JP2017503538A - 医療用インプラント - Google Patents
医療用インプラント Download PDFInfo
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- JP2017503538A JP2017503538A JP2016534927A JP2016534927A JP2017503538A JP 2017503538 A JP2017503538 A JP 2017503538A JP 2016534927 A JP2016534927 A JP 2016534927A JP 2016534927 A JP2016534927 A JP 2016534927A JP 2017503538 A JP2017503538 A JP 2017503538A
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- 239000007943 implant Substances 0.000 title claims abstract description 100
- 210000005248 left atrial appendage Anatomy 0.000 claims abstract description 33
- 239000000463 material Substances 0.000 claims abstract description 7
- 238000000034 method Methods 0.000 claims description 8
- 239000004809 Teflon Substances 0.000 claims description 4
- 229920006362 Teflon® Polymers 0.000 claims description 4
- 230000008878 coupling Effects 0.000 claims description 4
- 238000010168 coupling process Methods 0.000 claims description 4
- 238000005859 coupling reaction Methods 0.000 claims description 4
- 239000010408 film Substances 0.000 claims description 4
- 229910052751 metal Inorganic materials 0.000 claims description 4
- 239000002184 metal Substances 0.000 claims description 4
- 210000003205 muscle Anatomy 0.000 claims description 4
- 238000003698 laser cutting Methods 0.000 claims description 3
- 229910001000 nickel titanium Inorganic materials 0.000 claims description 3
- 238000009958 sewing Methods 0.000 claims description 3
- 238000003856 thermoforming Methods 0.000 claims description 3
- 239000010409 thin film Substances 0.000 claims description 3
- 230000000717 retained effect Effects 0.000 claims 1
- 208000007536 Thrombosis Diseases 0.000 description 6
- 238000004873 anchoring Methods 0.000 description 6
- 210000001008 atrial appendage Anatomy 0.000 description 4
- 230000007246 mechanism Effects 0.000 description 3
- 238000005496 tempering Methods 0.000 description 3
- 206010003658 Atrial Fibrillation Diseases 0.000 description 2
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- 238000002513 implantation Methods 0.000 description 1
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- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 description 1
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- 210000001147 pulmonary artery Anatomy 0.000 description 1
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- 230000009861 stroke prevention Effects 0.000 description 1
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Images
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- 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
- A61B17/12122—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder within the heart
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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
- 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
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- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/844—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents folded prior to deployment
-
- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/848—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00579—Barbed implements
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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
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00597—Implements comprising a membrane
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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
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00632—Occluding a cavity, i.e. closing a blind opening
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/848—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
- A61F2002/8483—Barbs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/848—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
- A61F2002/8486—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs provided on at least one of the ends
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- Surgery (AREA)
- Cardiology (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Reproductive Health (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Surgical Instruments (AREA)
Abstract
Description
(a)1つまたは複数のアンカー要素の遠位端に、かかり付き(barbed)先端が設けられ、先端およびかかりは、かかり付き先端が左心耳の筋組織に係留される目的で、ケージ構造体を越えて突出し、または
(b)1つまたは複数のアンカー要素は、ケージ構造体を越えて横方向に突出し、左心耳の筋組織に対して横方向に支持される目的で、湾曲形態で近位方向に延在し、もしくは
(c)選択肢(a)および(b)の組合せが提供される
インプラントによって達成される。
Claims (20)
- 血管内手段によって患者の左心耳を閉塞する医療用インプラント(1)であって、近位側が接続ウェブ(2)を介して保持リング(4)に取り付けられ遠位側が収束ウェブ(3)のリムによって制限されている複数のウェブ(3)を備えるケージ構造体(10)を有し、自己拡張材料からなり、収縮状態では溝付きチューブの形状を有し、拡張後は、前記ケージ構造体(10)の直径が前記保持リング(4)より大きくなる、医療用インプラント(1)において、
少なくとも1つまたはいくつかのアンカー要素(7)が、前記ケージ構造体(10)内にかつそれに対して遠位側に配置され、前記アンカー要素が、近位側から前記保持リング(4)に直接または間接的に接続され、(a)前記1つまたは複数のアンカー要素(7a)の遠位端に、かかり(9)がある先端(8)が設けられ、該先端(8)および該かかり(9)が、前記左心耳の筋組織に係留される目的で、前記ケージ構造体(10)を越えて突出し、または(b)前記1つまたは複数のアンカー要素(7b)が、前記ケージ構造体(10)を越えて横方向に突出し、前記左心耳の前記筋組織に対して横方向に支持される目的で、湾曲形態で近位方向に延在し、もしくは(c)選択肢(a)および(b)の組合せが提供されることを特徴とするインプラント。 - 前記保持リング(4)の周囲にわたって等しく間隔をあけて配置された少なくとも2つのアンカー要素(7a、7b)によって特徴付けられる、請求項1に記載のインプラント。
- 前記アンカー要素(7a)の前記かかり(9)が外側に向いていることを特徴とする、請求項2に記載のインプラント。
- 前記アンカー要素(7a、7b)が、前記ケージ構造体内部に配置され、前記保持リング(4)に直接取り付けられていることを特徴とする、請求項1〜3のいずれか一項に記載のインプラント。
- 保持リング(4)から前記ケージ構造体(10)に向かって延在する前記接続ウェブ(2)に穿孔(6)が設けられていることを特徴とする、請求項1〜4のいずれか一項に記載のインプラント。
- 前記近位領域に配置されたカバーによって特徴付けられる、請求項1〜5のいずれか一項に記載のインプラント。
- 前記カバーがTeflonの薄膜または膜から構成されていることを特徴とする、請求項6に記載のインプラント。
- 前記カバーが、前記穿孔を利用する縫付によって前記ケージ構造体(10)に取り付けられていることを特徴とする、請求項6または7に記載のインプラント。
- 前記ケージ構造体(10)が、分岐し収束するウェブ(3)の網から構成されていることを特徴とする、請求項1〜8のいずれか一項に記載のインプラント。
- 前記ケージ構造体(10)の遠位リムが丸い先端(5)を有していることを特徴とする、請求項1〜9のいずれか一項に記載のインプラント。
- 前記保持リング(4)におけるガイドカテーテル用の継手によって特徴付けられる、請求項1〜10のいずれか一項に記載のインプラント。
- 前記ケージ構造体(10)の前記近位領域に、前記保持リング(4)が配置されている中心の深くなっている部分が設けられていることを特徴とする、請求項1〜11のいずれか一項に記載のインプラント。
- 前記アンカー要素(7b)が、各々、前記保持リング(4)において2つの接続ウェブ(2)の間に配置されていることを特徴とする、請求項1〜12のいずれか一項に記載のインプラント。
- 前記アンカー要素(7b)に丸い端部(12)が設けられていることを特徴とする、請求項1〜13のいずれか一項に記載のインプラント。
- 前記アンカー要素(7b)が、前記ケージ構造体(10)に対して遠位側に配置され、前記ケージ構造体(10)を越えて横方向に突出し、保持チューブ(14)を介して前記保持リング(4)に接続されていることを特徴とする、請求項1に記載のインプラント。
- 隣接するアンカー要素(7b)が互いに対で接続されていることを特徴とする、請求項15に記載のインプラント。
- 前記アンカー要素(7b)の前記先端が、内側に曲げられて前記ケージ構造体(10)に向いていることを特徴とする、請求項13〜16のいずれか一項に記載のインプラント。
- 保持リング(4)、ケージ構造体(10)およびアンカー要素(7a、7b)が、形状記憶金属から構成されていることを特徴とする、請求項1〜17のいずれか一項に記載のインプラント。
- 前記形状記憶金属がニッケル−チタン合金であることを特徴とする、請求項13に記載のインプラント。
- レーザ切断によりチューブから製造され、その拡張形状が、熱成形法を採用することによってもたされることを特徴とする、請求項13または14に記載のインプラント。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102013019890.9 | 2013-11-28 | ||
DE102013019890.9A DE102013019890A1 (de) | 2013-11-28 | 2013-11-28 | Medizinisches Implantat |
PCT/EP2014/075942 WO2015079023A1 (de) | 2013-11-28 | 2014-11-28 | Medizinisches implantat |
Publications (3)
Publication Number | Publication Date |
---|---|
JP2017503538A true JP2017503538A (ja) | 2017-02-02 |
JP2017503538A5 JP2017503538A5 (ja) | 2018-01-11 |
JP6527514B2 JP6527514B2 (ja) | 2019-06-05 |
Family
ID=52232137
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2016534927A Active JP6527514B2 (ja) | 2013-11-28 | 2014-11-28 | 医療用インプラント |
Country Status (10)
Country | Link |
---|---|
US (1) | US10034786B2 (ja) |
EP (1) | EP3073936B1 (ja) |
JP (1) | JP6527514B2 (ja) |
CN (1) | CN106163425B (ja) |
BR (1) | BR112016012108B1 (ja) |
DE (1) | DE102013019890A1 (ja) |
ES (1) | ES2958514T3 (ja) |
PL (1) | PL3073936T3 (ja) |
RU (1) | RU2688695C1 (ja) |
WO (1) | WO2015079023A1 (ja) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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CN110831520A (zh) * | 2017-04-27 | 2020-02-21 | 波士顿科学国际有限公司 | 具有织物保持倒钩的闭塞医疗装置 |
Families Citing this family (12)
Publication number | Priority date | Publication date | Assignee | Title |
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CN106923884B (zh) * | 2015-12-31 | 2018-12-21 | 先健科技(深圳)有限公司 | 左心耳封堵器 |
CN106923886B (zh) * | 2015-12-31 | 2022-04-22 | 先健科技(深圳)有限公司 | 左心耳封堵器 |
CN106923883B (zh) * | 2015-12-31 | 2019-09-03 | 先健科技(深圳)有限公司 | 左心耳封堵器 |
EP3403596A1 (de) | 2017-05-16 | 2018-11-21 | Universitätsklinikum Jena | Implantations- und verankerungssystem für einen vorhofohrokkluder |
US11173023B2 (en) * | 2017-10-16 | 2021-11-16 | W. L. Gore & Associates, Inc. | Medical devices and anchors therefor |
CN111867490B (zh) * | 2018-02-14 | 2024-01-30 | 波士顿科学医学有限公司 | 闭塞医疗装置 |
DE102019100530B4 (de) | 2019-01-10 | 2021-05-06 | Qatna Medical GmbH | Okkluder und System zur Einführung eines Okkluders |
DE102019100531B4 (de) | 2019-01-10 | 2021-08-19 | Qatna Medical GmbH | Okkludereinführsystem und Einführeinheit |
EP3911277A4 (en) * | 2019-01-14 | 2023-02-22 | Valfix Medical Ltd. | PERCUTANEOUS VALVE IMPLANTS |
WO2020163507A1 (en) * | 2019-02-08 | 2020-08-13 | Conformal Medical, Inc. | Devices and methods for excluding the left atrial appendage |
DE102020101456A1 (de) * | 2020-01-22 | 2021-07-22 | Andramed Gmbh | Valvulotom |
CN111870286A (zh) * | 2020-07-24 | 2020-11-03 | 广东脉搏医疗科技有限公司 | 一种无铆型封堵器 |
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CN106163425A (zh) | 2016-11-23 |
JP6527514B2 (ja) | 2019-06-05 |
ES2958514T3 (es) | 2024-02-09 |
CN106163425B (zh) | 2022-01-07 |
BR112016012108A2 (ja) | 2017-08-08 |
EP3073936A1 (de) | 2016-10-05 |
US10034786B2 (en) | 2018-07-31 |
RU2688695C1 (ru) | 2019-05-22 |
US20170156898A1 (en) | 2017-06-08 |
EP3073936B1 (de) | 2023-07-26 |
BR112016012108B1 (pt) | 2022-03-03 |
PL3073936T3 (pl) | 2024-02-05 |
DE102013019890A1 (de) | 2015-05-28 |
RU2016125511A (ru) | 2018-01-10 |
WO2015079023A1 (de) | 2015-06-04 |
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