JP3535098B2 - 弁修復手術のための経皮濾過カテーテル - Google Patents

弁修復手術のための経皮濾過カテーテル

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Publication number
JP3535098B2
JP3535098B2 JP2000575576A JP2000575576A JP3535098B2 JP 3535098 B2 JP3535098 B2 JP 3535098B2 JP 2000575576 A JP2000575576 A JP 2000575576A JP 2000575576 A JP2000575576 A JP 2000575576A JP 3535098 B2 JP3535098 B2 JP 3535098B2
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JP
Japan
Prior art keywords
catheter
filter
proximal end
lumen
balloon
Prior art date
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Expired - Fee Related
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JP2000575576A
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JP2002527157A (ja
Inventor
ユエ−テー・ジャン
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Edwards Lifesciences Corp
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Edwards Lifesciences Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12136—Balloons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/01—Filters implantable into blood vessels
    • A61F2/013—Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A61B2017/22062—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation to be filled with liquid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A61B2017/22065—Functions of balloons
    • A61B2017/22067—Blocking; Occlusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A61B2017/22065—Functions of balloons
    • A61B2017/22069—Immobilising; Stabilising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • 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
    • A61F2/01—Filters implantable into blood vessels
    • A61F2002/018—Filters implantable into blood vessels made from tubes or sheets of material, e.g. by etching or laser-cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0006—Rounded shapes, e.g. with rounded corners circular
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0067—Three-dimensional shapes conical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0093—Umbrella-shaped, e.g. mushroom-shaped

Description

【発明の詳細な説明】
【０００１】（発明の技術分野） 本発明は一般的には、血管内で血栓物質を捕獲するため
の配置に用いるフィルター装置に関し、さらに詳しく
は、心臓手術の間に大動脈や心臓からの血栓物質を捕捉
するために大動脈内に経皮的に配置するための連結フィ
ルターを有するカテーテルシステムに関する。
【０００２】（発明の背景） 心拍は、冠状動脈バイパス、及び弁修復、中隔欠損修
復、血管粘液腫除去、動脈瘤修復、心筋の穿孔などを含
む他の心血管手術といった病的状態の主な原因となる。
手術後の心拍数の増加と先天的なファクターは歳をとる
につれて、左心室の機能不全、慢性糖尿病、心肺のバイ
パス時間の長時間化、周辺低血圧、以前の心拍の履歴、
双方の頚動脈の疾病を起こす。手術前の血栓症のメカニ
ズムは頭蓋外または頭蓋内の閉塞による大脳への血流の
減少、頚動脈腫瘍プラーク又は動動脈プラークからのア
テローム性動脈硬化片の塞栓、左心室壁塞栓又は大動脈
塞栓及び心臓又は大動脈から空気の十分の除去の塞栓な
どを増加させる。弁修復手術において、重い石灰質の大
動脈又は僧帽弁の操作はその後の塞栓とともに左冠状動
脈又は左心室内のカルシウムを取り除く。アテローム片
は最も頻繁に脳を塞栓するが、秘蔵、腎臓、すい臓、及
び胃腸などの身体の部分にも影響を及ぼす。これらの周
辺器官の塞栓は組織の乏血又は死を引き起こす。
【０００３】さらに、血栓症の他のファクター、例え
ば、胸壁外傷は、心臓手術において循環系の支持及び中
央胸骨切開のための心肺バイパスの使用から病的状態へ
しばしば誘引を引き起こす。拍動−心臓及びポート−ア
クセスアプローチを用いた最小の侵入手法は大動脈閉
塞、心停止薬の投与、左心室の減圧を発展し、最も危険
の少ない方式である冠状動脈の血管移植や他の心臓の処
理を可能にする。
【０００４】それゆえ、心臓手術において大動脈の血栓
及び又は心停止薬の投与を容易にする侵入性が最も低い
装置及び方法が必要とされ、それは患者への周囲の血栓
症の危険性を減少させるための動脈フィルターを備え
る。
【０００５】（発明の要旨） 本発明は、アテローム性破片、脂肪、心筋組織片及び空
気などを含む血栓を捕捉することができる経皮濾過カテ
ーテルを提供する。そのカテーテルはさらに、心臓手術
特に心臓弁修復手術において大動脈血栓及び心停止薬投
与を行うことができる。
【０００６】１実施形態では、カテーテルは、近位端と
遠方端を有する長手部材から構成される。遠方端は、
（１）長手部材により運ばれる内腔と連通したバルーン
オクルダーと、（２）長手部材のバルーンオクルダーの
奥手に設けられた拡張可能フィルターとを有している。
バルーンオクルダーと拡張可能フィルターは、長手部材
の近位端において、独立して操作される。拡張可能フィ
ルターは典型的には、円周の曲げられた近位端前記長手
部材と連続する近位端と放射的に拡張する遠方端を有す
る。
【０００７】他の実施形態では、長手部材は、例えば、
心停止薬液を浸出させるための第２内腔を有する。拡張
可能フィルターは１実施形態として傘フレーム（構造に
ついては、完全に参照することによってこれに編入する
Barbutらの米国特許番号5,769,816とAmbriscoらの米国
特許出願番号09/070,660を参照）を有する伸縮性のフレ
ームと他の実施形態として膨張シール（構造については
Barbutらの米国特許番号5,769,816を参照）で構成され
ている。さらに、実施形態では拡張可能フィルターは長
手部材の近位端において少なくとも引っ張り線によって
操作可能である。
【０００８】本発明は、さらに、心臓手術において血栓
物質を補足するための方法を提供しそれによって、血栓
による神経の合併症から患者を保護する。方法は、近位
端と遠方端、その遠方端に取りつけられたバルーンオク
ルダー、及びそのバリーんオクルダーの奥手に取りつけ
られた拡張可能フィルターを有する長手部材を有する経
皮濾過カテーテルを用いる。大腿部又は上腕部の血管な
どの患者の経皮血管内の内経皮的な切開を通して長手部
材を挿入して進めていく。最小侵入の心臓の処置におい
て経皮濾過カテーテルは皮下的に周辺の血管を通って又
はしばしば患者の肋骨間に配置された最小のアクセスポ
ートを通って大動脈へ進められる。フィルターは拡張
し、周辺器官へ流れる血栓物質を補足するために大動脈
弁の上に位置し拡張する。バルーンオクルダーは、膨張
し心臓と冠状動脈の周辺の血管系から分離を循環する。
第２内腔を有する実施形態では、第２内腔は、（１）心
臓の機能を停止させるために心停止薬液を送り込むた
め、又は、（２）圧力モニターを運ぶために用いられ
る。心臓が停止した後心肺バイパスは循環系をサポート
するために設けられ、冠状動脈移植、心臓弁修復、中隔
欠損修復、血管粘液腫除去、動脈瘤修復、心筋の穿孔な
どのあらゆる心肺手術が実行される。
【０００９】ここで開示された経皮濾過カテーテルを利
用することによる多くの効果が存在することが理解され
るであろう。例えば、カテーテルは、（１）カテーテル
の挿入のための皮下的なアクセスによって、大規模な組
織切開の必要を回避でき、（２）バルーンオクルダーに
よる大動脈の閉塞によって大動脈壁の損傷を最小限にし
従来のクランピングに比較して血栓の除去の危険性が減
少し、（３）心臓手術中の血栓材料を捕捉するフィルタ
ーによって皮下的な患者の血栓症の危険性を減少でき、
（４）心臓機能の停止のために心停止薬液を浸出でき、
（５）最小の心臓侵入処置において肋間の切開を通して
装置を進めてアクセスすることができる。
【００１０】（詳細な説明） ここで開示された装置と方法は、心臓手術の間に血栓の
おそれがあると判断される患者に使用可能であり、これ
によって関連する合併症と病院での滞在期間を短くする
ことができる。図１は、第１実施形態にしたがった経皮
濾過カテーテルを示している。カテーテルは長手部材
１、遠方端２及び近位端３を有している。ゴム状弾性を
有するバルーンで構成されたバルーンオクルダー５が長
手部材１に取りつけられ膨張用内腔６に連通している。
拡張可能なフィルター１０は長手部材１のバルーンオク
ルダーの奥手側に取りつけられ、カテーテルの近位端で
操作機構１２によって操作される。
【００１１】図２は、第２内腔を有する経皮濾過フィル
ターの他の実施形態を示している。カテーテルは、バル
ーンオクルダーを膨張させるためにバルーンオクルダー
５と膨張部７に連通した第２内腔を内腔６に対して付加
的に有している。第２内腔２０はポート２２と連通して
おり心停止薬液を浸出させたり、流体又は気体を吸引し
たり及び/又は圧力モニターを収納したりするために用
いることができる。長手部材１に取りつけられたフィル
ター１０は、伸長フレーム１５を有しカテーテルの近位
端において機構１２によって駆動できる。
【００１２】経皮濾過カテーテルの長さは一般には２０
から９０センチメートル程度であり、好ましくはほぼ５
０センチメートルである。カテーテルの外径はおよそ
０．１から０．４センチメートルであり、好ましくはほ
ぼ０．２センチメートルである。バルーンオクルダーが
膨張したとき１．０から５．０センチメートルの径を有
し、さらに好ましくは２．０から４．０センチメートル
である。フィルターが拡張したとき、一般には１．０か
ら５．０センチメートルの径を有し、さらに好ましくは
２．０から４．０センチメートルである。前述の範囲は
端に典型的な装置の寸法を示す目的のために記述したも
のである。本発明の原理にしたがって構成された実際の
装置の寸法は、それらの基本的原理から離れることのな
い列挙された範囲外で変化する場合もある。
【００１３】この装置の使用方法は図３に開示されてい
る。患者の大腿部に小さい経皮的切開をつけた後、経皮
カテーテルの遠方端をその切開を通して大動脈まで進ま
せる。拡張可能なフィルター１０がその後拡張し、空
気、悪性アテローマ、組織片、脂肪、血栓などを含む心
臓や大動脈からの血栓物質を捕捉する。バルーンオクル
ダー５は連通している膨張内腔６を通して膨張され心肺
をバイパスするために大動脈を閉塞する。心停止薬液を
内腔２０とポート２２を通して心臓に送り込むことによ
って心臓停止が達成される。内腔２０とポート２２は、
圧力モニターを配置したり、心臓及び大動脈から流体、
血液、空気、組織又はプラーク片の吸引にも用いられ
る。外科医はその後様々な心臓手術を進めることができ
る。
【００１４】図４は、経皮濾過カテーテルのための異な
った経皮的侵入個所を示している。カテーテルは一般に
患者の大腿部の血管から侵入される。右の股間３０また
は左の股間３２はカテーテルの長手部材１の挿入のため
の経皮的切開位置として共通し、ここでは左の股間３２
を通して挿入し大動脈に達した状態を示している。しか
し、大腿部の血管がアテローム性動脈硬化のためカテー
テルの操作に適さない患者もいる。変形例として、カテ
ーテルは右の前腕前部の部分３４又は左の前腕前部の部
分３６を通して挿入することもできる。カテーテルの長
手部材１は前腕前部の部分３４を通して右上腕血管と腕
頭動脈を通って進み、大動脈まで進む。大動脈内での最
終的なカテーテルの配置の後、拡張フィルター１０は膨
張し血栓を捕捉し、バルーンオクルダーは膨張して心臓
と冠状動脈を周囲の脈管系から分離する。
【００１５】ここで開示された装置は、特に弁修復手術
に好適に用いられることが理解されるであろう。なぜな
らこれらの手術は大動脈封鎖の場所の血栓物質を発生さ
せるものと認識されるからである。参照することによっ
て編入するMcBrideらのGlenn's Thoracic and Cardiova
scular Surgery, 6th Ed., Vol.II(1986) によれば、中
間胸骨切除はしばしば大動脈弁または大動脈弁を含む弁
の組み合わせの配置のために用いられる切開である。右
心房、下部血管、主血管への静脈カニュレーションの
後、大動脈の動脈カニュレーションは、その内部に開示
された経皮濾過カテーテルを用いた心肺バイパスとして
用いる。カテーテルは、大腿部血管又は上腕血管を経由
して大動脈を進み配置される。バルーンオクルダーまた
は他の不浸透性のダムは分散させ周辺組織から心臓を分
離する。フィルターは、大動脈弁または僧帽弁から固化
したプラークを捕捉するためオクルダーの上流を分散さ
せる。バイパスマシンからの酸素化した血液はオクルダ
ーの下流へカテーテルを通して浸透される。心停止薬液
は大動脈の根上の外圧大動脈弁が手動で閉じる間、大動
脈根又は直接冠動脈の小孔へ投薬される。
【００１６】大動脈弁の修復においては、大動脈は右冠
状静脈の上約１から１．５センチメートルの横方向の切
開を通して開かれる。僧帽弁の修復への標準的なアプロ
ーチは、しばしば血管間の溝と平行な切開を通って左心
房に入る。左心室の明視化のために重い石灰質又は繊維
室の弁を十分に切除した後、脱石灰の間環からの小片で
あるカルシウムを絡めとるためにスポンジがこの脈管に
しばしば配置される。左心房オリフィスに配置された培
養棒はカルシウムがこの管内で血栓するのを防止し、弁
の表出のための開創器が通常右心房オリフィスを閉鎖す
る。病原弁が取り除かれた後補綴弁が弁状環内に縫合さ
れる。大動脈はその後２層縫合によって閉じられる。大
動脈オクルダーと濾過は取り除かれ、患者は心肺バイパ
スを取り除かれる。
【００１７】いくつかの詳細が図面と例によって開示さ
れた上述の発明は理解の明確の目的のために開示された
ものであり、請求の範囲内に属する他の変形や修正が存
在することは明確である。 ［図面の簡単な説明］
【図１】 第１実施形態にしたがった経皮濾過カテーテ
ルである。
【図２】 他の実施形態にしたがった第２内腔を有する
カテーテルである経皮濾過カテーテルである。
【図３】 大動脈内に進んだ位置にある経皮濾過カテー
テルを示す図である。
【図４】 患者に使用するために経皮濾過カテーテルの
侵入のための異なったアクセス経路を示す図である。
フロントページの続き (72)発明者 ユエ−テー・ジャン アメリカ合衆国94539カリフォルニア州 フレモント、スカイ・ロード43659番 (56)参考文献 特開 平２−279148（ＪＰ，Ａ) 特開 平６−190049（ＪＰ，Ａ) 特開 平７−124251（ＪＰ，Ａ) 特表 平９−509074（ＪＰ，Ａ) 米国特許4794928（ＵＳ，Ａ) 米国特許5102415（ＵＳ，Ａ) 米国特許5152777（ＵＳ，Ａ) 国際公開96／19941（ＷＯ，Ａ１) (58)調査した分野(Int.Cl.7，ＤＢ名) A61M 25/00 - 25/18 A61B 17/00 A61F 2/06

Claims (10)

    (57)【特許請求の範囲】
  1. 【請求項１】 遠方端と近位端を有する長手部材と； 前記長手部材の遠方端に取りつけられたバルーンオクル
    ダーであって、前記バルーンは前記長手部材によって運
    ばれた内腔と連通した区画を形成し； 前記長手部材の前記バルーンオクルダーの奥手に取りつ
    けられ、前記バルーンオクルダーと独立して操作可能な
    拡張可能フィルターとを備え、前記フィルターは前記長
    手部材に固定された近位端と前記フィルターが操作され
    たとき開く遠方端とを有する、経皮濾過カテーテル。
  2. 【請求項２】 前記バルーンオクルダーはゴム状弾性バ
    ルーンで構成されている請求項１記載のカテーテル。
  3. 【請求項３】 流体注入のための第２の内腔をさらに備
    えたことを特徴とする請求項１記載のカテーテル。
  4. 【請求項４】 前記第２の内腔は圧力モニターを収納す
    るのに適していることを特徴とする請求項３記載のカテ
    ーテル。
  5. 【請求項５】 前記拡張可能フィルターは前記長手部材
    の近位端から操作可能である請求項１記載のカテーテ
    ル。
  6. 【請求項６】 前記拡張可能フィルターはさらに拡張フ
    レームを備えている請求項１記載のカテーテル。
  7. 【請求項７】 前記拡張フレームは傘フレームで構成さ
    れている請求項６記載のカテーテル。
  8. 【請求項８】 前記拡張フレームは、膨張シールを構成
    する請求項６記載のカテーテル。
  9. 【請求項９】 前記拡張可能フィルターは、少なくとも
    １つの引っ張り線における操作で動作可能である請求項
    １記載のカテーテル。
  10. 【請求項１０】 前記拡張可能フィルターは、円周の曲
    げられた近位端前記長手部材と連続する近位端と放射的
    に拡張する遠方端を有する請求項１記載のカテーテル。
JP2000575576A 1998-10-13 1999-10-08 弁修復手術のための経皮濾過カテーテル Expired - Fee Related JP3535098B2 (ja)

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US09/170,359 US6051014A (en) 1998-10-13 1998-10-13 Percutaneous filtration catheter for valve repair surgery and methods of use
US09/170,359 1998-10-13
PCT/US1999/023528 WO2000021604A1 (en) 1998-10-13 1999-10-08 Percutaneous filtration catheter for valve repair surgery and methods of use

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AU760885B2 (en) 2003-05-22
CA2344715A1 (en) 2000-04-20
AU6296799A (en) 2000-05-01
EP1121173A1 (en) 2001-08-08
JP2002527157A (ja) 2002-08-27
US6051014A (en) 2000-04-18
US6692512B2 (en) 2004-02-17
EP1121173A4 (en) 2006-02-01
US6287321B1 (en) 2001-09-11
CA2344715C (en) 2009-07-28
WO2000021604A1 (en) 2000-04-20

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