JP2017521136A - 血管を再成形するためのデバイスおよび方法 - Google Patents
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Abstract
Description
本願は、2014年6月8日に出願された仮出願第62/009,267号(代理人管理番号48624−703.101)の利益を主張し、この出願の全開示が、参照により、本明細書に援用される。
1.発明の分野
本発明は、生物学的脈管を処置するためのシステムおよび方法に関し、より具体的には、周囲の血圧の増加に応答した血流の低減が流動調整を調整することを可能にするために、静脈を再成形しかつそれらの静脈の生体力学を修正するためのシステムおよび方法に関する。
EDを処置するため、ならびに静脈および動脈を通る血流を調整するための方法およびデバイスは、米国特許公開第2005/0277907号、第2011/0066254号、および第2011/007458号、ならびに米国特許第8,240,313号に説明されている。また、Rao and Donatucci(2001)Urologic Clinics28:309−319も参照されたい。
本発明は、患者の血管系を通る(具体的には、静脈を通る)血流を阻害するためだけではなく、動脈流における使用も見出すための方法およびデバイスを提供する。本方法は、インプラントの対向端部上のアンカが脈管の壁をともに引き寄せるように血管の壁を通したインプラントの設置に依拠し、この引き寄せが、血管管腔の形状を形作り直すかまたは構成し直す。多くの場合、再成形された管腔は、本来の管腔より楕円形となる。他の事例では、新しい形状は、8の字または蝶ネクタイに類似する。さらに他の実施形態では、管腔の片側は、必ずしも形状を変化させることなく、略円形のままであり得るように、脈管管腔の面積を減少させるように閉鎖されることが可能である。
Claims (22)
- 静脈を通る血流を阻害するための方法であって、前記方法は、
前記静脈の壁内の近位場所を通して内向きに、および前記静脈の前記壁内の遠位場所を通して外向きに、インプラントを穿通させることと、
前記遠位場所に隣接する前記壁の外部表面上に前記インプラントの遠位端部を係留することと、
前記近位場所に隣接する前記壁の前記外部表面上に前記インプラントの近位端部を係留することと
を含み、
前記インプラントの係留された端部は、第1の場所と第2の場所との間の前記静脈の管腔を形作り直すことにより、血流を阻害する、方法。 - 穿通させることは、前記壁上の近位場所および遠位場所を通してカニューレを前進させることを含み、前記インプラントは、前記カニューレ上の遠位領域にわたって担持される、請求項1に記載の方法。
- 前記インプラントは、カニューレの遠位領域にわたってコイル状にされた細長部材を備える、請求項1に記載の方法。
- 前記インプラントの前記遠位端部を係留することは、前記遠位端部が前記遠位場所に隣接する前記壁の前記外部表面にわたって位置付けられた後、前記遠位端部を解放することを含む、請求項1に記載の方法。
- 前記インプラントの前記近位端部を係留することは、前記遠位端部が解放された後、かつ前記近位端部が前記遠位端部から事前に選択された距離に位置付けられた後、前記近位端部を解放することを含む、請求項4に記載の方法。
- 前記インプラント前記近位端部を係留することは、前記近位端部が前記近位場所に隣接する前記壁の前記外部表面にわたって位置付けられた後、前記近位端部を解放することを含む、請求項5に記載の方法。
- 前記インプラントの前記遠位端部を係留することは、前記近位端部が解放された後、かつ、前記近位端部から事前に選択された距離に前記遠位端部が位置付けられた後、前記遠位端部を解放することを含む、請求項1に記載の方法。
- 穿通させることは、前記壁上の前記近位場所および前記遠位場所を通してカニューレを前進させることを含み、前記インプラントは、前記カニューレの内部に拘束される、請求項7に記載の方法。
- 前記インプラントは、遠位アンカになるように事前に成形された遠位端部と近位アンカになるように事前に成形された近位端部とを有する細長部材を備え、前記細長部材は、前記カニューレの内部に拘束されると、直線化された構成となる、請求項1に記載の方法。
- 前記細長部材の前記遠位端部を係留することは、前記遠位端部が前記遠位場所に隣接する前記壁の前記外部表面にわたってアンカ構成をとるように、前記遠位端部を前記カニューレから前進させることを含む、請求項9に記載の方法。
- 前記細長部材の前記近位端部を係留することは、前記近位端部が前記近位場所に隣接する前記壁の前記外部表面にわたってアンカ構成をとるように、前記近位端部を前記カニューレから解放することを含む、請求項10に記載の方法。
- 前記細長部材の前記遠位端部は、前記カニューレ内でプッシャを前進させることによって前進され、前記細長部材の前記近位端部は、前記カニューレを後退させることによって解放される、請求項11に記載の方法。
- 前記インプラントは、背部静脈において係留されることにより、勃起不全に悩まされている患者を処置する、請求項1に記載の方法。
- 静脈を通る血流を阻害するためのインプラントであって、前記インプラントは、
遠位端部および近位端部を有する弾性細長部材であって、前記遠位端部および近位端部は、各々、拘束されると送達構成をとり、拘束解除されるとアンカ構成をとるように、事前に成形される、弾性細長部材
を備え、
遠位端部および近位端部は、そのアンカ構成にあるとき、前記インプラントが前記静脈の壁の前記外部表面上の各アンカとともに前記静脈内に埋め込まれるときに静脈の対向壁間の距離を制御する中央領域によって分離される、インプラント。 - 前記細長部材は、直線中央領域によって分離されるコイル状遠位端部およびコイル状近位端部を有するワイヤを備える、請求項14に記載のインプラント。
- 前記細長部材は、反れた遠位端部および反れた近位端部を有するワイヤを備える、請求項14に記載のインプラント。
- 前記細長部材は、各端部に調節可能なアンカを有する、請求項14に記載のインプラント。
- 各端部は、拘束から解放されると、広がるように分岐される、請求項14に記載のインプラント。
- 各端部は、各端部に圧潰可能なディスクを有する、請求項14に記載のインプラント。
- インプラント送達システムであって、前記インプラント送達システムは、
請求項1に記載のインプラントと、
静脈の対向壁を穿通し、前記壁を横断して拘束された構成で前記インプラントを担持し、遠位アンカが前記壁上の遠位部位の前記外部表面に対して位置付けられかつ近位アンカが前記壁上の近位部位の前記外部表面に対して位置付けられるように前記インプラントを解放するように構成される、送達カニューレと
を備える、インプラント送達システム。 - 前記カニューレは、内側針および外側マンドレルを備え、前記細長部材の遠位端部は、前記針に取り外し可能に固定され、前記インプラントの近位端部は、第1の方向における前記マンドレルに対する前記針の回転が前記細長部材を前記カニューレにわたってよりきつく巻き付かせかつ反対方向における前記針の回転が前記細長部材を前記カニューレから解放するように前記マンドレルに取り外し可能に固定される、請求項20に記載のインプラント送達システム。
- 前記カニューレは、中空本体と、前記中空本体の管腔内に配置されるプッシャとを備え、前記インプラントは、前記カニューレ本体の前記管腔内に存在するとき、直線構成に拘束され、前記インプラントは、前記管腔内で前記カテーテル本体に対して前記プッシャを前進させることによって、前記カニューレ本体から解放される、請求項21に記載のインプラント送達システム。
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US20190076151A1 (en) | 2019-03-14 |
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