JP4667716B2 - ステント式拡開方法および装置 - Google Patents
ステント式拡開方法および装置 Download PDFInfo
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- JP4667716B2 JP4667716B2 JP2002570935A JP2002570935A JP4667716B2 JP 4667716 B2 JP4667716 B2 JP 4667716B2 JP 2002570935 A JP2002570935 A JP 2002570935A JP 2002570935 A JP2002570935 A JP 2002570935A JP 4667716 B2 JP4667716 B2 JP 4667716B2
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- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
-
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/068—Modifying the blood flow model, e.g. by diffuser or deflector
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
-
- 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
- A61M25/10—Balloon catheters
- A61M25/1002—Balloon catheters characterised by balloon shape
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
- External Artificial Organs (AREA)
Description
a.流れ剥離の区域の減少/排除。斯かる区域は、二分岐幾何学形状において最も多く見出される。
b.流体流により血管壁に付与される剪断応力の増大。
c.ステントの長さに沿う平均流体速度の加速の導入/増進。
d.流体流の径方向(血管壁に直交する方向)の成分の減少/排除。
e.双方向(前後方向)の剪断応力を単方向剪断応力へと置き換えること。
f.血管壁からの物質移動の促進。
g.可能的な非層流パターンから層流への遷移。
h.他の、未だ説明されていない特性。流れ障害に関して厳密には何が再狭窄を促進するかの研究は進行中である。本発明者等はこれが如何にして生ずるかの全ては認識していないが、流れ様式を改善すれば再閉塞の蓋然性が最小化されることを発見した。
1.流れ障害(最も一般的には流れ剥離)の区域を含む血管幾何学形状;これの最も一般的な例は二分岐部である。現在のデバイスによるステント式拡開(stenting)の後で存在するこの流れ障害の区域は、ステントが上述の要因の任意のひとつに依り再閉塞を引き起こしやすくさせる。故に、障害の区域を減少/排除すれば再閉塞の蓋然性は最小化される。
図2a乃至図7bおよび図10は、本発明に係る拡開ステントの構造形状(profile)を示している。図2a乃至図7bおよび図10は“ステント”を示していると称されることもあるが、これらの図が実際に示すものはステント包絡面(stent envelope)もしくは構造形状の概略図であって、示されたステント包絡面の形成に寄与するセル・パターンもしくは他のステント構造は示されない。
上記ステントの一実施例において、該ステントは自己拡開ステントである。この自己拡開ステントのひとつの代表的実施例において該自己拡開ステントは図2a乃至図2cに示された如く、異なる断面積を有する少なくとも2個の区画と、異なる断面積を有する該少なくとも2個の区画を相互に接続するテーパ区画とを有する。図3a乃至図7bおよび図10に示された他の実施例の構造もまた、自己拡開ステントとして実施され得る。
Claims (22)
- 血管の内腔に植設されるステントであって、拡開時に内腔の血液の流れ障害を最小化するために人工的テーパを生成して血管の内腔形状をテーパ形状に変更するテーパ部を備え、該テーパ部は、長手軸心に関して非対称であることを特徴とするステント。
- 前記テーパ形状は、流れ剥離を最小化すべく選択される、請求項1記載のステント。
- 前記ステントは内腔の二分岐部に人工的テーパを生成する如くテーパ付けられる、請求項1記載のステント。
- 前記ステントは拡開されたときにテーパ形状を有する自己拡開ステントである、請求項1記載のステント。
- 前記ステントは、異なる断面積を有する少なくとも2個の区画と、異なる断面積を有する該2個の区画を相互に接続するテーパ区画とを有する、請求項4記載のステント。
- 当該ステントはバルーン拡開可能ステントであり、送達用バルーンによりテーパー形状へ拡開される、請求項1記載のステント。
- 前記ステントは送達されて拡開されたときに均一形状を有する自己拡開ステントであり、バルーンによりテーパー形状へ拡開される、請求項1記載のステント。
- 当該ステントの拡開状態において第1ステント・セグメント断面積を有すべく構成された第1ステント・セグメントと、
上記第1ステント・セグメントに関して長手方向にオフセットされると共に、当該ステントの拡開状態において第2ステント・セグメント断面積を有すべく構成された第2ステント・セグメントと、
当該ステントの拡開状態においてテーパ付きステント・セグメント構造を取るべく構成され、該テーパ付きステント・セグメント構造は上記第1ステント・セグメントを上記第2ステント・セグメントに接続する、第3ステント・セグメントとを備え、前記第1、第2および第3ステント・セグメントは当該ステントの拡開状態において該ステントの包絡面が該ステントの長手軸心に関して非対称的である如く構成された、血管に植設されるステントであって、拡開時に、血管内の血流を変更でき、血液の流れ障害を最小化するために血管に人工的テーパ区域を確立して血管の内腔形状をテーパ形状に変更する、非均一テーパを有するステント。 - 前記第2ステント・セグメント断面積は前記第1ステント・セグメント断面積と異なる、請求項8記載のステント。
- 当該ステントの拡開状態において、
前記第1ステント・セグメントは第1直円柱を備え、且つ、
前記第2ステント・セグメントは第2直円柱を備える、
請求項8記載のステント。 - 前記第3ステント・セグメントは前記第1ステント・セグメントおよび前記第2ステント・セグメントの少なくとも一方に直接接続される、請求項8記載のステント。
- 前記第1、第2および第3ステント・セグメントはそれらの拡開状態において当該ステントが截頭円錐である如く構成される、請求項8記載のステント。
- 当該ステントの拡開状態において当該ステントの前記包絡面は、
当該ステントの長手軸心を含む横断平面内の輪郭であって、湾曲線と、当該ステントの長手軸心に関して所定角度とされた直線との一方を備える輪郭を有する第1部分と、
当該ステントの長手軸心を含む横断平面内の輪郭であって、当該ステントの長手軸心に対して平行な直線を備える輪郭を有する第2部分とを画成し、
上記第1部分および上記第2部分は協働して当該ステントの前記包絡面を画成する、
請求項8記載のステント。 - 前記第1部分は半円柱形状である、請求項13記載のステント。
- 当該ステントの長手軸心に直交する平面内において当該ステントの任意のステント・セグメントの断面は円形である、請求項8記載のステント。
- 前記ステントは自己拡開もしくはバルーン拡開可能の一方である、請求項8記載のステント。
- 請求項16記載のステントを備えるステントを展開配置するキットであって、
上記ステントの拡開状態において前記第1ステント・セグメントは前記第1ステント・セグメント断面積を有し、前記第2ステント・セグメントは前記第2ステント・セグメント断面積を有し、且つ、前記第3ステント・セグメントは前記テーパ付きステント・セグメント構造を取る如く、内腔内で上記ステントを拡開するために膨張されるべく構成された送達用バルーンを更に含む、キット。 - 前記バルーンは、
前記第1ステント・セグメントを前記第1ステント・セグメント断面積へと拡開すべく上記バルーンの膨張状態において第1バルーン・セグメント断面積を有すべく構成された第1バルーン・セグメントと、
上記第1バルーン・セグメントに関して長手方向にオフセットされると共に、前記第2ステント・セグメントを前記第2ステント・セグメントへと拡開すべく上記バルーンの膨張状態において第2バルーン・セグメント断面積を有すべく構成された第2バルーン・セグメントと、
上記バルーンの膨張状態においてテーパ付きバルーン・セグメント構造を取るべく構成され、該テーパ付きバルーン・セグメント構造が上記第1バルーン・セグメントを上記第2バルーン・セグメントに接続する、第3バルーン・セグメントとを含む、請求項17記載のキット。 - 前記第2ステント・セグメント断面積は前記第1ステント・セグメント断面積と異なる、請求項18記載のキット。
- 請求項16記載のステントを展開配置する送達用バルーンであって、
該バルーンは、前記ステントの拡開状態において前記第1ステント・セグメントは前記第1ステント・セグメント断面積を有し、前記第2ステント・セグメントは前記第2ステント・セグメント断面積を有し、且つ、前記第3ステント・セグメントは前記テーパ付きステント・セグメント構造を取る如く、内腔内で上記ステントを拡開するために膨張されるべく構成される、送達用バルーン。 - 当該バルーンは、前記第1ステント・セグメントを前記第1ステント・セグメント断面積へと拡開すべく上記バルーンの膨張状態において第1バルーン・セグメント断面積を有すべく構成された第1バルーン・セグメントと、上記第1バルーン・セグメントに関して長手方向にオフセットされると共に、前記第2ステント・セグメントを前記第2ステント・セグメント断面積へと拡開すべく上記バルーンの膨張状態において第2バルーン・セグメント断面積を有すべく構成された第2バルーン・セグメントと、上記バルーンの膨張状態においてテーパ付きバルーン・セグメント構造を取るべく構成され、該テーパ付きバルーン・セグメント構造が上記第1バルーン・セグメントを上記第2バルーン・セグメントに接続する、第3バルーン・セグメントとを含む、請求項20記載のバルーン。
- 前記第2バルーン・セグメント断面積は前記第1バルーン・セグメント断面積と異なる、請求項21記載のバルーン。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US27541901P | 2001-03-13 | 2001-03-13 | |
PCT/US2002/007529 WO2002071975A2 (en) | 2001-03-13 | 2002-03-13 | Method and apparatus for stenting |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2008256364A Division JP4979666B2 (ja) | 2001-03-13 | 2008-10-01 | ステント式拡開方法および装置 |
Publications (2)
Publication Number | Publication Date |
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JP2005518225A JP2005518225A (ja) | 2005-06-23 |
JP4667716B2 true JP4667716B2 (ja) | 2011-04-13 |
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Application Number | Title | Priority Date | Filing Date |
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JP2002570935A Expired - Fee Related JP4667716B2 (ja) | 2001-03-13 | 2002-03-13 | ステント式拡開方法および装置 |
JP2008256364A Expired - Lifetime JP4979666B2 (ja) | 2001-03-13 | 2008-10-01 | ステント式拡開方法および装置 |
JP2011195718A Expired - Fee Related JP5198637B2 (ja) | 2001-03-13 | 2011-09-08 | ステント式拡開方法および装置 |
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JP2008256364A Expired - Lifetime JP4979666B2 (ja) | 2001-03-13 | 2008-10-01 | ステント式拡開方法および装置 |
JP2011195718A Expired - Fee Related JP5198637B2 (ja) | 2001-03-13 | 2011-09-08 | ステント式拡開方法および装置 |
Country Status (10)
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US (6) | US20040249439A1 (ja) |
EP (4) | EP2957265A1 (ja) |
JP (3) | JP4667716B2 (ja) |
AT (1) | ATE444042T1 (ja) |
AU (1) | AU2002252307B2 (ja) |
CA (3) | CA2439962C (ja) |
DE (1) | DE60233864D1 (ja) |
ES (2) | ES2546625T3 (ja) |
HK (1) | HK1211828A1 (ja) |
WO (1) | WO2002071975A2 (ja) |
Cited By (1)
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JP2012525939A (ja) * | 2009-05-08 | 2012-10-25 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | 拡張型骨インプラント |
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US7892273B2 (en) | 2001-12-03 | 2011-02-22 | Xtent, Inc. | Custom length stent apparatus |
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JP4081522B2 (ja) * | 2003-05-23 | 2008-04-30 | 新 石丸 | 一時留置型のステント及びステントグラフト |
US7241308B2 (en) * | 2003-06-09 | 2007-07-10 | Xtent, Inc. | Stent deployment systems and methods |
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JP2012525939A (ja) * | 2009-05-08 | 2012-10-25 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | 拡張型骨インプラント |
US9216023B2 (en) | 2009-05-08 | 2015-12-22 | DePuy Synthes Products, Inc. | Expandable bone implant |
US9925055B2 (en) | 2009-05-08 | 2018-03-27 | DePuy Synthes Products, Inc. | Expandable bone implant |
US10646349B2 (en) | 2009-05-08 | 2020-05-12 | DePuy Synthes Products, Inc. | Expandable bone implant |
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LAPS | Cancellation because of no payment of annual fees |