JP4481826B2 - 血栓溶解用カテーテル - Google Patents
血栓溶解用カテーテル Download PDFInfo
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- JP4481826B2 JP4481826B2 JP2004542059A JP2004542059A JP4481826B2 JP 4481826 B2 JP4481826 B2 JP 4481826B2 JP 2004542059 A JP2004542059 A JP 2004542059A JP 2004542059 A JP2004542059 A JP 2004542059A JP 4481826 B2 JP4481826 B2 JP 4481826B2
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- thrombolysis
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- thrombolysis catheter
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
- A61B18/245—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter for removing obstructions in blood vessels or calculi
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
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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
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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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
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
- A61B2017/00871—Material properties shape memory effect polymeric
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M2025/0058—Catheters; Hollow probes characterised by structural features having an electroactive polymer material, e.g. for steering purposes, for control of flexibility, for locking, for opening or closing
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- Medical Informatics (AREA)
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- Otolaryngology (AREA)
- Electromagnetism (AREA)
- Optics & Photonics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Saccharide Compounds (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Laser Surgery Devices (AREA)
- Materials For Medical Uses (AREA)
- Radiation-Therapy Devices (AREA)
- Surgical Instruments (AREA)
- Electrotherapy Devices (AREA)
Description
本特許出願明細書は、2001年10月5日に提出された米国出願第09/971,419号、2002年6月21日に提出された米国出願第10/177, 491号、および2002年6月21日に提出された米国出願第10/176,977号に関連する。
本願発明は血栓溶解用カテーテルに関するものであって、より詳しくは、患者の血管の自然な曲線を反映するように形を調節することができる血栓溶解用のカテーテルに関連する。
閉塞性脳梗塞(「脳卒中」ともよばれる)は、脳の動脈が閉塞することによって生じる、主要な公衆衛生上の問題である。この閉塞は、たとえば凝血塊または塞栓が脳の小動脈の1つにつまることによって生じ、脳梗塞を引き起こしたり、未治療のまま放置すると死に至ることもある。しかし、充分早期に発見すれば、この閉塞はさまざまな技術によって除去することができる。その技術には、局所または全身用血栓溶解剤(たとえばヘパリン、およびウロキナーゼなど)、ならびに血管形成術、光剥離または高温血栓溶解(たとえばレーザー血栓溶解)および機械的血栓溶解(たとえば流体ジェットによる水力血栓溶解または超音波血栓溶解)などの非化学的技術が含まれる。
カテーテル10の遠位部14から放出されたレーザー光は、凝血塊Cに当たって当該凝血塊を血管Vから除去する。さらなる知見は、その開示の全体が引用により本願明細書に援用される米国特許第6,117, 128号に見つけることができる。
上述およびその他の従来技術の問題点は、本願発明の新規血栓溶解用カテーテル装置であって、当該装置には(a)複数の独立に制御可能な電気活性高分子アクチュエータであって、当該アクチュエータが受け取った制御シグナルに基づいて前記血栓溶解カテーテルに屈曲を提供する、アクチュエータを含む、細長い血栓溶解用カテーテル部分、(b)前記複数のアクチュエータに結合し、前記複数のアクチュエータに制御シグナルを送る制御ユニット、および(c)閉塞除去装置、
含む装置によって解決される。
電気活性高分子アクチュエータは、前記血栓溶解用カテーテル部分長の大部分に関して有利に提供される。たとえば、本願発明の血栓溶解用カテーテルの電気活性高分子アクチュエータは、前記血栓溶解用カテーテル部分の長さの5 cm、10 cm、15 cm、20 cm、または25 cm、またはそれ以上を占めるように配置されてよい。
とえばS字曲線)および面外曲線(たとえばらせん形)、ならびにその他のはるかに複雑な曲線などを含む、無限に近い範囲の曲線を提供するように制御することができる。たと
えば、本願発明のある実施態様では、前記電気活性高分子アクチュエータは、前記血栓用カテーテル部分が前進して通る血管の自然な方向性に相補的になるように、血栓溶解用カテーテル部分に方向性を与えるように制御することができる。たとえば、前記血栓溶解用カテーテル部分に、たとえば、頭部動脈または内頚動脈の少なくとも一部分の自然な方向性などの、動脈管の少なくとも一部分の自然な方向性に対応するような面外曲線を提供することができる。
領域が含まれる。ある実施態様では、前記血栓溶解用カテーテル部分には基質層が含まれ、前記活性化メンバ、前記カウンター電極および前記の電解質含有領域は前記基質層の上に配置されるだろう。ある実施態様では、前記基質層は管状に巻かれている。
つまり、これにより、たとえば頭部血管に一般に存在する粉瘤から塞栓を取り除く確率が低くなる。
本願発明は、ここからは、本願発明のいくつかの実施例が示される付属の図面を参照して、より十分に説明されるだろう。しかし、本願発明は様々な形態に具体化されてもよく、本願明細書に記載の実施態様に限定されると解釈されてはならない。
)であるため、これらの特徴は本願発明の血栓溶解用カテーテルの作製に理想的である。
置依存性の電気的特性から推測することができる。しかし、望ましい場合には、多数のひずみゲ
ージを用いて、前記集合体内のアクチュエータおよび構造要素の配置に関する電子的フィードバックを提供することができる。この電子的フィードバックはまた、生理学的変化、安定性の増大、
エラー修正、およびドリフトの免除などの補正を含む、多数のさらなる利点も提供する。本願発明への使用に好適なひずみゲージには、(a)フィードバック電気的高分子要素であって、そのインピーダンスまたは抵抗が前記装置のひずみ量の関数で変化するフィードバック電気的高分子要と、(b)前記装置のひずみ量の関数で前記装置の抵抗が変化し、その結果ひずみ量が容易に定量化および監視できる、従来のひずみゲージ、が含まれる。そのようなひずみゲージは、ナショナルインストゥルメンツ社(テキサス州オースチン)を含む、多数のさまざまな供給源から市販されており、圧電抵抗性ひずみゲージ(抵抗がひずみに対して非線形に変化する)、および結合金属性ひずみゲージ(典型的に、抵抗がひずみに対して線形に変化する)が含まれる。
ザインでは、前記構造要素602(および多くの場合、前記基質層605)は、集合体620全体が予め曲げられた配置になるように働き、その構造は例えば線状配置であってもよい。アクチュエータ610を用いて、この構造を望ましい程度まで曲げる。
イミド(たとえばKAPTON)などの硬質高分子からつくられており、適切な柔軟性を与えるために、たとえばレーザーなどを用いた選択的な切断によって緩められる。
具体的な例はPTFEである。
たとえば、図6Dは基質層605上に配置された8個の活性メンバ612の断面である。前記活性化メンバ612の上には、電解質含有層614、カウンター電極618、およびバリア層620がある。前記バリア層620は、たとえば粘着物質619などを用いて基質層605に密着させる。図6Dの
配置には一般的なカウンター電極618が含まれる。前記活性メンバ612は典型的には、個別の活性化のために、別々のトラックワイヤ(非表示)を取り付ける。
電解質含有層614は活性化メンバ612およびカウンター電極領域618と接触する。バリア層620は、たとえば粘着物質619などを用いて基質層605に密着させる。活性化領域は典型的には、個別の活性化のために、別々のトラックワイヤ(非表示)を取り付ける。前記カウンター電極領域618にはまた、別々のトラックワイヤ(非表示)を取り付けることも可能で、またはこれらの領域が1つのカウンター電極の部分(たとえばデジタル構造)を構成することもできる。
制御装置に連結する専用サーキットを用いて、前記装置と直接通信できるように配置してもよい。しかし、各要素が一般的な通信ケーブルによって制御装置と通信できるように、これらの要素を配置するのが、より典型的である。各要素からのシグナルは、デジタルまたはアナログであってよい。必要であれば、デジタル-アナログ、またはアナログ-デジタル転換器を用いて、前記
シグナルを1つのフォーマットから他のフォーマットに変換してもよい。
シグナルは、電子インターフェイスにあるドライバーからケーブル束1250を通って前記血栓溶解用カテーテル部分1200内のアクチュエータに送られ、前記血栓溶解用カテーテル部分1200の3次元形状を制御する。望ましい場合には、コンピュータマウスパッドまたは組み込み式もしくは周辺機器のジョイスティックなどの操縦メカニズムを用いて、上述の通り前記血栓溶解用カテーテル部分1200を操縦および制御してもよい。本願発明のある実施態様では、シグナルが前記ひずみゲージから出力され、ケーブル束1250を通って前記コンピュータ1254内の電子インターフェイスに送られる場合、前記血栓溶解用カテーテル部分1200にはひずみゲージが提供される。これらのシグナルはコンピュータ1254で処理され、たとえば(a)前記アクチュエータに安定性、エラー修正、およびドリフトの免除を提供し、および(b)望ましい場合には、生体内における前記血栓溶解用カテーテルのバーチャル画像を提供する。
図13に図示された血栓溶解用カテーテル装置には、コンピュータ1354などの制御ユニットによって制御される多数の電子的アクチュエータ(非表示)を含む血栓溶解用カテーテル部分1300が含まれる。電源(非表示)およびドライバーを含むワイヤレスインターフェイス(非表示)を、前記血栓溶解用カテーテル部分1300の近位端内に提供する。前記血栓溶解用カテーテル部分1300のワイヤレスインターフェイスは、遠隔のコンピュータ1354内のもう一方のワイヤレスインターフェイスと通信する。
部分1400内のアクチュエータ1410への制御シグナルは、コンピュータ1454からワイヤレスインターフェイス1460a、1460bを通って前記血栓溶解用カテーテル部分1400へ送られる。同時に、データ(たとえばひずみゲージ1416からのデータ)が、前記血栓溶解用カテーテル部分1400から前記ワイヤレスインターフェイス1460a、1460bを通って前記コンピュータ1454へ送られる。
Claims (7)
- 血栓溶解用カテーテル装置であって、当該装置において(a)複数の独立に制御可能な電気活性高分子アクチュエータであって、各々が、電気刺激に応答して収縮または伸長する電気活性高分子を含む活性メンバと、電解質と、カウンター電極とを有するとともに、当該電気活性高分子アクチュエータが受け取った電気刺激を含む制御シグナルに基づいて前記血栓溶解カテーテル部分に屈曲を提供する、電気活性高分子アクチュエータを含む、細長い血栓溶解用カテーテル部分と、(b)前記複数のアクチュエータに結合し、前記複数のアクチュエータに制御シグナルを送る制御ユニットと、(c)閉塞を除去する装置と、
を含む、血栓溶解用カテーテル装置。 - 請求項1に記載の血栓溶解用カテーテル装置であって、当該血栓溶解用カテーテル装置において、前記の閉塞を除去する装置がレーザーと導光部であって、前記レーザーが前記導光部に光学的に連結される、レーザーと導光部を含む、血栓溶解用カテーテル装置。
- 請求項1に記載の血栓溶解用カテーテル装置であって、当該血栓溶解用カテーテル装置において、前記の複数の電気活性高分子アクチュエータが、前記血栓溶解用カテーテル部分の軸長の少なくとも2cmに沿って配置される、血栓溶解用カテーテル装置。
- 請求項1に記載の血栓溶解用カテーテル装置であって、当該血栓溶解用カテーテル装置において、少なくとも3つの独立に制御可能な電気活性高分子アクチュエータを含む、血栓溶解用カテーテル装置。
- 請求項1に記載の血栓溶解用カテーテル装置であって、当該血栓溶解用カテーテル装置において、前記アクチュエータが、前記血栓溶解用カテーテル部分が面外曲線を含む形状を提供するように、前記血栓溶解用カテーテル部分の範囲内に配置される、血栓溶解用カテーテル装置。
- 請求項5に記載の血栓溶解用カテーテル装置であって、当該血栓溶解用カテーテル装置において、前記の面外曲線が頭部または脳動脈の少なくとも一部分の自然な方向性に対応する、血栓溶解用カテーテル装置。
- 請求項5に記載の血栓溶解用カテーテル装置であって、当該血栓溶解用カテーテル装置において、前記の面外曲線が内頸動脈の少なくとも一部分の自然な方向性に対応する、血栓溶解用カテーテル装置。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/262,829 US20040068161A1 (en) | 2002-10-02 | 2002-10-02 | Thrombolysis catheter |
PCT/US2003/031259 WO2004030554A1 (en) | 2002-10-02 | 2003-10-02 | Thrombolysis catheter |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2006512940A JP2006512940A (ja) | 2006-04-20 |
JP4481826B2 true JP4481826B2 (ja) | 2010-06-16 |
Family
ID=32041894
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2004542059A Expired - Fee Related JP4481826B2 (ja) | 2002-10-02 | 2003-10-02 | 血栓溶解用カテーテル |
Country Status (9)
Country | Link |
---|---|
US (2) | US20040068161A1 (ja) |
EP (2) | EP1795141A2 (ja) |
JP (1) | JP4481826B2 (ja) |
AT (1) | ATE372092T1 (ja) |
AU (1) | AU2003279108A1 (ja) |
CA (1) | CA2510615A1 (ja) |
DE (1) | DE60316175T2 (ja) |
ES (1) | ES2291701T3 (ja) |
WO (1) | WO2004030554A1 (ja) |
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- 2002-10-02 US US10/262,829 patent/US20040068161A1/en not_active Abandoned
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2003
- 2003-10-02 JP JP2004542059A patent/JP4481826B2/ja not_active Expired - Fee Related
- 2003-10-02 AU AU2003279108A patent/AU2003279108A1/en not_active Abandoned
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- 2003-10-02 AT AT03770618T patent/ATE372092T1/de not_active IP Right Cessation
- 2003-10-02 EP EP07005991A patent/EP1795141A2/en not_active Withdrawn
- 2003-10-02 EP EP03770618A patent/EP1558165B1/en not_active Expired - Lifetime
- 2003-10-02 ES ES03770618T patent/ES2291701T3/es not_active Expired - Lifetime
- 2003-10-02 CA CA002510615A patent/CA2510615A1/en not_active Abandoned
- 2003-10-02 DE DE60316175T patent/DE60316175T2/de not_active Expired - Lifetime
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2010
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CA2510615A1 (en) | 2004-04-15 |
JP2006512940A (ja) | 2006-04-20 |
EP1558165B1 (en) | 2007-09-05 |
WO2004030554A1 (en) | 2004-04-15 |
EP1795141A2 (en) | 2007-06-13 |
ES2291701T3 (es) | 2008-03-01 |
US20100191175A1 (en) | 2010-07-29 |
ATE372092T1 (de) | 2007-09-15 |
AU2003279108A1 (en) | 2004-04-23 |
EP1558165A1 (en) | 2005-08-03 |
US20040068161A1 (en) | 2004-04-08 |
DE60316175D1 (en) | 2007-10-18 |
DE60316175T2 (de) | 2008-05-29 |
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