JP2017535352A - 血管から閉塞性血餅を除去するための血餅回収デバイス - Google Patents
血管から閉塞性血餅を除去するための血餅回収デバイス Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320725—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
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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
- A61F2/01—Filters implantable into blood vessels
- A61F2/013—Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
- A61B2017/22034—Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2215—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2217—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions single wire changing shape to a gripping configuration
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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
- A61F2/01—Filters implantable into blood vessels
- A61F2002/016—Filters implantable into blood vessels made from wire-like elements
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0073—Quadric-shaped
- A61F2230/008—Quadric-shaped paraboloidal
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0091—Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
Abstract
Description
一事例では、デバイスが少なくとも2つの波パターンを有する。これらの波パターンが互いに重ね合わされ得る。一事例では、第1のパターンが1つの波長および1つの振幅を有し、第2のパターンが、第1のパターンの波長および振幅より大きい1つの波長および1つの振幅を有する。
一実施形態では、拘束構成で、血餅係合区間が実質的に平坦である。
拡張構成で、血餅係合区間が曲線状であってよい。
一実施形態では、拘束構成および拡張構成で、血餅係合区間が実質的に曲線状である。
一事例では、拡張構成で、血餅係合区間が螺旋形態または渦巻き形態である。
一実施形態では、血餅係合要素が概略反対方向を向く2つの表面を有し、一方または両方の表面が拡張配備構成で血餅に係合可能である。
一事例では、デバイスが、近位側区間と、遠位側区間と、近位側区間と遠位側区間との間にある血餅係合区間とを備え、ここでは、近位側区間が血餅係合区間を基準として摺動可能に移動可能である。近位側区間が、カラーなどの摺動可能要素と、カラーから延在する近位側ストラットとを備えることができ、血餅係合区間が近位側シャフトを備え、カラーが近位側シャフトを基準として摺動可能に移動可能である。近位側区間のストラットのうちの少なくともいくつかのストラットが、近位側シャフトを基準としてカラーが近位方向に移動するときに血餅係合区間と近位側ストラットとの間で血餅を少なくとも部分的に捕捉するために遠位方向に延在してよい。
一実施形態では、血餅係合区間が、ストラットおよびクラウンによって画定される複数のセルを備え、ストラットおよび/またはクラウンの少なくとも一部が波状の形態に位置合わせされ、それにより血餅の埋め込みが改善される。
一実施形態では、拡張構成で、デバイスの血餅係合区間の少なくとも一部分が長手方向軸を中心とした概略渦巻きまたは螺旋構成である。血餅係合区間が遠位側管状区間をさらに備えることができる。血餅分断部分(clot fragment portion)が管状区間の遠位端のところに設けられ得る。
本発明は血管から閉塞性血餅を除去するための方法をさらに提供し、この方法が、
長手方向に延在する起伏状形態を有する血餅係合区間を有する血餅回収デバイスを提供するステップであって、このデバイスが拘束送達構成および拡張配備構成を有する、ステップと、
閉塞性血餅の方に向かうように且つ閉塞性血餅を横切るようにマイクロカテーテルを前進させるステップと、
マイクロカテーテルの中にデバイスを装填してデバイスをマイクロカテーテルの遠位側部分まで前進させるステップと、
血餅を埋め込ませるためにデバイスを配備するステップと、
デバイスの少なくとも一部分および捕捉された血餅を回収カテーテルの中に回収するステップと、
を含む。
いくつかの事例では、この方法が、血餅と血餅を囲む血管壁の一部分との間にデバイスの一部分を配備することを含む。
この方法が、デバイスおよび血餅を近位側に引っ張る前に血餅内にさらに埋め込ませるために、配備後にデバイスを近位側に引っ張るのを遅延させることを含むことができる。
いくつかの事例では、この方法が血餅の中にデバイスを埋め込むためにデバイスを捻じることを含む。
一事例では、拡張構成で、血餅係合区間が曲線状である。
別の事例では、拡張構成で、血餅係合区間が実質的に平坦である。
一事例では、拡張構成で、血餅係合区間が螺旋形態または渦巻き形態である。
別の事例では、拡張構成で、血餅係合区間が概略s形である。
一事例では、デバイスが、デバイスが拡張配備構成にあるときに血液の流れのための流れチャンネルを画定する部分を備える。
一事例では、デバイスが、重ね合わされ得る少なくとも2つの波パターンを有する。第1のパターンが1つの波長および1つの振幅を有し、第2のパターンが、第1のパターンの波長および振幅より大きい1つの波長および1つの振幅を有する。
一事例では、血餅係合要素が1つまたは複数の血餅握持特徴部分を備える。
一事例では、デバイスが、Nitinolなどの形状記憶材料の平坦シートから形成される。
本発明の血餅回収デバイスを提供することと、
マイクロカテーテルの中にデバイスを装填することであって、ここでは、デバイスが拘束送達構成である、ことと、
マイクロカテーテルを閉塞性血餅まで前進させることと、
血餅を捕捉するためにデバイスを配備することと、
捕捉された血餅と共にデバイスを回収カテーテルの中に回収することと
を含む。
デバイス700が、近位側細長部材(図示せず)に接続され得る近位側ストラット706および707を備える。これらの近位側ストラットが遠位側においてストラットの要素のネットワークに接続され、このネットワークが、側方レール701および702と、フローティングセル705と、接続アーム703とを備える。
Claims (38)
- 血管から閉塞性血餅を除去するための血餅回収デバイスであって、拘束送達構成および拡張配備構成を有する血餅係合要素を備え、前記血餅係合要素が、第1の周囲部分と、第2の周囲部分と、前記第1の周囲部分と第2の周囲部分との間を延在する血餅係合区間とを有し、前記拡張構成では、前記周囲部分が横方向に離間され、前記血餅係合区間が前記周囲部分の間を延在し、前記デバイスの少なくとも一部分が長手方向に延在する起伏状縁部を有する、血餅回収デバイス。
- 前記起伏状縁部が波状の形態を有する、請求項1に記載の血餅回収デバイス。
- 前記起伏状縁部が正弦波の形態を有する、請求項1または2に記載の血餅回収デバイス。
- 少なくとも2つの波パターンを有する、請求項1から3までのいずれか一項に記載の血餅回収デバイス。
- 前記波パターンが互いに重ね合わされる、請求項4に記載の血餅回収デバイス。
- 第1のパターンが1つの波長および1つの振幅を有し、第2のパターンが、前記第1のパターンの波長および振幅より大きい1つの波長および1つの振幅を有する、請求項4または5に記載の血餅回収デバイス。
- 前記波形状を修正するためのアクチベータを備える、請求項2から6までのいずれか一項に記載の血餅回収デバイス。
- 前記アクチベータが少なくとも1つのプッシュワイヤおよび/または少なくとも1つのプルワイヤを備える、請求項7に記載の血餅回収デバイス。
- 前記血餅係合要素が1つまたは複数の血餅握持特徴部分を備える、請求項1から8までのいずれか一項に記載の血餅回収デバイス。
- 前記拘束構成で、前記血餅回収区間が実質的に平坦である、請求項1から9までのいずれか一項に記載の血餅回収デバイス。
- 前記拡張構成で、前記血餅係合区間が曲線状である、請求項10に記載の血餅回収デバイス。
- 前記拡張構成で、前記血餅係合区間が実質的に平坦である、請求項10に記載の血餅回収デバイス。
- 前記拘束構成および前記拡張構成で、前記血餅係合区間が実質的に曲線状である、請求項1から9までのいずれか一項に記載の血餅回収デバイス。
- 前記拡張構成で、前記血餅係合区間が螺旋形態または渦巻き形態である、請求項11または13に記載の血餅回収デバイス。
- 前記拡張構成で、前記血餅係合区間が概略S形である、請求項11または13に記載の血餅回収デバイス。
- 前記血餅係合要素が概略反対方向を向く2つの表面を有し、一方または両方の表面が前記拡張配備構成で血餅に係合可能である、請求項1から15までのいずれか一項に記載の血餅回収デバイス。
- 前記拡張配備構成にあるときに血液の流れのための流れチャンネルを画定する部分を備える、請求項1から16までのいずれか一項に記載の血餅回収デバイス。
- 近位側区間と、遠位側区間と、前記近位側区間と前記遠位側区間との間にある血餅係合区間とを備え、前記近位側区間が前記血餅係合区間を基準として摺動可能に移動可能である、請求項1から9までのいずれか一項に記載の血餅回収デバイス。
- 前記近位側区間が、カラーと、前記カラーから延在する近位側ストラットとを備え、前記血餅係合区間が近位側シャフトを備え、前記カラーが前記近位側シャフトを基準として摺動可能に移動可能である、請求項18に記載の血餅回収デバイス。
- 前記近位側区間の前記ストラットのうちの少なくともいくつかのストラットが、前記近位側シャフトを基準として前記カラーが近位方向に移動するときに前記血餅係合区間と前記近位側ストラットとの間で血餅を少なくとも部分的に捕捉するための遠位方向に延在する、請求項19に記載の血餅回収デバイス。
- 前記波パターンが2.0mmから6.0mmの振幅を有する、請求項2または3に記載の血餅回収デバイス。
- 前記波パターンが3.0mmから8.0mmのピッチを有する、請求項2、3または21に記載の血餅回収デバイス。
- 前記血餅係合区間が、ストラットおよびクラウンによって画定される複数のセルを備え、前記ストラットおよび/または前記クラウンの少なくとも一部が前記波状の形態に位置合わせされ、それにより血餅の埋め込みが改善される、請求項2から22までのいずれか一項に記載の血餅回収デバイス。
- 前記デバイスの前記血餅係合区間が平坦区間および曲線状区間の両方を有する横断面を有する、請求項1から23までのいずれか一項に記載の血餅回収デバイス。
- 前記拡張構成で、前記デバイスの前記血餅係合区間の少なくとも一部分が長手方向軸を中心とした概略渦巻きまたは螺旋構成である、請求項1から24までのいずれか一項に記載の血餅回収デバイス。
- 前記血餅係合区間が遠位側管状区間をさらに備える、請求項25に記載の血餅回収デバイス。
- 前記管状区間の遠位端のところに血餅分断部分を有する、請求項26に記載の血餅回収デバイス。
- 前記血餅係合区間が、セル要素から形成される一対の側方レールを備え、前記一対の側方レールに対して複数の血餅係合ストラット要素が接続され、前記セル要素が、前記側方レールによって画定される平面の両側から突出する、請求項1から9までのいずれか一項に記載の血餅回収デバイス。
- 前記血餅係合区間が複数のセグメントを備え、隣接するセグメントが互いに約90°のところで位置合わせされる、請求項1から9までのいずれか一項に記載の血餅回収デバイス。
- 前記セグメントの少なくともいくつかのセグメントが横断面において平坦形状である、請求項29に記載の血餅回収デバイス。
- 遠位側血餅断片保護区間を備える、請求項1から30までのいずれか一項に記載の血餅回収デバイス。
- 血管から閉塞性血餅を除去するための方法であって、
長手方向に延在する起伏状形態を有する血餅係合区間を有する血餅回収デバイスを提供するステップであって、前記デバイスが拘束送達構成および拡張配備構成を有する、ステップと、
閉塞性血餅の方に向かうようにおよび閉塞性血餅を横切るようにマイクロカテーテルを前進させるステップと、
前記マイクロカテーテルの中に前記デバイスを装填して前記デバイスを前記マイクロカテーテルの遠位側部分まで前進させるステップと、
前記血餅を埋め込むために前記デバイスを配備するステップと、
前記デバイスの少なくとも一部分および前記捕捉された血餅を回収カテーテルの中に回収するステップと
を含む、方法。 - 前記血餅の中に前記デバイスを配備するステップを含む、請求項32に記載の方法。
- 前記血餅と前記血餅を囲む血管壁の一部分との間に前記デバイスの一部分を配備するステップを含む、請求項32または33に記載の方法。
- 前記血餅の中に前記デバイスを配置した後で前記デバイスを近位側に引っ張るステップを含む、請求項33または34に記載の方法。
- 前記デバイスおよび前記血餅を近位側に引っ張る前に前記血餅内にさらに埋め込ませるために、配備後に前記デバイスを近位側に引っ張るのを遅延させるステップを含む、請求項35に記載の方法。
- 回収カテーテルの中に回収する前に前記デバイスをより大きい脈管の中へ引っ張るステップを含む、請求項35または36に記載の方法。
- 前記血餅の中に前記デバイスを埋め込むために前記デバイスを捻じるステップを含む、請求項32から37までのいずれか一項に記載の方法。
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CN106999196A (zh) | 2017-08-01 |
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US20230320739A1 (en) | 2023-10-12 |
CN106999196B (zh) | 2020-07-28 |
ES2920773T3 (es) | 2022-08-09 |
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