JP2020531152A - 閉塞装置 - Google Patents
閉塞装置 Download PDFInfo
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- JP2020531152A JP2020531152A JP2020511334A JP2020511334A JP2020531152A JP 2020531152 A JP2020531152 A JP 2020531152A JP 2020511334 A JP2020511334 A JP 2020511334A JP 2020511334 A JP2020511334 A JP 2020511334A JP 2020531152 A JP2020531152 A JP 2020531152A
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Abstract
Description
本出願は、2017年8月21日出願の米国仮特許出願第62/547,966号の優先権を主張する。本明細書及び上記で参照した出願で引用する全ての文書及び参考文献を、参照することにより本書に援用する。
系動脈瘤の症状のうちの1つを経験している。
に詰めた後すなわち動脈瘤を満たした後、コイル間には空間が残る。血液循環に起因する継続的な血流力が、コイルの塊を圧縮させるように作用し、動脈瘤頸部に腔を生じさせる。それゆえ、動脈瘤は再疎通し得る。
る。
数の特定の実施形態に限定することを意図するものではない。むしろ、本発明は、本発明の趣旨及び範囲内に入る全ての修正、代替構成、及び等価物を網羅することが意図されている。そのようなものとして、図面は、説明に役立つものであり、限定的なものではない。
には、メッシュのピンチポイントによって、又はピンチポイントを囲むマーカー50、60によって両軸端に画定された、圧縮性メッシュのバスケット形のキャリッジ30がある。
サイズ及び形状に適応するために、キャリッジ30の数(n)並びに各キャリッジ30の長さ(l)及び対応する幅(w)を選択するように、異なる方法で構成され得る。そのようなものとして、別の実施形態では、自由空気中、キャリッジ30は、その長さ(l)がその幅(w)以下であり、且つ展開(圧縮)形状においてその幅(w)がlを上回ったままであるように、設計され得る。
部分である。理論に縛られたくはないが、この折り返されたすなわち二重ワイヤメッシュ材料層40は、動物実験では、装置10の急性血栓形成120の増進に寄与すると考えられている作用機構を誘発する。ワイヤストランドに起因する高表面積を有する二重(dual/double)層40間に少量の血餅を局在化させることは、うっ血80、並びに血栓120の核形成及び安定化を促すと考えられている。展開形状では、折り畳まれた二重層40を有するディスク形の本体20は、非展開の二重層閉塞装置と比較すると、より深さがあり、約15%の幅の変化を生じ、これは、ピンチポイント又はマーカー50、60に圧力が加えられるときの本体の直径の増大につながる。この幅の変化/直径の増大は、動脈瘤70の壁に沿って分配された、突出するメッシュ本体90に血液が圧力を加えるため、展開された装置10の効果的な固定を達成することに寄与する。そのような形態はまた、末梢動脈又は静脈の閉塞のために、装置10の突出する本体90を動脈瘤70の壁又は血管壁に十分に並置させる。動物実験に基づいて、そのようなディスク形の本体20は、十分なメッシュ密度を提供して、急性のうっ血80をもたらす。さらに、展開後のそのような本体形態を分析することに基づいて、ワイヤメッシュ/編組の分布は、比較的均一なままであることが知られている。
態では、各ピンチポイントを取り囲む1つ又は複数のマーカー50、60は、装置10がカテーテル(又はマイクロカテーテル)内に配置される箇所及び装置10がひとたび動脈瘤70又は身体の管腔内で展開されると配置される箇所に関する、X線下での位置基準を提供する。
ンド又は編組を含む又は部分的に含む。
Drive、Billerica、Mass)から入手可能なEPO−TEK(登録商標)353ND−4などの熱硬化性2液型エポキシである。そのような接着剤又はエポキシ材料は、マーカー60の内側にコアワイヤの接合部を封入し、その機械的安定性を高める。
Sci B Polym Phys.著者原稿;PMC 2012 June 15に入手可能を参照)。
はポリマーコーティング又は押出しによって被覆されてもよい。放射線不透過性のワイヤストランド上へのコーティング又は押出しは、X線透視による視覚化を提供するだけでなく、曲げ疲労に対するストランドの抵抗を増加させ、また、ストランドの潤滑性を増加させる可能性がある。一実施形態では、ポリマーコーティング又は押出しは、ヘパリンなどの凝固に抵抗する傾向がある薬剤でコーティング又は処理される。そのような凝固抵抗性コーティングは一般的に知られている。ポリマーコーティング又は押出しは、任意の好適な押出可能なポリマー、又はTeflon(登録商標)若しくはポリウレタンなど薄いコーティングで塗布することができる任意のポリマーとし得る。
びサイズに関係し、また、開口又は細孔の開放状態が送達と展開との間で変化する状況において細孔が開く又は閉じる程度に関連する。一般的に、弾性メッシュ材料の高いメッシュ密度領域は、大まかに言えば約40%以上の金属面積と約60%以下の開口面積とを有する。
Claims (11)
- a. 中央ピンチポイントを含む連続的なメッシュ構造と;
b. 前記中央ピンチポイントから遠位方向に外向きに延在する、ディスク形の弾性メッシュ本体と;
c. 前記中央ピンチポイントから(b)の前記弾性メッシュ本体の対向する側に遠位方向に延在する圧縮性メッシュキャリッジであって、前記圧縮性メッシュキャリッジは前記キャリッジの各端部にピンチポイントを含み、及び前記キャリッジ端部のピンチポイントの一方は(a)の前記中央ピンチポイントである、圧縮性メッシュキャリッジと
を含む、閉塞装置であって、
前記連続的なメッシュ構造は、第1の送達形状及び第2の拡張可能な展開形状を有し、及び前記弾性メッシュ本体の長さ(x)は、自由空気中及び前記展開形状において、前記圧縮性メッシュキャリッジの長さ(y)を上回る、閉塞装置。 - マーカーが、前記連続的なメッシュ構造の少なくとも1つのピンチポイントを取り囲む、請求項1に記載の閉塞装置。
- 前記連続的なメッシュ構造が、展開形状に拡張し、及び身体の管腔又は動脈瘤を満たす、請求項1に記載の閉塞装置。
- 前記連続的なメッシュ構造が、前記閉塞装置の組織一体化及び/又は安定化の向上のために、粗いメッシュ密度を有する、請求項1に記載の閉塞装置。
- 前記閉塞装置の前記弾性メッシュ本体が単一メッシュ層である、請求項1に記載の閉塞装置。
- 前記閉塞装置の前記弾性メッシュ本体が二重メッシュ層である、請求項1に記載の閉塞装置。
- 前記二重メッシュ層が、周方向に折り畳まれた単一メッシュ層を含む、請求項6に記載の閉塞装置。
- 動脈瘤の治療及び/又は改善用のキットであって;
a. 請求項1に記載の閉塞装置と;
b. 前記閉塞装置に対応する送達システム又は切離しシステムと
を含む、キット。 - 前記送達システムが、マイクロカテーテル、カテーテル、ガイドワイヤ、又はプッシャーワイヤである、請求項8に記載のキット。
- 前記切離しシステムが電解切離しシステムである、請求項8に記載のキット。
- 患者の動脈瘤を治療又は改善するための方法であって:
a. 請求項1に記載の閉塞装置を動脈瘤まで送達することと;
b. 前記閉塞装置を前記動脈瘤内で展開し、それにより、前記患者の前記動脈瘤を治療又は改善することと
を含む、方法。
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