JP2020503147A - 動脈瘤治療装置向けの抗血栓性コーティング - Google Patents
動脈瘤治療装置向けの抗血栓性コーティング Download PDFInfo
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- 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
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Abstract
Description
Claims (105)
- 血管管腔の中に挿入して動脈瘤を治療する装置であって、
複数の支柱を含む概して円筒形のメッシュ区画であって、前記支柱が、前記支柱間に間質間隙を形成し、近位面および遠位面を有し、かつ前記近位面から前記遠位面まで軸方向に沿って延びる装置管腔を画定し、前記管腔が前記装置に血流を通すように構成される、メッシュ区画と、
前記近位面の外周から近位尖端まで延びる複数の支柱を含む近位テーパ付き区画と、を備え、
前記近位尖端が、半径方向に前記近位面の外周と整列し、または前記近位面の前記外周の半径方向外側に配置され、
前記近位テーパ付き区画の複数の前記支柱は、前記複数の前記支柱がいずれも前記装置管腔により画定された断面領域を横断しないように、前記近位面の前記外周上の異なる場所から前記近位尖端まで、軸方向および外周方向に延びる、装置。 - 前記概して円筒形のメッシュ区画の複数の支柱が、編み込まれたワイヤから形成される、請求項1に記載の装置。
- 前記近位テーパ付き区画の複数の支柱が、前記概して円筒形のメッシュ区画の編み込まれたワイヤから形成される、請求項2に記載の装置。
- 前記編み込まれたワイヤが、前記近位テーパ付き区画の内部で少なくとも部分的に編み込まれる、請求項2または3に記載の装置。
- 前記複数の支柱の一つまたは複数が、前記近位テーパ付き区画の内部で反転させられ、前記反転した支柱の一つまたは複数が、前記近位のテーパ付き区画の内部で半径方向外向きおよび前記近位尖端に向かって屈曲するように、かつ前記近位尖端が、前記近位面の前記外周の半径方向外側に配置されるようにする、請求項1ないし4のいずれか一項に記載の装置。
- 前記複数の支柱が、前記近位尖端からまたはその近傍から延び、かつ流入する血流と界面をなすように構成された前記近位面の前記外周まで延びる縁部を形成しており、かつ前記縁部が、前記軸方向寸法に平行に前記近位尖端を通って延びる長手方向の軸に対する取り出し角を画定し、前記取り出し角が、約80度以下である、請求項1ないし5のいずれか一項に記載の装置。
- 前記取り出し角が約70度以下である、請求項6に記載の装置。
- 前記取り出し角が少なくとも約30度である、請求項6または7に記載の装置。
- 前記取り出し角が少なくとも約40度である、請求項8に記載の装置。
- 前記装置が、前記近位面の外径により画定される、約0.2以下である断面領域の割合を占める、請求項1ないし9のいずれか一項に記載の装置。
- 前記割合が約0.1以下である、請求項10に記載の装置。
- 前記割合が約0.05以下である、請求項11に記載の装置。
- 前記割合が約0.01以下である、請求項12に記載の装置。
- 前記近位テーパ付き区画の前記複数の支柱および前記概して円筒形のメッシュ区画が、約0.01インチ以下の直径を有する、請求項1ないし13のいずれか一項に記載の装置。
- 前記近位テーパ付き区画の前記複数の支柱および前記概して円筒形のメッシュ区画が、約0.005インチ以下の直径を有する、請求項14に記載の装置。
- 前記概して円筒形のメッシュ区画が、前記動脈瘤に隣接して位置するように構成された中央区画を含み、前記中央区画が、前記概して円筒形のメッシュ区画の残りの少なくとも一部分よりも実質的に高支柱密度を含む、請求項1ないし15のいずれか一項に記載の装置
- 前記中央区画が、拘束のない構成において前記近位面の外径より大きい外径を含む、請求項16に記載の装置。
- 前記高支柱密度が、前記概して円筒形のメッシュ区画の低密度部分におけるよりも小さいピッチの編み込まれたワイヤの結果である、請求項16または17に記載の装置。
- 前記高支柱密度が、前記概して円筒形のメッシュ区画の低密度部分とは異なる織りパターンの結果である、請求項16ないし18のいずれか一項に記載の装置。
- 前記中央区画が、差し渡し約0.01インチ以下の間質間隙を含む、請求項16ないし19のいずれか一項に記載の装置。
- 前記中央区画が、差し渡し約0.008インチ以下の間質間隙を含む、請求項20に記載の装置。
- 前記概して円筒形のメッシュ区画が、前記概して円筒形のメッシュ区画の中央近傍の半径方向外向きの圧縮反力よりも大きい、前記近位面に隣接する半径方向外向きの圧縮反力を与えるように構成される、請求項1ないし21のいずれか一項に記載の装置。
- 前記遠位面の外周から遠位尖端まで延びている複数の支柱を含む遠位テーパ付き区画をさらに含み、
前記遠位尖端が、半径方向に前記遠位面の前記外周と整列し、または前記遠位面の前記外周の半径方向外側に配置され、
前記遠位テーパ付き区画の前記複数の支柱は、前記複数の支柱がいずれも、前記装置管腔により画定された断面領域を横断しないように、前記遠位面の前記周上の異なる場所から前記遠位尖端まで、軸方向および外周方向に延びる、請求項1ないし22のいずか一項に記載の装置。 - 前記遠位テーパ付き部分からの前記複数の支柱が、前記近位尖端から遠位に位置する放射線不透過性のマーカー環を通って延びている、請求項23に記載の装置。
- 前記遠位テーパ付き部分からの前記複数の支柱が、前記遠位尖端に遠位となるようにして平行に整列して、遠位引き出し区分を形成する、請求項23または24に記載の装置。
- 前記遠位引き出し区分の周りに配置された金属性ヘリカルコイルをさらに含む、請求項25に記載の装置。
- 前記金属性ヘリカルコイルが白金またはイリジウムを含む、請求項26に記載の装置。
- 前記遠位面が開口しており、前記軸方向に対して実質的に垂直である、請求項1ないし22のいずれか一項に記載の装置。
- 前記開口した遠位面が、前記概して円筒形のメッシュ区画の内部の前記複数の支柱の内部に、無外傷性屈曲により形成された周縁部を含む、請求項28に記載の装置。
- 前記近位テーパ付き区画の内部の前記複数の支柱が、前記近位面の前記外周の周りに実質的に均一に分配される、請求項1ないし29のいずれか一項に記載の装置。
- 前記近位尖端と共線関係にある押し出しワイヤをさらに含む、請求項1ないし30のいずれか一項に記載の装置。
- 前記近位テーパ付き区画の内部の前記複数の支柱が、前記近位尖端に近位に平行となるようにして整列し、前記複数の支柱の近位端部が、前記押し出しワイヤの遠位端部に接合されており、前記複数の支柱が、前記押し出しワイヤの外周の周りに実質的に均一に分配される、請求項31に記載の装置。
- 前記押し出しワイヤが、前記近位テーパ付き区画に永久に接合される、請求項31ないし32のいずれか一項に記載の装置。
- 前記押し出しワイヤが、前記近位テーパ付き区画に取り外し可能に接合される、請求項31または32に記載の装置。
- 前記押し出しワイヤの前記遠位端部が、テーパ付き部分を含む、請求項31ないし34のいずれか一項に記載の装置。
- 前記押し出しワイヤの前記遠位端部が、前記押し出しワイヤを取り巻く複数のプラスチック環を含み、前記近位テーパ付き区画からの前記複数の支柱の近位端部が前記プラスチック環を取り巻く、請求項22ないし35のいずれか一項に記載の装置。
- 前記複数のプラスチック環が、互いから少なくとも約1cm離れて軸方向に沿って離間している、請求項36に記載の装置。
- 前記近位テーパ付き部分からの前記複数の支柱が、前記近位尖端に近位に位置する放射線不透過性のマーカー環を通って延びている、請求項1ないし37のいずれか一項に記載の装置。
- 前記装置が、収縮した構成および拡張した構成を含み、前記装置が、前記拡張した構成よりも前記収縮した構成において、前記近位尖端から前記装置の遠位端部までのさらに長軸長さ、および装置管腔の小径を有する、請求項1から38のいずれか一項に記載の装置。
- 前記概して円筒形のメッシュ区画の前記複数の支柱、および前記近位テーパ付き区画が、形状記憶材料を含み、前記装置が、記憶された形状として前記拡張した構成を呈するように構成される、請求項39に記載の装置
- 前記装置管腔の少なくとも一部分の周りに配置されたポリマースリーブをさらに含む、請求項1ないし40のいずれか一項に記載の装置。
- 前記スリーブが、前記概して円筒形のメッシュ区画の内径に施される、請求項41に記載の装置。
- 前記スリーブが、前記概して円筒形のメッシュ区画の外径に施される、請求項41または42に記載の装置。
- 前記スリーブが内層および外層を含み、前記概して円筒形の区画の少なくとも一部分が、前記内層と前記外層の間に挟まれている、請求項41ないし43のいずれか一項に記載の装置。
- 前記内層および外層が、前記間質間隙の少なくともいくつかの内部で一体に結合されている、請求項44に記載の装置。
- 前記スリーブが、前記スリーブの近位端部の近傍および前記スリーブの遠位端部の近傍に配置されるが前記スリーブの中央区画の内部には配置されない開口を含む、請求項41ないし45のいずれか一項に記載の装置。
- 前記スリーブがフルオロエラストマーを含む、請求項41ないし46のいずれか一項に記載の装置。
- 前記スリーブが、フッ素化エチレンプロピレン(FEP)、ポリテトラフルオロエチレン(PTFE)、ポリフッ化ビニリデン(PVDF)、またはポリ(塩化ビニリデンコヘキサフルオロプロピレン)(PVDF−HFP)を含む、請求項41ないし47のいずれか一項に記載の装置。
- 前記スリーブがシラスティック(silastic)を含む、請求項41ないし48のいずれか一項に記載の装置。
- 前記スリーブがポリジメチルシロキサン(PDMS)を含む、請求項49に記載の装置。
- 前記スリーブが、A:B:Aトリブロックコポリマーを含み、前記Aブロックが、テトラフルオロエチレン(TFE)、エチレン、およびヘキサフルオロプロピレン(HFP)を含み、前記Bブロックが、フッ化ビニリデン(VDF)、ヘキサフルオロプロピレン(HFP)、およびテトラフルオロエチレン(TFE)を含む、請求項41ないし50のいずれか一項に記載の装置。
- 前記スリーブが、ポリビニルピロリドン(PVP)、ホスホリルコリン(PC)、ポリエチレングリコール(PEG)、セリーン(商標)、PEG化した分子、またはフッ素化した分子で含侵され、またはコーティングされて、抗血栓性の表面を与える、請求項41ないし51のいずれか一項に記載の装置。
- 前記概して円筒形の区画の前記複数の支柱が、コーティング材料でコーティングされている、請求項1ないし52のいずれか一項に記載の装置。
- 前記コーティング材料が、プラズマ堆積させたフッ素、プラズマ堆積させたグライム(glyme)、ホスホリルコリン、ダイヤモンド状炭素、フッ素化したダイヤモンド状炭素、ポリビニルピロリドン(PVP)、フッ素化エチレンプロピレン(FEP)、ポリテトラフルオロエチレン(PTFE)、ポリフッ化ビニリデン(PVDF)、ポリ(フッ化ビニリデンコヘキサフルオロプロピレン)(PVDF−HFP)、フルオロホスファゼン、カルボシキベタイン、スルホベタイン、メタクリル化したカルボキシベタイン、メタクリル化したスルホベタイン、フルオロシラン、ヘパリンまたはヘパリン状分子;ヒルジン;クルクミン;トロンボモジュリン;プロスタサイクリン;DMP728血小板GPIIb/IIIa拮抗薬;キトサン、硫酸化キトサン;ヒアルロン酸;タンタルをドープした酸化チタン;酸窒化物、酸化物層、または炭化ケイ素を含む、請求項53に記載の装置。
- 前記複数の支柱と前記コーティング材料との間にポリn−ブチルメタクリレート(PBMA)、またはポリ(p−キシリレン)ポリマーの下地材層を含む、請求項53または54に記載の装置。
- 前記コーティング材料が、前記間質間隙の少なくとも一部分を完全に覆う、請求項53ないし55のいずれか一項に記載の装置。
- 前記コーティング材料が、前記間質間隙の一部分を覆っており、前記部分は、前記動脈瘤の頚部を前記部分が覆うようにして、動脈瘤に隣接して配置されるように構成される、請求項56に記載の装置。
- 前記コーティング材料が、前記間質間隙の交互の列を覆う、請求項56に記載の装置。
- 前記装置管腔が、内径を有する内面および外径を有する外面を含み、かつ前記コーティングが、前記内面に施された第1のコーティングおよび前記外面に施された第2のコーティングを含み、前記第1および前記第2のコーティングが、明確に異なる生物学的特性を有する、請求項53ないし58のいずれか一項に記載の装置。
- 前記装置が、前記第1のコーティングが、主に血栓形成を低減するように設計され、かつ前記第2のコーティングが、主に内皮化を促進するように設計される、請求項59に記載の装置。
- 前記コーティングが、前記装置管腔と整列した方向に、前記装置の長さに沿って少なくとも一つの生物学的特性に勾配を形成する、請求項53ないし60のいずれか一項に記載の装置。
- 前記勾配が、少なくとも前記近位面から前記概して円筒形のメッシュ区画の前記中央に向かって延び、かつその後、前記概して円筒形のメッシュ区画の前記中央から前記遠位面に向かって反転する、請求項61に記載の装置。
- 前記少なくとも一つの生物学的特性が、内皮化の促進であり、内皮化が、前記近位面および前記遠位面の近傍よりも前記概して円筒形のメッシュ区画の前記中央に向かってさらに促進される、請求項62に記載の装置。
- 前記少なくとも一つの生物学的特性が、血栓形成の低減であり、血栓形成が、前記概して円筒形のメッシュ区画の前記中央よりも前記近位面および前記遠位面に向かってさらに低減される、請求項62に記載の装置。
- 前記少なくとも一つの生物学的特性が、血栓形成の低減および内皮化の促進を含み、内皮化の促進が減少するにつれ前記血栓形成の低減が増加する、請求項62に記載の装置。
- 前記勾配が、前記装置の前記長さに沿って変動する加工条件に従って前記装置の前記表面に前記コーティングを施すことにより形成される、請求項61ないし65のいずれか一項に記載の装置。
- 前記勾配が、前記装置の前記長さに沿って前記コーティングの組成を変動させることにより形成される、請求項61ないし65のいずれか一項に記載の装置。
- 前記編み込まれたワイヤが少なくとも24本のワイヤを含む、請求項2ないし67のいずれか一項に記載の装置。
- 前記編み込まれたワイヤが少なくとも48本のワイヤを含む、請求項68に記載の装置。
- 前記概して円筒形の区画の前記複数の支柱が、ニチノール、DFT(登録商標)、白金、コバルトクロム、ステンレス鋼、フルオロポリマー、ポリエチレン、ポリウレタン、ポリエーテルブロックアミド、または形状記憶ポリマーを含む、請求項1ないし69のいずれか一項に記載の装置。
- 前記概して円筒形の区画の前記複数の支柱が、ポリテトラフルオロエチレン(PTFE)、ポリフッ化ビニリデン(PVDF)、ポリビニリデン−ヘキサフルオロプロピレン(PVDF−HFP)、ペルフルオロプロピレン、オクタフルオロプロパン、パリレンHT(Parylene HT)、パリレンAF−4、パリレンF、パリレンVT−4;1H,1H,2H,2H−ペルフルオロドデシルトリクロロシラン、(トリデカフルオロ−1,1,2,2,テトラヒドロオクチル)シラン、ヘキサデカフルオロデク(hexadecafluordodec)−11−エン−1−イルトリメトキシシラン、またはポリ(p−キシリレン)ポリマーでコーティングされる、請求項70に記載の装置。
- 前記近位尖端が、前記近位面の前記外周の半径方向外側に配置される、請求項1ないし71のいずれか一項に記載の装置。
- 血管管腔の中に挿入して動脈瘤を治療する装置であって、
近位端部および遠位端部であって、前記遠位端部が前記近位端部よりも血管管腔の下流に位置する、近位端部および遠位端部と;
装置表面と;
前記装置表面に施されたコーティングと、を含み、前記コーティングが、前記装置表面上での血栓形成を低減させるように、かつ前記装置表面での内皮化を促進するように設計される、装置。 - 前記装置が前記血管管腔と整列した管腔を形成し、前記管腔が、内径を有する内面および外径を有する外面を含み、かつ前記コーティングが、前記内面に施された第1のコーティングおよび前記外面に施された第2のコーティングを含み、前記第1および第2のコーティングが、明確に異なる生物学的特性を有する、請求項73に記載の装置。
- 前記第1のコーティングが主に血栓形成を低減するように設計され、前記第2のコーティングが主に内皮化を促進するように設計される、請求項74に記載の装置。
- 前記コーティングが、前記管腔と整列した前記装置の長さに沿って、少なくとも一つの生物学的特性に勾配を形成する、請求項71ないし74のいずれか一項に記載の装置。
- 前記勾配が、前記近位端部から前記装置の前記中央に向かって延び、かつその後、前記装置の前記中央から前記遠位端部に向かって反転する、請求項76に記載の装置。
- 前記少なくとも一つの生物学的特性が、内皮化の促進であり、内皮化が、前記近位端部および前記遠位端部よりも前記装置の前記中央に向かってさらに促進される、請求項77に記載の装置。
- 前記少なくとも一つの生物学的特性が、血栓形成の低減であり、血栓形成が、前記装置の前記中央よりも前記近位端部および前記遠位端部に向かって低減される、請求項77に記載の装置。
- 前記少なくとも一つの生物学的特性が、血栓形成の低減および内皮化の促進を含み、前記血栓形成の低減が、前記内皮化の促進が減少するにつれ増加する、請求項77に記載の装置。
- 前記勾配が、前記装置の長さに沿って変動する加工条件に従って前記装置の前記表面に前記コーティングを施すことにより形成される、請求項76ないし80のいずれか一項に記載の装置。
- 前記勾配が、前記装置の前記長さに沿って前記コーティングの組成を変動させることにより形成される、請求項76ないし80のいずれか一項に記載の装置。
- 前記コーティングが、プラズマ堆積させたフッ素、プラズマ堆積させたグライム、ホスホリルコリン、ダイヤモンド状炭素、フッ素化したダイヤモンド状炭素、ポリビニルピロリドン(PVP)、フッ素化したエチレンプロピレン(FEP)、ポリテトラフルオロエチレン(PTFE)、ポリフッ化ビニリデン(PVDF)、ポリ(フッ化ビニリデンコヘキサフルオロプロピレン)(PVDF−HFP)、フルオロホスファゼン、カルボシキベタイン、スルホベタイン、メタクリル化したカルボキシベタイン、メタクリル化したスルホベタイン、フルオロシラン、ヘパリンまたはヘパリン状分子;ヒルジン;クルクミン;トロンボモジュリン;プロスタサイクリン;DMP728血小板GPIIb/IIIa拮抗薬;キトサン、硫酸化キトサン;ヒアルロン酸;タンタルをドープした酸化チタン;酸窒化物、酸化物層、および炭化ケイ素からなる群から選択される少なくとも一つの材料を含む、請求項73ないし82のいずれか一項に記載の装置。
- 前記コーティングが、プラズマ堆積させたフッ素、プラズマ堆積させたグライム、ホスホリルコリン、ダイヤモンド状炭素、フッ素化したダイヤモンド状炭素、ポリビニルピロリドン(PVP)、フッ素化したエチレンプロピレン(FEP)、ポリテトラフルオロエチレン(PTFE)、ポリフッ化ビニリデン(PVDF)、ポリ(フッ化ビニリデンコヘキサフルオロプロピレン)(PVDF−HFP)、フルオロホスファゼン、カルボシキベタイン、スルホベタイン、メタクリル化したカルボキシベタイン、メタクリル化したスルホベタイン、フルオロシラン、ヘパリンまたはヘパリン状分子;ヒルジン;クルクミン;トロンボモジュリン;プロスタサイクリン;DMP728血小板GPIIb/IIIa拮抗薬;キトサン、硫酸化キトサン;ヒアルロン酸;タンタルをドープした酸化チタン;酸窒化物、酸化物層、および炭化ケイ素の群からから選択される少なくとも二つの材料を含む、請求項73ないし83のいずれか一項に記載の装置。
- 血管の管腔内に挿入して動脈瘤を治療する装置であって、
前記血管管腔と整列するように構成された管腔を有する概して円筒形の区画、および
前記管腔の両端に配置された近位端部および遠位端部、を含み、
前記装置が、編み込まれたワイヤから形成される、装置。 - 前記編み込まれたワイヤが、少なくとも24本のワイヤを含む、請求項85に記載の装置。
- 前記編み込まれたワイヤが、少なくとも48本のワイヤを含む、請求項85または86に記載の装置。
- 前記編み込まれたワイヤが、前記装置の前記中央に向かって前記装置の高密度部分を形成して動脈瘤と界面をなすように織り込まれる、請求項85ないし87のいずれか一項に記載の任意の装置。
- 前記装置の高密度部分が、差し渡し約0.01インチ以下の、前記ワイヤ間の間隙を有する、請求項87の装置。
- 前記装置の高密度部分が、差し渡し約0.008インチ以下の、前記ワイヤ間の間隙を有する、請求項89の装置。
- 前記ワイヤが、前記近位端部および前記遠位端部において前記装置の低密度部分を形成するように配置される、請求項85から89のいずれか一項に記載の任意の装置。
- 前記低密度部分が、前記管腔の近似的に中心において整列した尖端を有する円錐として形成される、請求項91に記載の装置。
- 前記低密度部分が、前記管腔の前記外周に沿って整列した尖端と一体になる前記円筒形区画の前記ワイヤの漸減として形成され、前記近位端部の前記尖端が、外周方向に前記遠位端部の前記尖端と整列した、請求項91に記載の装置。
- ニチノール、DFT(登録商標)、白金、コバルトクロム、ステンレス鋼、フルオロポリマー類、ポリエチレン、ポリウレタン、ポリエーテルブロックアミド類、ポリテトラフルオロエチレン(PTFE)、および形状記憶ポリマー類からなる群から選択された少なくとも一つの材料から形成されたワイヤを含む、請求項85ないし93のいずれか一項に記載の装置。
- 前記装置に、ポリ(p−キシリレン)ポリマー類、ポリフッ化ビニリデン(PVDF)、ポリビニリデン−ヘキサフルオロプロピレン(PVDF−HFP)、ペルフルオロプロピレン、オクタフルオロプロパン、パリレンHT、パリレンAF−4、パリレンF、パリレンVT−4;1H,1H,2H,2H−ペルフルオロドデシルトリクロロシラン、(トリデカフルオロ−1、1、2、2、テトラヒドロオクチル)シラン;またはヘキサデカフルオロドデク−11−エン−1−イルトリメトキシシランを少なくとも部分的にコーティングした、請求項85ないし94のいずれか一項に記載の装置。
- 血管内部の動脈瘤を治療する方法であって、
前記血管中に動脈瘤治療装置を挿入することを含み、
前記装置が、
複数の支柱を含む概して円筒形のメッシュ区画であって、前記支柱が、前記支柱間に間質間隙を形成し、近位面および遠位面を有し、かつ前記近位面から前記遠位面まで軸方向に沿って延びる装置管腔を画定し、前記管腔が前記装置に血流を通すように構成される、メッシュ区画と、
前記概して円筒形のメッシュ区画を押し出しワイヤに接合する近位テーパ付き区画と、を含む、方法。 - 前記概して円筒形のメッシュ区画が、前記概して円筒形のメッシュ区画の残りよりも高い支柱密度を有する中央区画を含み、前記方法が、前記動脈瘤の頚部を前記中央区画が実質的に覆うようにして、前記中央区画を前記動脈瘤に隣接させて配置することをさらに含む、請求項96に記載の方法。
- 前記概して円筒形のメッシュ区画が、その長さの少なくとも一部分に沿ってチューブ状のスリーブを含み、前記方法が、前記動脈瘤の頚部を前記中央区画が実質的に覆うようにして、前記チューブ状のスリーブを前記動脈瘤に隣接させて配置することをさらに含む、請求項96または97に記載の方法。
- 前記動脈瘤の中に、または隣接させてマイクロカテーテルを挿入すること、および複数の動脈瘤充填用コイルを前記動脈瘤中に送達することをさらに含む、請求項96ないし98のいずれか一項に記載の方法。
- 前記マイクロカテーテルが、前記血管の壁と前記動脈瘤治療装置との間に挿入される、請求項99に記載の方法。
- 前記マイクロカテーテルが、前記装置管腔の内部に、かつ前記概して円筒形のメッシュ区画の前記間質間隙の一つを通して挿入される、請求項99に記載の方法。
- 前記複数の動脈瘤充填用コイルを送達した後に前記押し出しワイヤを近位に退縮させることにより前記動脈瘤治療装置を除去することをさらに含む、請求項99ないし101のいずれか一項に記載の方法。
- 前記動脈瘤治療装置を永久ステントに置き換えることをさらに含む、請求項102に記載の方法。
- 前記押し出しワイヤの少なくとも一部分を前記装置の残りから取り外し、前記動脈瘤に隣接して永久に配置された前記概して円筒形のメッシュ区画を残すことをさらに含む、請求項99ないし101のいずれか一項に記載の方法。
- 前記近位テーパ付き区画が、前記近位面の外周から近位尖端まで延びる複数の支柱を含み、前記近位尖端は、半径方向に前記近位面の前記外周と整列し、または前記近位面の前記外周の半径方向外側に配置されており、前記近位テーパ付き区画の複数の支柱は、前記複数の支柱がいずれも、前記装置管腔により画定された断面領域を横断しないように、前記近位面の外周上の異なる場所から軸方向および周方向に、前記近位尖端まで延びる、請求項96ないし104のいずれか一項に記載の方法。
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US20200323535A1 (en) | 2020-10-15 |
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CN110381855A (zh) | 2019-10-25 |
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WO2018129194A1 (en) | 2018-07-12 |
EP3565511A4 (en) | 2021-02-17 |
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