JP2017060751A - 閉塞装置 - Google Patents
閉塞装置 Download PDFInfo
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12027—Type of occlusion
- A61B17/12031—Type of occlusion complete occlusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
- A61B17/12118—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm for positioning in conjunction with a stent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
- A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
- A61B17/12177—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure comprising additional materials, e.g. thrombogenic, having filaments, having fibers or being coated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12181—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices
- A61B17/12186—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices liquid materials adapted to be injected
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00526—Methods of manufacturing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Vascular Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
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Abstract
Description
(i)金属クリップで動脈瘤の底部周辺を束縛ししっかり締める、外科的クリッピング、(ii)小さく柔軟なワイヤコイル(マイクロコイル)またはブレイズ状ボール装置を動脈瘤に詰めること、(iii)動脈瘤を「満たす」または「詰める」ための塞栓材料の使用、(iv)動脈瘤のある患者の血管を閉塞する取り外し可能なバルーンまたはコイルの使用、(v)動脈瘤から血流をそらすためにステントを用いること。
(項目1)
複数の開口部を定義する複数のブレイズ状フィラメントを含み、遠位領域及び近位領域を含み、圧縮された構造から拡張した構造へと拡張可能であるフレームと、少なくともその近位領域に沿う上記フレームに連結するメッシュコンポーネントと、を含む患者の血管の目標領域を閉塞するための移植物であり、上記複数のフィラメント及び開口部はフレーム多孔率をひとまとめに定義し、上記メッシュコンポーネントは複数のフィラメント及び複数の開口部を含み、上記複数のフィラメント及び開口部は、そこに血流を流す第1多孔率をひとまとめに定義し、上記第1多孔率は上記フレーム多孔率よりも小さく、それにより上記移植物への血流が上記フレームの上記遠位領域に沿うより上記近位領域を沿う方がより制限される、上記移植物。
(項目2)
上記メッシュコンポーネントが、第1メッシュコンポーネントであり、上記移植物が上記近位領域に沿う上記フレームに連結する第2メッシュコンポーネントをさらに含む、上記項目に記載の上記移植物。
(項目3)
上記第2メッシュコンポーネントが上記第1多孔率とは異なる第2多孔率を含む、上記項目のいずれかに記載の上記移植物。
(項目4)
第1及び第2メッシュコンポーネントが、それぞれフレームの第1及び第2開口部に覆い被さり、上記第1開口部が上記第2開口部へ隣接している、上記項目のいずれかに記載の上記移植物。
(項目5)
上記近位領域に沿う上記フレームに連結する第3メッシュコンポーネントをさらに含む、上記項目のいずれかに記載の上記移植物。
(項目6)
上記第3メッシュコンポーネントが、上記第1多孔率とは異なる第3多孔率を含む、上記項目のいずれかに記載の上記移植物。
(項目7)
上記第2メッシュコンポーネントが第2多孔率を含み、上記第3メッシュコンポーネントが上記第2多孔率とは異なる第3多孔率を含む、上記項目のいずれかに記載の上記移植物。
(項目8)
上記メッシュコンポーネントが、複数の連結部分で上記フレームにしっかりと連結される、上記項目のいずれかに記載の上記移植物。
(項目9)
上記メッシュコンポーネントが、上記複数の連結部分で上記フレームに溶接される、上記項目のいずれかに記載の上記移植物。
(項目10)
開口部を定義するために互いに交わるフィラメントを備え、圧縮された構造から拡張した構造へと拡張可能であるブレイズ状フレームと、上記フレームに連結されるメッシュコンポーネントと、を含む患者の血管の目標領域を閉塞するための移植物であり、上記フィラメント及び開口部はそれぞれフレーム多孔率を定義し、上記メッシュコンポーネントはそこに血流を流す第1多孔率をひとまとめに定義するフィラメント及び開口部を含み、上記移植物への血流を制限するために上記第1多孔率は上記フレーム多孔率よりも小さい、上記移植物。
(項目11)
上記メッシュコンポーネントが第1メッシュコンポーネントであり、上記移植物が上記フレームに連結する第2メッシュコンポーネントをさらに含む、上記項目のいずれかに記載の上記移植物。
(項目12)
上記第2メッシュコンポーネントが上記第1多孔率とは異なる第2多孔率を含む、上記項目のいずれかに記載の上記移植物。
(項目13)
上記第2メッシュコンポーネントが、上記第1メッシュコンポーネントに隣接して配置される、上記項目のいずれかに記載の上記移植物。
(項目14)
上記近位領域に沿う上記フレームに連結する第3メッシュコンポーネントをさらに含む、上記項目のいずれかに記載の上記移植物。
(項目15)
上記メッシュコンポーネントが上記フレームの全てを実質的に取り囲む、上記項目のいずれかに記載の上記移植物。
(項目16)
上記複数の第1及び第2フィラメントが単層を形成するよう混交する、上記項目のいずれかに記載の上記移植物。
(項目17)
開口部を定義するよう交差するフィラメントを含み、上記フィラメント及び開口部はそれぞれフレーム多孔率を定義する、チューブ型ブレイズの端を実質的に閉じられた構造へと留め具を用いて閉じることと、上記実質的に閉じられた端を保持する間、開口端へと型を挿入して上記型の周囲に上記ブレイズを配置することと、上記型に基づき装置本体形状を定めることと、上記移植物上にメッシュコンポーネントを連結することと、を含む移植物の組み立てを実行する方法であり、上記メッシュコンポーネントはそこに血流を流す第1多孔率をひとまとめに定義するフィラメント及び開口部を含み、上記移植物への血流を制限するために上記第1多孔率は上記フレーム多孔率よりも小さい、上記方法。
(項目18)
上記メッシュコンポーネントが第1メッシュコンポーネントを含み、上記連結することが、第2メッシュコンポーネントを上記第1メッシュコンポーネントに隣接する上記移植物へ連結することを含む、上記項目のいずれかに記載の上記方法。
(項目19)
上記連結することが、第3メッシュコンポーネントを上記移植物へ連結することを含む、上記項目のいずれかに記載の上記方法。
(項目20)
上記連結することが、上記メッシュコンポーネントを上記移植物の外部に沿って配置することを含む、上記項目のいずれかに記載の上記方法。
移植物は、フレーム及びフレームに連結するメッシュコンポーネントを含むことができる。メッシュコンポーネントは、第1多孔率を定義でき、フレームはフレーム多孔率を定義できる。メッシュコンポーネント及びフレームの複合多孔率は、移植物への血流を抑制できる。
さらに、送達システム及び手順は、本明細書に記述されるような1つ以上の移植可能な装置を含む移植可能な装置を送達するために実行できる。さらに、システム及び方法は、動脈瘤へ移植可能な装置の送達及び/または除去または再配置のために装置を回収することのために提供される。
いくつかの実施形態では、移植可能な装置の複合構造は、異なる多孔率を有する2つまたは3つの素材を含むことができる。さらに、移植可能な装置の複合構造は、異なる多孔率を有する5、6、またはそれ以上の異なる素材のために含むことができる。移植可能な装置のいくつかの実施形態は、特定の多孔率形状を提供するよう構成できる。多孔率形状は単一の、移植可能な装置全体の表面にわたって均一である平均多孔率、または複合的移植可能な装置をひとまとめに形成する異なる平均多孔率を有する複数の平均多孔率区間、部分、または領域を含むことができる。
いくつかの実施形態に従って、移植可能な装置の少なくとも一部分は、少なくとも1つまたは全ての移植可能な装置の治療的な、総括的な、または撮像特性または特徴を向上するためのコーティングまたは材料を含むことができる。
本明細書に述べられる装置及び方法は、医療装置または血管系内へのステントの配置及び使用に限定しないが、さらなる治療用途をいくつでも含んでもよい。他の治療場所は、あらゆる中空解剖学的構造を含む体の範囲または領域を含んでもよい。
本明細書に記述される様々な機能及び要素は、従属技術の範囲から逸脱することなく、示されたものと異なって区別されてもよい。これらの構成への様々な修正は、当業者に容易に明らかとなり、本明細書に定義される一般的な原理は他の構成へ適用してもよい。よって、多くの変更及び修正が従属技術の範囲から逸脱することなく、当業者によって従属技術に加えられてもよい。
Claims (20)
- 複数の開口部を定義する複数のブレイズ状フィラメントを含み、遠位領域及び近位領域を含み、圧縮された構造から拡張した構造へと拡張可能であるフレームと、少なくともその近位領域に沿う前記フレームに連結するメッシュコンポーネントと、を含む患者の血管の目標領域を閉塞するための移植物であり、前記複数のフィラメント及び開口部はフレーム多孔率をひとまとめに定義し、前記メッシュコンポーネントは複数のフィラメント及び複数の開口部を含み、前記複数のフィラメント及び開口部は、そこに血流を流す第1多孔率をひとまとめに定義し、前記第1多孔率は前記フレーム多孔率よりも小さく、それにより前記移植物への血流が前記フレームの前記遠位領域に沿うより前記近位領域を沿う方がより制限される、前記移植物。
- 前記メッシュコンポーネントが、第1メッシュコンポーネントであり、前記移植物が前記近位領域に沿う前記フレームに連結する第2メッシュコンポーネントをさらに含む、請求項1に記載の前記移植物。
- 前記第2メッシュコンポーネントが前記第1多孔率とは異なる第2多孔率を含む、請求項2に記載の前記移植物。
- 第1及び第2メッシュコンポーネントが、それぞれフレームの第1及び第2開口部に覆い被さり、前記第1開口部が前記第2開口部へ隣接している、請求項2に記載の前記移植物。
- 前記近位領域に沿う前記フレームに連結する第3メッシュコンポーネントをさらに含む、請求項2に記載の前記移植物。
- 前記第3メッシュコンポーネントが、前記第1多孔率とは異なる第3多孔率を含む、請求項7に記載の前記移植物。
- 前記第2メッシュコンポーネントが第2多孔率を含み、前記第3メッシュコンポーネントが前記第2多孔率とは異なる第3多孔率を含む、請求項7に記載の前記移植物。
- 前記メッシュコンポーネントが、複数の連結部分で前記フレームにしっかりと連結される、請求項1に記載の前記移植物。
- 前記メッシュコンポーネントが、前記複数の連結部分で前記フレームに溶接される、請求項16に記載の前記移植物。
- 開口部を定義するために互いに交わるフィラメントを備え、圧縮された構造から拡張した構造へと拡張可能であるブレイズ状フレームと、前記フレームに連結されるメッシュコンポーネントと、を含む患者の血管の目標領域を閉塞するための移植物であり、前記フィラメント及び開口部はそれぞれフレーム多孔率を定義し、前記メッシュコンポーネントはそこに血流を流す第1多孔率をひとまとめに定義するフィラメント及び開口部を含み、前記移植物への血流を制限するために前記第1多孔率は前記フレーム多孔率よりも小さい、前記移植物。
- 前記メッシュコンポーネントが第1メッシュコンポーネントであり、前記移植物が前記フレームに連結する第2メッシュコンポーネントをさらに含む、請求項21に記載の前記移植物。
- 前記第2メッシュコンポーネントが前記第1多孔率とは異なる第2多孔率を含む、請求項22に記載の前記移植物。
- 前記第2メッシュコンポーネントが、前記第1メッシュコンポーネントに隣接して配置される、請求項22に記載の前記移植物。
- 前記近位領域に沿う前記フレームに連結する第3メッシュコンポーネントをさらに含む、請求項22に記載の前記移植物。
- 前記メッシュコンポーネントが前記フレームの全てを実質的に取り囲む、請求項21に記載の前記移植物。
- 前記複数の第1及び第2フィラメントが単層を形成するよう混交する、請求項21に記載の前記移植物。
- 開口部を定義するよう交差するフィラメントを含み、前記フィラメント及び開口部はそれぞれフレーム多孔率を定義する、チューブ型ブレイズの端を実質的に閉じられた構造へと留め具を用いて閉じることと、前記実質的に閉じられた端を保持する間、開口端へと型を挿入して前記型の周囲に前記ブレイズを配置することと、前記型に基づき装置本体形状を定めることと、前記移植物上にメッシュコンポーネントを連結することと、を含む移植物の組み立てを実行する方法であり、前記メッシュコンポーネントはそこに血流を流す第1多孔率をひとまとめに定義するフィラメント及び開口部を含み、前記移植物への血流を制限するために前記第1多孔率は前記フレーム多孔率よりも小さい、前記方法。
- 前記メッシュコンポーネントが第1メッシュコンポーネントを含み、前記連結することが、第2メッシュコンポーネントを前記第1メッシュコンポーネントに隣接する前記移植物へ連結することを含む、請求項41に記載の前記方法。
- 前記連結することが、第3メッシュコンポーネントを前記移植物へ連結することを含む、請求項44に記載の前記方法。
- 前記連結することが、前記メッシュコンポーネントを前記移植物の外部に沿って配置することを含む、請求項41に記載の前記方法。
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ES2843630T3 (es) | 2021-07-19 |
CN106539605B (zh) | 2020-03-31 |
EP3153114A1 (en) | 2017-04-12 |
EP3808284A1 (en) | 2021-04-21 |
CA2941941A1 (en) | 2017-03-23 |
US20170079662A1 (en) | 2017-03-23 |
CA2941941C (en) | 2020-09-15 |
US20200038032A1 (en) | 2020-02-06 |
US10478194B2 (en) | 2019-11-19 |
JP6568506B2 (ja) | 2019-08-28 |
KR20180064364A (ko) | 2018-06-14 |
CN106539605A (zh) | 2017-03-29 |
EP3153114B1 (en) | 2020-11-04 |
US11357510B2 (en) | 2022-06-14 |
JP2019171113A (ja) | 2019-10-10 |
KR20170035813A (ko) | 2017-03-31 |
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