JP2019515748A - 内頚動脈血栓摘出デバイスおよび方法 - Google Patents
内頚動脈血栓摘出デバイスおよび方法 Download PDFInfo
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Abstract
Description
本出願は、「System and Method for Interventional Cardiac Device」という名称の2016年5月6日出願の米国仮特許出願第62/332,495号の利益を主張する。
Claims (32)
- 少なくとも90センチメートルの作業区間長さ、近位端部、および遠位端部を有する細長いシースと、
前記シースの前記近位端部に位置するアクセスポートと、
前記シースの前記遠位端部に位置する遠位ポートと、
前記シースを通って前記アクセスポートと前記遠位ポートとの間に延びる作業ルーメンと、
前記シースの前記遠位端部に位置する膨張可能なバルーンと、
前記シースの前記近位端部に位置する膨張ポートと、
前記シース内で前記膨張ポートと前記バルーンとの間に延びる膨張ルーメンとを備え、
前記シースは、動脈切開部を通じて患者の血管構造内へ前記シースの前記作業長さを直接挿入して前記バルーンを標的部位に位置決めすることを可能にするように構成される、
バルーン案内シース。 - 前記シースの外径は、約0.104から0.124インチである、請求項1に記載のバルーン案内シース。
- 前記作業ルーメンの内径は、約0.087から0.113インチである、請求項2に記載のバルーン案内シース。
- 前記シースの外径は、その作業長さに沿って概して一定である、請求項3に記載のバルーン案内シース。
- 前記シースは、前記遠位端部に凹部を含み、
前記バルーンは、前記バルーンが非膨張状態にあるとき、実質上前記凹部内に位置する、
請求項4に記載のバルーン案内シース。 - 前記シースの作業長さは、前記遠位端部が大腿動脈切開部から患者の内頚動脈に到達することを可能にするのに十分なほど長い、請求項5に記載のバルーン案内シース。
- 請求項6に記載のバルーン案内シースを使用する方法であって、
前記患者の大腿動脈における動脈切開部を通じて前記バルーン案内シースを患者の血管構造内へ直接挿入することと、
前記患者の血管構造を通して前記バルーン案内シースを前進させ、前記患者の内頚動脈内に前記遠位端部を位置決めすることと、
前記バルーンを膨張させることと、
前記アクセスポートに比較的低い圧力を加えて塞栓を吸引することと、
前記バルーンを収縮させることと、
前記大腿動脈における前記動脈切開部を通じて前記バルーン案内シースを抜き取ることと、を含む方法。 - 請求項6に記載のバルーン案内シースを使用する方法であって、
前記患者の大腿動脈における動脈切開部を通じて前記バルーン案内シースを患者の血管構造内へ直接挿入することと、
前記患者の血管構造を通して前記バルーン案内シースを前進させ、前記患者の内頚動脈内に前記遠位端部を位置決めすることと、
前記バルーンを膨張させることと、
前記患者の内頚動脈内に前記遠位端部を位置決めした後、前記アクセスポートを通して前記バルーン案内シース内へツールを挿入することと、
前記バルーン案内シースを通して前記遠位ポートの外であって前記患者の頚動脈内へ前記ツールを前進させることと、
前記ツールを作動させて塞栓を回収することと、
前記ツールを前記バルーン案内シースから抜き取ることと、
前記バルーンを収縮させることと、
前記大腿動脈における前記動脈切開部を通じて前記バルーン案内シースを抜き取ることと、を含む方法。 - 前記バルーン案内シース内へ前記ツールを挿入することは、遠位端部を有する中間アクセス吸引カテーテルを挿入し、前記患者の内部冠状動脈の錐体部、海綿状部、または大脳部内に前記遠位端部を位置決めすることと、
前記中間アクセス吸引カテーテルに比較的低い圧力を加えて前記塞栓を吸引することと
を含む、請求項8に記載の方法。 - 前記中間アクセス吸引カテーテルを挿入することは、先細りした先端部を有するカテーテルを挿入することを含む、請求項9に記載の方法。
- 中間アクセス吸引カテーテルを挿入することは、外径約7から9Frのカテーテルを挿入することを含む、請求項9に記載の方法。
- 中間アクセス吸引カテーテルを挿入することは、外径約8Frのカテーテルを挿入することを含む、請求項9に記載の方法。
- ツールを挿入することは、第1の網目密度の近位部分と、前記第1の網目密度より高い第2の網目密度の遠位部分とを有するステントレトリーバを挿入することを含む、請求項8に記載の方法。
- 前記シースは、前記遠位端部に凹部を含み、
前記バルーンは、前記バルーンが非膨張状態にあるとき、実質上前記凹部内に位置する、
請求項1に記載のバルーン案内シース。 - 前記シースの外径は、約0.104から0.120インチである、請求項14に記載のバルーン案内シース。
- 前記作業ルーメンの内径は、約0.087から0.113インチである、請求項15に記載のバルーン案内シース。
- 前記バルーンは、前記遠位ポートを越えて延び、前記バルーンが膨張状態にあるとき、前記遠位ポート内への漏斗形の開口を画定する、請求項16に記載のバルーン案内シース。
- 前記バルーンは、前記遠位ポートを越えて延び、前記バルーンが膨張状態にあるとき、前記遠位ポート内への漏斗形の開口を画定する、請求項1に記載のバルーン案内シース。
- 近位端部、遠位端部、および作業区間長さを有する細長いシースであって、前記作業区間長さが、前記遠位端部が大腿動脈切開部から患者の内頚動脈に到達することを可能にするのに十分なほど長い、細長いシースと、
前記シースの前記近位端部に位置するアクセスポートと、
前記シースの前記遠位端部に位置する遠位ポートと、
前記シースの前記遠位端部に位置する可撓性の先端部であって、前記シースのうち前記先端部と前記アクセスポートとの間の部分より高い可撓性を有する可撓性の先端部と、
前記シースを通って前記アクセスポートと前記遠位ポートとの間に延びる作業ルーメンとを備え、
前記シースは、前記患者の大腿動脈における動脈切開部を通じて患者の血管構造内へ前記シースの前記作業長さを挿入して前記遠位ポートを前記患者の内頚動脈の錐体部、海綿状部、または大脳部内の標的部位に位置決めすることを可能にするのに十分な剛性および先端部可撓性を有するように構成される、
中間アクセス吸引カテーテル。 - 前記シースの外径は、約8Frである、請求項19に記載の中間アクセス吸引カテーテル。
- 前記シースの内径は、約0.080から0.090インチである、請求項20に記載の中間アクセス吸引カテーテル。
- 前記可撓性の先端部は、縮小した外径へ先細りしている、請求項20に記載の中間アクセス吸引カテーテル。
- 前記可撓性の先端部は、前記遠位ポートで約6から7Frの外径へ先細りする、請求項22に記載の中間アクセス吸引カテーテル。
- 前記可撓性の先端部は、縮小した外径へ先細りしている、請求項19に記載の中間アクセス吸引カテーテル。
- 請求項19に記載の中間アクセス吸引カテーテルを使用する方法であって、
前記患者の大腿動脈における動脈切開部を通じて前記中間アクセス吸引カテーテルを患者の血管構造内へ挿入することと、
前記患者の血管構造を通して前記中間アクセス吸引カテーテルを前進させ、前記患者の内頚動脈の錐体部、海綿状部、または大脳部内に前記可撓性の先端部を位置決めすることと、
前記アクセスポートに比較的低い圧力を加えて塞栓を吸引することと、
前記大腿動脈における前記動脈切開部を通じて前記中間アクセス吸引カテーテルを抜き取ることと、を含む方法。 - シース/ガイドツールであって、
近位端部および遠位端部を有する細長い管状部材、
前記近位端部に位置するアクセスポート、
前記遠位端部に位置する遠位ポート、
前記遠位端部に位置する直径方向に拡張可能な先端部、および
前記アクセスポートと前記遠位ポートとの間に延びる内径を有するルーメンを含む
シース/ガイドツールと、
拡張ツールであって、
前記シース/ガイドツールのルーメンの前記内径より小さい外径、近位端部、および遠位端部を有する細長い管状部材、
前記近位端部に位置する膨張ポート、
前記遠位端部に位置する膨張可能なバルーン、ならびに
前記膨張ポートと前記バルーンとの間に延びる膨張ルーメンを含む
拡張ツールと、を備え、
前記拡張ツールは、前記シース/ガイドツール内へ挿入することができ、前記拡張ツールの前記バルーンは、前記シース/ガイドツールの前記拡張可能な先端部に隣接して位置決めされ、前記バルーンは、膨張して前記先端部を拡張させる、
血管内機器セット。 - 前記シース/ガイドツールの前記直径方向に拡張可能な先端部は、凹面形の形状に拡張することができる、請求項26に記載の血管内機器セット。
- 請求項26に記載の血管内機器セットを使用する方法であって、
前記シース/ガイドツールを患者の血管構造内へ挿入することと、
前記患者の血管構造を通して前記シース/ガイドツールを前進させ、前記遠位端部を標的部位に位置決めすることと、
前記拡張ツールを前記シース/ガイドツールの前記アクセスポート内へ挿入することと、
前記シース/ガイドツールを通して前記拡張ツールを前進させ、前記拡張可能な先端部内に前記膨張可能なバルーンを位置決めすることと、
前記バルーンを膨張させて、前記シース/ガイドツールの前記拡張可能な先端部を拡張させ、前記患者の血管構造の壁に係合させることと、
前記バルーンを収縮させ、前記拡張ツールを前記シース/ガイドツールから抜き取ることと、
前記シース/ガイドツールおよび拡張させた先端部を介して前記患者の血管構造内で処置を実行することと、
前記シース/ガイドツールを前記患者の血管構造から抜き取ることと、を含む方法。 - 第1の網目密度を有する近位部分と、第2の網目密度を有し凹面形の遠位部分とを含む直径方向に拡張可能な管状メッシュを備えるステントレトリーバであって、前記第2の網目密度は、前記第1の網目密度より高く、前記ステントレトリーバが直径方向に拡張した状態にあるとき、塞栓を捕らえるのに十分なほど高い、ステントレトリーバ。
- 前記凹面形の遠位部分は、前記ステントレトリーバが拡張状態にあるとき、実質上閉じている、請求項29に記載のステントレトリーバ。
- 第1の網目密度を有し直径方向に拡張可能な近位部材と、
前記近位部材の方へ開いている凹面形の形状を有し第2の網目密度を有する直径方向に拡張可能な遠位部材と、を備えるステントレトリーバであって、前記第2の網目密度は、前記第1の網目密度より高く、前記ステントレトリーバが拡張状態にあるとき、塞栓を捕らえるのに十分なほど高い、
ステントレトリーバ。 - 前記遠位部材は、前記ステントレトリーバが拡張状態にあるとき、実質上閉じている、請求項31に記載のステントレトリーバ。
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