材は形状記憶特性を有するとともに、漸増的に調整可能な曲率半径を形成するために駆動可能であることを特徴とする請求項5に記載の器具。
- 前記アクチュエータは摺動部を含むことを特徴とする請求項4に記載の器具。
- 湾曲した配向に針ガイドを駆動するための、アクチュエータを前記取っ手にさらに含むことを特徴とする請求項5に記載の器具。
- 前記アクチュエータは回転ノブを含むことを特徴とする請求項8に記載の器具。
- 前記第1のルーメンは非外傷性の先端を有する針ガイドによって形成されることを特徴とする請求項1に記載の器具。
- 前記非外傷性の先端は高分子材料で形成されることを特徴とする請求項10に記載の器具。
- 前記非外傷性の先端は放射線不透過性の材料を含むことを特徴とする請求項10に記載の器具。
- 前記放射線不透過性の材料は、放射線不透過性の材料から形成される複数のコイルを含むことを特徴とする請求項12に記載の器具。
- 前記尖端はランセットポイントおよび主斜角を含むことを特徴とする請求項2に記載の器具。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US201161556128P | 2011-11-04 | 2011-11-04 | |
US61/556,128 | 2011-11-04 | ||
PCT/US2012/063444 WO2013067446A1 (en) | 2011-11-04 | 2012-11-02 | Systems and methods for percutaneous intravascular access and guidewire placement |
Publications (3)
Publication Number | Publication Date |
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JP2015504328A true JP2015504328A (ja) | 2015-02-12 |
JP2015504328A5 JP2015504328A5 (ja) | 2015-12-24 |
JP5964445B2 JP5964445B2 (ja) | 2016-08-03 |
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JP2014540164A Active JP5964445B2 (ja) | 2011-11-04 | 2012-11-02 | 経皮的な血管内アクセスおよびガイドワイヤ配置用のシステムおよび方法 |
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US (3) | US8951276B2 (ja) |
EP (1) | EP2773413B1 (ja) |
JP (1) | JP5964445B2 (ja) |
AU (1) | AU2012324006B2 (ja) |
CA (1) | CA2854593C (ja) |
IN (1) | IN2014CN04089A (ja) |
WO (1) | WO2013067446A1 (ja) |
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JP2019533539A (ja) * | 2016-11-11 | 2019-11-21 | アベニュ メディカル インコーポレイテッド | 経皮的血管内アクセスとワイヤー配置に用いられるシステム及び方法 |
JP2019536532A (ja) * | 2016-11-01 | 2019-12-19 | ベイリス メディカル カンパニー インコーポレイテッドBaylis Medical Company Inc. | 組織を穿刺する方法およびデバイス |
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US8951276B2 (en) | 2015-02-10 |
AU2012324006A1 (en) | 2013-05-23 |
EP2773413A4 (en) | 2015-02-25 |
US20130123827A1 (en) | 2013-05-16 |
CA2854593C (en) | 2019-07-16 |
JP5964445B2 (ja) | 2016-08-03 |
US20150201962A1 (en) | 2015-07-23 |
EP2773413A1 (en) | 2014-09-10 |
CA2854593A1 (en) | 2013-05-10 |
US9522016B2 (en) | 2016-12-20 |
WO2013067446A1 (en) | 2013-05-10 |
US9801653B2 (en) | 2017-10-31 |
US20170071627A1 (en) | 2017-03-16 |
EP2773413B1 (en) | 2020-01-08 |
AU2012324006B2 (en) | 2015-07-16 |
IN2014CN04089A (ja) | 2015-07-10 |
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