JP2018167039A - ポリマーベースの閉塞デバイス、システムおよび方法 - Google Patents
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Abstract
Description
それでもなお、既存のアプローチは欠点を有している場合がある。例えば、金属コイルはより小規模な利用分野には好適でないかもしれず、X線透過性がなく、罹患組織の最大限の封鎖を達成することは困難である場合が多く、或る種のタイプのエンドリークの閉塞については実績ある技術が存在しない。
Claims (45)
- 第1の形態および第2の形態を有する細長要素を含む閉塞デバイスにおいて、
第1の形態が比較的低い横断輪郭を有し、
第2の形態が不規則変形させられており、
細長要素には、その表面積、表面抗力および/または軸方向輪郭を増大させるための少なくとも1つの修正が含まれ、
細長要素が、第1の形態における第1の体積およびアルギナートの投与後の第2の形態において第1の体積より大きい第2の体積を有する、
ことを特徴とする閉塞デバイス。 - 細長要素の少なくとも一部分が、第2の形態に向かって付勢されている、ことを特徴とする請求項1に記載の閉塞デバイス。
- 細長要素が、第1の形態または第2の形態のいずれに向かっても付勢されておらず、第2の形態が不規則である、ことを特徴とする請求項1に記載の閉塞デバイス。
- 細長要素が管状であり、第1の形態において開いており、第2の形態においては充填材で塞がれている、ことを特徴とする請求項1に記載の閉塞デバイス。
- 充填材がゲルを含む、ことを特徴とする請求項4に記載の閉塞デバイス。
- 充填材が、塞栓剤を含む、ことを特徴とする請求項4に記載の閉塞デバイス。
- 充填材が、別個の閉塞デバイスを構成する、ことを特徴とする請求項4に記載の閉塞デバイス。
- 細長要素がフィラメントを含む、ことを特徴とする請求項1に記載の閉塞デバイス。
- 細長要素が延伸ポリテトラフルオロエチレン(ePTFE)を含む、請求項1に記載の閉塞デバイス。
- 細長要素にはカルシウム含有溶液が吸収させられている、ことを特徴とする請求項1に記載の閉塞デバイス。
- 細長要素にはヒドロゲルが吸収させられている、ことを特徴とする請求項1に記載の閉塞デバイス。
- ヒドロゲルがポリビニルアルコールを含む、ことを特徴とする請求項11に記載の閉塞デバイス。
- 細長要素が生体吸収性ポリマーコーティングを含む、ことを特徴とする請求項1に記載の閉塞デバイス。
- 細長要素が、螺旋形態にある細長要素に接着されたポリマーフィルムを含んでいる、ことを特徴とする請求項1に記載の閉塞デバイス。
- 細長要素が、その上に螺旋状に巻き付けられたポリマーフィラメントを含んでいる、ことを特徴とする請求項1に記載の閉塞デバイス。
- 細長要素が1つ以上のX線不透過性要素またはエコー源性要素を含む、ことを特徴とする請求項1に記載の閉塞デバイス。
- カテーテルのルーメン内に位置設定される細長要素を含む閉塞用システムにおいて、
細長要素はカテーテルのルーメンを通る液圧流が発生した時点で閉塞のための部位まで送達されるように構成されており、
細長要素が多孔質であり、かつ、細長要素には治療用組成物、膨潤性作用物質、生物活性剤、薬剤または化合物のうちの少なくとも1つが吸収させられており、
細長要素には送達に好適な第1の形態と閉塞に好適な第2の形態とが含まれている、ことを特徴とするシステム。 - 細長要素を切断するように適応された切断用要素をさらに含み、切断用要素は、患者から閉塞デバイスを引き抜くことなく切断準備完了状態にリセット可能である、ことを特徴とする請求項17に記載の閉塞システム。
- 細長要素がカテーテルのルーメンを通って送達され、ルーメンには側壁内に第1のアパーチャが含まれており、カッターにはカテーテルの遠位部分と同心の管部分が含まれ、管部分の側壁内に第2のアパーチャが含まれている、ことを特徴とする請求項17に記載の閉塞システム。
- カッターは、偏向された位置へと付勢され得るものの、細長要素に対し遠位方向で力が加えられた場合には非偏向位置をとる、ことを特徴とする請求項17に記載の閉塞システム。
- 延伸ポリテトラフルオロエチレン(ePTFE)で構成された多孔質の細長要素にカルシウム含有溶液を吸収させるステップと、
送達用カテーテルを介して、カルシウムを吸収させた多孔質の細長要素を、標的閉塞部位に送達するステップと、
カルシウムを吸収させた多孔質の細長要素が標的閉塞部位まで完全に送達され、標的閉塞部位により画定される体積内に完全に存在する状態になった後、アルギナート含有溶液を標的閉塞部位に投与するステップと、
を含むことを特徴とする閉塞方法。 - 標的閉塞部位が動脈瘤である、ことを特徴とする請求項21に記載の方法。
- カルシウムを吸収させた多孔質の細長要素が、要素の長さに沿って変動する断面寸法を有する、ことを特徴とする請求項21に記載の方法。
- カルシウムを吸収させた多孔質の細長要素が、要素の長さに沿って変動する弾性係数を有する、ことを特徴とする請求項21に記載の方法。
- カルシウムを吸収させた多孔質の細長要素が、要素の長さに沿って弱体化された領域を有する、ことを特徴とする請求項21に記載の方法。
- カルシウムを吸収させた多孔質の細長要素が、
アルギナート含有溶液の投与前に標的送達部位の体積よりも実質的に少ない第1の体積を占有し、
アルギナート含有溶液の投与後には標的送達部位の体積の80%超である第2の体積を占有する、
ことを特徴とする請求項21に記載の方法。 - 第2の体積が標的送達部位の体積の90%超である、ことを特徴とする請求項28に記載の方法。
- 第2の体積が、標的送達部位の体積に実質的に等しい、ことを特徴とする請求項26に記載の方法。
- スタイレットを用いて細長要素の近位端部に力を加えることによってカルシウムを吸収させた多孔質の細長要素が標的閉塞部位まで送達される、ことを特徴とする請求項21に記載の方法。
- 生理的食塩溶液で細長要素をフラッシングすることによって液圧により、カルシウムを吸収させた多孔質の細長要素が標的閉塞部位まで送達される、ことを特徴とする請求項21に記載の方法。
- 細長要素と物理的に接触している送達用部材に対して力を加えることによって、カルシウムを吸収させた多孔質の細長要素が標的閉塞部位まで送達される、ことを特徴とする請求項21に記載の方法。
- カルシウムを吸収させた多孔質の細長要素の送達に先立ち、送達用カテーテルを介して標的閉塞部位まで第1の細長要素が送達され、第1の細長要素はカルシウムを吸収させた多孔質の細長要素よりも剛性が高い、ことを特徴とする請求項21に記載の方法。
- 第1の細長要素の後端がカルシウムを吸収させた多孔質の細長要素の前端に対し固定的に取付けられている、ことを特徴とする請求項32に記載の方法。
- 別個の細長要素を各々収納する複数のルーメンを含むカテーテルを用いて標的閉塞部位にアクセスするステップと;
複数のルーメンのうちの第1のルーメンを介して標的閉塞部位まで第1の細長要素を送達するステップと;
複数のルーメンのうちの第2のルーメンを介して標的閉塞部位まで第2の細長要素を送達するステップと;
を含む、ことを特徴とする閉塞方法。 - 第1の細長要素が第2の細長要素の長さとは異なる長さを有する、ことを特徴とする請求項34に記載の方法。
- カテーテルが少なくとも6つのルーメンを含む、ことを特徴とする請求項34に記載の方法。
- カテーテルを用いて第2の標的閉塞部位にアクセスするステップと、
複数のルーメンのうちの第3のルーメンを介して第2の標的閉塞部位まで第3の細長要素を送達するステップと、をさらに含む、
ことを特徴とする請求項34に記載の方法。 - 送達ステップには、スタイレットを用いて細長要素の近位端部を駆動するステップが含まれる、ことを特徴とする請求項34に記載の方法。
- 送達ステップには、細長要素に対して液圧力を加えるステップが含まれる、ことを特徴とする請求項34に記載の方法。
- 近位端部、遠位端部および近位端部から遠位端部またはその近くの場所まで延在する送達用ルーメンを含むカテーテルと;
個別の細長要素を各々収納する複数の分配用ルーメンを含むディスペンサーであって、複数の分配用ルーメンの各分配用ルーメンについて、それぞれの分配用ルーメンがカテーテルの送達用ルーメンと流体連通状態となるような形でディスペンサーを位置づけできるように、カテーテルの近位端部との関係において位置づけ可能であるディスペンサーと;
を含む、
ことを特徴とする閉塞用システム。 - 細長要素の各々が異なる長さを有する、ことを特徴とする請求項40に記載のシステム。
- ディスペンサーがさらに、分配用ルーメンの各々について、それぞれの細長要素に付随する長さを標示する視覚的インジケータを含む、ことを特徴とする請求項40に記載のシステム。
- ディスペンサーがさらに、分配用ルーメンの各々について、それぞれの細長要素に付随する体積を標示する視覚的インジケータを含む、ことを特徴とする請求項40に記載のシステム。
- ディスペンサーは、その長手方向軸のまわりでディスペンサーを回転させることによって位置づけ可能である、ことを特徴とする請求項40に記載のシステム。
- 標的閉塞部位まで第1の細長要素を送達するステップであって、第1の細長要素が、複数の分配用ルーメンを含むディスペンサーの第1の分配用ルーメンから送達用カテーテルの送達用ルーメンを介して送達されるステップと;
複数の分配用ルーメンのうちの第2の分配用ルーメンと送達用ルーメンの近位端部とを整列させるようにディスペンサーを位置づけするステップと;
第2の分配用ルーメンから送達用カテーテルの送達用ルーメンを介して標的閉塞部位まで第2の細長要素を送達するステップと、
を含む、ことを特徴とする閉塞方法。
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US13/565,707 US20130035665A1 (en) | 2011-08-05 | 2012-08-02 | Polymer-Based Occlusion Devices, Systems and Methods |
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- 2012-08-03 CA CA2842433A patent/CA2842433C/en not_active Expired - Fee Related
- 2012-08-03 KR KR1020147003854A patent/KR20140147075A/ko not_active Application Discontinuation
- 2012-08-03 AU AU2012294671A patent/AU2012294671A1/en not_active Abandoned
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