JP2018501077A - 塞栓術用マイクロカテーテル及びその使用 - Google Patents
塞栓術用マイクロカテーテル及びその使用 Download PDFInfo
- Publication number
- JP2018501077A JP2018501077A JP2017554657A JP2017554657A JP2018501077A JP 2018501077 A JP2018501077 A JP 2018501077A JP 2017554657 A JP2017554657 A JP 2017554657A JP 2017554657 A JP2017554657 A JP 2017554657A JP 2018501077 A JP2018501077 A JP 2018501077A
- Authority
- JP
- Japan
- Prior art keywords
- infusate
- microcatheter
- tube wall
- flow disruption
- pressure
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
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Abstract
Description
本発明は、本発明のある実施形態において、物質(例えば、塞栓材料及び/又は造影材料をはじめとする注入剤)を、例えば心臓血管系内に位置する、標的身体部分へ送達するためのマイクロカテーテル及び方法、特に塞栓術用マイクロカテーテル、局所塞栓術を実施すること及び注入剤(例えば、造影材料を含む塞栓ビーズ)を送達することにおける塞栓術用マイクロカテーテルの使用に関する。本発明のある実施形態は、(i)標的身体部分に向かう小血管において塞栓材料及び/又は造影材料をはじめとする注入剤を送達すること、並びに(ii)非標的塞栓(造影材料に関連する)を予防しながら、又は最小限に抑えながら、標的身体部分(例えば、癌性)を養う小血管において局所塞栓術を実施し、それにより小血管において塞栓を形成させること、に適用可能である。本発明のある実施形態は、非標的注入剤(例えば、塞栓材料及び/又は造影材料)をろ過するデバイス及び方法にも関する。
> 外径を有する管壁を含み、塞栓術用マイクロカテーテルに沿って延在する単一ルーメンを囲い込み、遠位出口を有する当該ルーメンへ開放されたチップで終結した遠位部分を含む、塞栓術用マイクロカテーテル、例えばマイクロカテーテル70を提供するが、管壁遠位部分が、ルーメンを通して適用可能で、注入液中の注入剤の注入懸濁液を、ルーメンを通してチップへ連続送達する際に、流入した注入剤の逆流の遠位部分の外周での通過を途絶するように構成された、注入剤流れ途絶区分を含むこと、
> 造影技術を利用して標的身体部分及び小血管を位置づけること、
> 小血管への近位入口の直ぐそばにカテーテルを提供するが、カテーテルが小血管へ開放された中空通路を含み、1mm以下の内径を有すること、
> チップ79が標的身体部分から選択された距離になるまで、中空通路を通り小血管内へマイクロカテーテル70を通過させること、
> 圧力供給源75を適用し、それにより注入剤(例えば、塞栓材料及び/又は造影材料)77をリザーバ76から標的身体部分へ送達すること、
> マイクロカテーテルチップ79と標的身体部分の間に注入剤77を蓄積させること、
> 管壁遠位部分78の内側の圧力P(78)を所定の拡張圧力Pdt以上にするようルーメン71を加圧し、それにより小血管を閉塞するまで、又は/及び、選択された圧力差P(S)が管壁遠位部分と標的身体部分の間に生じるまで、注入剤流れ途絶区分80が伸長すること。
Claims (35)
- 標的身体部分に向かう小血管において注入剤を送達するための塞栓術用マイクロカテーテルであって、前記マイクロカテーテルが、
外径を有する管壁によって取り囲まれて両端が開放された単一のルーメンを備え、
前記管壁の近位部分が、圧力供給源及び注入液中の注入剤の注入懸濁液を含有するように構成されたリザーバに連結可能であり、前記管壁の遠位部分がチップで終結し、
前記管壁の遠位部分が、前記ルーメンを介して適用可能で、適用されると、前記リザーバから前記チップまでの前記注入懸濁液の連続送達の間に、隣接する前記管壁遠位部分の外周での流入した前記注入剤の逆流の通過を途絶するように構成された、注入剤流れ途絶区分を備える、塞栓術用マイクロカテーテル。 - 前記流れ途絶区分が、前記流入した前記注入剤の逆流の速度を低減するように、前記流入した前記注入剤の逆流を逸らす又は遮断するように、前記流入した前記注入剤の逆流において乱流もしくは渦を起こすように、又は/及び、周辺の局所圧力を上昇させるように構成される、請求項1に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記注入液の一部を前記逆流と反対に注射することによって前記途絶のために構成され、前記流れ途絶区分が、前記流れ途絶区分の周辺に、又は/及び、前記区分に沿って分布された複数の開口を備え、各前記開口は、前記注入懸濁液の前記注入液の通過を可能にし、前記注入懸濁液の前記注入剤の通過を遮断するような形状又は/及びサイズである、請求項1又は2に記載のマイクロカテーテル。
- 前記開口の少なくとも1つが、前記注入剤の最小径よりも小さな最大断面寸法を有する割れ目の付いたスリットを含む、請求項3に記載のマイクロカテーテル。
- 前記開口の少なくとも1つが、前記注入剤の最小径よりも小さな最大断面寸法を有する細孔を含む、請求項3又は4に記載のマイクロカテーテル。
- 前記最大断面寸法が約30ミクロン以下である、請求項4又は5に記載のマイクロカテーテル。
- 前記細孔が、前記ルーメンの長手方向軸に対して、又は/及び、それに隣接する断面の放射軸に対して角度を持って、溝の端部に位置する、請求項5に記載のマイクロカテーテル。
- 異なる方向に角度を持って位置した少なくとも2つの前記細孔を含むため、前記細孔の第一の1つの直ぐそばの前記注入液の第一流れが、前記細孔の第二の1つの直ぐそばの前記注入液の第二流れと少なくとも部分的に交差する、請求項7に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記管壁遠位部分の他の区分の材料よりも硬質である材料を含む、請求項1〜8のいずれか1項に記載のマイクロカテーテル。
- 前記流れ途絶区分が、金属材料、硬質ポリマー材料、又はそれらの組み合わせで作製される、請求項9に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記流れ途絶区分から外方に分岐し、前記区分の周辺で、又は/及び、前記区分に沿って分布された複数の突出部を含む、請求項1〜10のいずれか1項に記載のマイクロカテーテル。
- 前記突出部が可撓性である、請求項11に記載のマイクロカテーテル。
- 前記流れ途絶区分が、密接に嵌合した外部管内を遠位方向に通過される時、前記突出部が、前記管壁遠位部分に沿って近位方向にまっすぐな形態に曲がるように構成される、請求項11に記載のマイクロカテーテル。
- 前記突出部が、弛緩した構成の時に、前記チップに向かって遠位方向に巻かれている、請求項11に記載のマイクロカテーテル。
- 前記突出部が、ねじ山、プロング、又はバルジの形態である、請求項11に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記管壁遠位部分の他の区分の材料よりも薄い材料を含む、請求項1〜15のいずれか1項に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記管壁遠位部分の他の区分の材料よりも可撓性の材料を含む、請求項1に記載のマイクロカテーテル。
- 前記管壁が前記流れ途絶区分を1つの部材として含み、前記区分と構造的に連続している、単一の一体化された構造物として構成される、請求項1〜17のいずれか1項に記載のマイクロカテーテル。
- 前記管壁の外径が約1mm以下である、請求項1〜18のいずれか1項に記載のマイクロカテーテル。
- 前記管壁が、腹腔動脈又は肝動脈から発生する小血管へ挿入するように構成される、請求項1〜19のいずれか1項に記載のマイクロカテーテル。
- 前記管壁が、腫瘍又は癌性組織である標的身体部分への前記注入剤の前記送達のために構成される、請求項1〜20のいずれか1項に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記標的身体部分から離れて前記管壁遠位部分の前記チップに向かう前記注入剤の流れの際に、遠位近接において乱流を誘発するような形状である、請求項1〜21のいずれか1項に記載のマイクロカテーテル。
- 前記管壁遠位部分のチップが前記流れ途絶区分を含む、請求項1〜22のいずれか1項に記載のマイクロカテーテル。
- 前記流れ途絶区分が、感圧性であり、前記管壁遠位部分の内側の圧力が所定の圧力に等しい場合のみ、前記流入した前記注入剤の逆流を途絶するように構成される、請求項1〜23のいずれか1項に記載のマイクロカテーテル。
- 管壁遠位部分の内側の圧力が前記所定の圧力未満である場合に、前記流れ途絶区分で提供される側部開口を覆うように構成され、及び、前記管壁遠位部分の内側の圧力が前記所定の圧力を超える場合に、前記側部開口を露出するように構成された、弁機構をさらに備える、請求項24に記載のマイクロカテーテル。
- 前記流れ途絶区分の伸長及び縮小の前、間及び後に、前記注入懸濁液を前記リザーバから前記チップまで連続送達する間、前記管壁遠位部分の内側の圧力が前記所定の圧力と等しい場合に、第一の平均径から前記管壁外径よりも大きな第二の平均径へ伸長し、及び、前記管壁遠位部分の内側の前記圧力が前記所定の圧力未満になると再度、前記第一の平均径まで縮小するように構成される、請求項24に記載のマイクロカテーテル。
- 前記管壁が、前記管壁の配置の際に第一の平均周囲圧力を有する前記小血管へ障害なく挿入するようなサイズであり、前記管壁遠位部分の内側の前記圧力が、前記所定の拡張圧力未満で、かつ前記第一の平均周囲圧力を超える、第一の内部圧力である場合に、前記ルーメン及び前記チップを通した前記注入懸濁液の前記送達のために構成され、前記小血管内が前記第一の内部圧力以上である第二の平均周囲圧力まで上昇して、前記チップと前記標的身体部分の間に前記注入懸濁液が蓄積したら、前記管壁遠位部分の内側の前記圧力が、前記所定の拡張圧力以上である第二の内部圧力まで上昇し、それにより前記流れ途絶区分が、前記第二の平均径まで伸長するように、前記流れ途絶区分が構成される、請求項26に記載のマイクロカテーテル。
- 前記第一の内部圧力を超え、かつ前記第二の内部圧力未満である選択された第三の内部圧力の下では、前記流れ途絶区分が、前記第二の平均周囲圧力に対して、収縮期に応答して伸長し、拡張期に応答して縮小するように構成される、請求項27に記載のマイクロカテーテル。
- 前記所定の圧力が50mmHgを超える、請求項24〜28のいずれか1項に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記第一の平均径から、前記標的身体部分と直接血液連通する前記小血管の内径よりも大きな最大平均径まで拡張するように構成される、請求項22〜29のいずれか1項に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記標的身体部分と直接血液連通する前記小血管の内径未満の最大平均径まで拡張するように構成される、請求項22〜29のいずれか1項に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記注入液に対して浸透性で前記注入剤に対して不浸透性である材料を含み、それにより前記流れ途絶区分が前記第二の平均径に伸長すると、前記不浸透性材料が前記注入液の流れを可能にし、前記注入剤の通過及び流れを予防する、請求項22〜29のいずれか1項に記載のマイクロカテーテル。
- 前記流れ途絶区分が、前記流れ途絶区分が少なくとも部分的に伸長された時に前記注入剤の通過を可能にするサイズである少なくとも1つの開口を有するサブ区分を含む、請求項22〜32のいずれか1項に記載のマイクロカテーテル。
- 前記少なくとも1つの開口が、前記流れ途絶区分が前記第一の平均径である時に前記注入剤の流れを封鎖及び予防するように構成される、請求項33に記載のマイクロカテーテル。
- 前記少なくとも1つの開口が、少なくとも部分的に前記管壁の遠位方向に、又は/及び、前記チップに向かって、方向づけられている、請求項33に記載のマイクロカテーテル。
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HK1244458A1 (zh) | 2018-08-10 |
IL253364A0 (en) | 2017-09-28 |
CA2973327C (en) | 2024-05-21 |
IL253364B (en) | 2020-07-30 |
BR112017014786A2 (pt) | 2018-01-23 |
US20190329000A1 (en) | 2019-10-31 |
PL3242608T3 (pl) | 2021-10-04 |
KR102557862B1 (ko) | 2023-07-20 |
US10398875B2 (en) | 2019-09-03 |
JP6719482B2 (ja) | 2020-07-08 |
CN107206207A (zh) | 2017-09-26 |
CA2973327A1 (en) | 2016-07-14 |
KR20170104549A (ko) | 2017-09-15 |
US20170368306A1 (en) | 2017-12-28 |
CN107206207B (zh) | 2021-04-27 |
ES2853581T3 (es) | 2021-09-16 |
BR112017014786B1 (pt) | 2022-07-26 |
EP3242608A1 (en) | 2017-11-15 |
EP3242608B1 (en) | 2020-11-25 |
WO2016110824A1 (en) | 2016-07-14 |
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