JP4685796B2 - ステント縮小システム - Google Patents
ステント縮小システム Download PDFInfo
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- JP4685796B2 JP4685796B2 JP2006549253A JP2006549253A JP4685796B2 JP 4685796 B2 JP4685796 B2 JP 4685796B2 JP 2006549253 A JP2006549253 A JP 2006549253A JP 2006549253 A JP2006549253 A JP 2006549253A JP 4685796 B2 JP4685796 B2 JP 4685796B2
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- stent
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- cells
- bmp
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Classifications
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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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
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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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/9522—Means for mounting a stent or stent-graft onto or into a placement instrument
- A61F2/9524—Iris-type crimpers
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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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/9522—Means for mounting a stent or stent-graft onto or into a placement instrument
Description
本発明の請求の範囲を制限することなく、本発明のクレームされた実施形態の幾らかの簡単な要約が以下に記載される。本発明の要約された実施形態の更なる詳細な説明及び/又は本発明の付随的な実施形態は以下の本発明の詳細な説明に記載されている。
少なくとも一つの実施形態において、本発明は、ステント径縮小チャンバを介してステントが前進される際に該ステントを支持するマンドレルを含む。幾らかの実施形態において、マンドレルは段差状の直径を有し、該ステントが、マンドレルの隆起した直径部又はカラーによりその基端及び先端の一つ以上にて固定されることを可能にする。幾らかの実施形態において、マンドレルの先端はテーパ状になっており、マンドレルがカテーテルのようなステント送達システムと整合することを容易にする。幾らかの実施形態において、マンドレルはポリマー被覆を備えている。
図1乃至12に示されるように、本発明は上述の問題点に取り組む実施形態を含む。
上記されるように、本発明は種々の形態に具現化される。例えば図1に示される実施形態のような少なくとも一つの実施形態において、本発明は径方向ステント縮小組立体又はクリンパ10に関する。クリンパ10は、上記のような収縮部材の任意の形状及び/又はステント径縮小チャンバの任意の形状を備える。
図1乃至2に示されるように、流体ベアリング20は、一つ以上のポート24により流体源30からクリンパハウジング18に流体22を注入することにより確立される。各ポート24は各ブレード12の間に、及び/又は各ブレード12内にある一つ以上の流体通路26と流体連通している。流体通路26の各々がチャンバ14に通じている。圧力下にて流体をチャンバ14に注入し、かつクリンプ工程時に該チャンバ14内の流体圧力を実質的に維持することにより、ブレード12とステント16との間に流体ベアリング20が形成される。幾らかの実施形態において、流体圧は13789Pa乃至137895Pa(約2乃至約20psi)である。
幾らかの実施形態において、一つ以上のブレード12、マンドレル40及び/又は流体22及び/又は22aは、ステント16とクリンパ10又はその構成要素の幾らかとの間の摩擦界面を容易に最小限化するために超音波又は振動エネルギのその他の形態が与えられている。
EPCs−(内皮前駆細胞)これらの細胞は全骨髄から細胞表面マーカに基づいて分離され、内皮細胞になる。理論上は、これらの細胞は虚血組織に送られると新しい血管を形成する。
内皮細胞−フィブリンマトリクスとともに自己内皮細胞を移植すると血管形成が誘発され、虚血性のヒツジモデルで心機能が改善された。
線維芽細胞−線維芽細胞は成人の組織から容易に採取でき、増殖因子を与えるか、又は創傷治癒反応への関与をもたらす。線維芽細胞は創傷治癒において、細胞外マトリクスの合成及び沈着という重要な役割を担っている。線維芽細胞は一般に創傷治癒環境において収縮的になる。
MSCs+5−アザ−5−アザ(aza)を用いた間葉幹細胞の培養は、心筋細胞へと分化させる。これらの細胞は治療後自然に拍動する。
遺伝子改変細胞−患者から細胞を分離し、それらを生体外で遺伝子改変することにより、タンパク質の生成又は心疾患の治療に有益な細胞タイプへの分化が促進される。
胚幹細胞クローン−クローン技術を使用して、患者にとって遺伝子的に同一である心筋細胞、前駆細胞、又は幹細胞を作製する。
Claims (32)
- ステントの直径を縮小するためのシステムにおいて、前記システムは、
ステント収縮組立体と、
流体源と、を含み、
前記ステント収縮組立体は、
ハウジングと、
前記ハウジングに収容される複数の可動収縮部材と、
前記ハウジングに設けられるとともに前記流体源から前記ハウジング内に流体を注入するための少なくとも一つの流体ポートと、
を含み、
前記複数の可動収縮部材は互いに対して径方向に隣接して配置されるとともに絞り機構を形成し、
同複数の可動収縮部材は、断面が円形であるとともに減径された直径と減径前の直径との間にて直径を変更可能であり、かつステントを収容可能なチャンバを画定し、
前記複数の可動収縮部材の各々は、隣接する可動収縮部材とは流体通路を形成すべく一定の間隙にて離間した状態にて配置されており、前記流体通路の各々は前記流体ポート及び前記チャンバと流体連通可能であり、
前記ステントを前記チャンバに配置した後に前記流体源から前記ハウジング内に加圧流体が注入され、注入された加圧流体は、その圧力を維持した状態にて前記複数の可動収縮部材の間に形成された前記流体通路内を経て前記チャンバ内を流れ、それにより前記複数の可動収縮部材の絞り機構により同チャンバの直径が減少し、同時に前記流体が前記チャンバ内に流入することにより、前記可動収縮部材と前記チャンバに配置されたステントとの間に流体ベアリングが形成される、システム。 - 前記チャンバは第一の端部開口部と第二の端部開口部とを画定し、前記ステントは前記第一の端部開口部から前記第二の端部開口部までチャンバを貫通して移動可能である請求項1に記載のシステム。
- 前記減径された直径の形態において、第一の端部領域におけるチャンバの直径と前記チャンバの第二の端部領域における直径とは異なる請求項2に記載のシステム。
- 前記第二の端部領域におけるチャンバの直径は前記第一の端部領域におけるチャンバの直径より大きい請求項3に記載のシステム。
- 前記第二の端部領域はその内部にカテーテルの一部を移動可能に受承するべく構成及び配置されており、前記ステントは該ステントを前記チャンバを貫通して前進させることにより該カテーテル上に装填される請求項4に記載のシステム。
- 前記複数の可動収縮部材は前記ハウジングに機械的に係合している請求項2に記載のシステム。
- 前記ステント収縮組立体は少なくとも一つの密封部材を更に含み、前記少なくとも一つの密封部材は、前記チャンバの前記第一の端部開口部と前記第二の端部開口部とのうちの少なくとも一方に隣接するハウジングの一部と係合し、前記少なくとも一つの密封部材は前記第一の端部開口部と前記第二の端部開口部とのうちの少なくとも一方に対して流体密封を提供する請求項6に記載のシステム。
- 前記少なくとも一つの密封部材は第一の密封部材と第二の密封部材とを含み、前記第一の密封部材は前記チャンバの第一の端部開口部に隣接する前記ハウジングの一部と係合し、かつ前記第二の密封部材は前記チャンバの第二の端部開口部に隣接する前記ハウジングの一部と係合する請求項7に記載のシステム。
- 前記少なくとも一つの密封部材は可動流体密封体を含む請求項7に記載のシステム。
- 前記少なくとも一つの密封部材は入り組んだ通路を含む請求項7に記載のシステム。
- 前記少なくとも一つの密封部材は調整可能な弁を含む請求項7に記載のシステム。
- 請求項2に記載のシステムはマンドレルを更に含み、前記減径された形態において、前記マンドレルは、前記ステントを放出するために前記チャンバを貫通して前進されるべく構成及び配置されるシステム。
- 前記チャンバが前記減径前の直径の形態にある場合には前記ステントは第一の直径を有し、かつ前記チャンバが前記減径された直径の形態にある場合には前記ステントは第二の直径を有し、前記マンドレルは、前記ステントの前記第二の直径と少なくとも等しい直径を有する請求項12に記載のシステム。
- 前記マンドレルはステント装着領域を画定し、前記ステントは前記ステント装着領域の少なくとも一部の周囲に配置される請求項12に記載のシステム。
- 前記マンドレルは第一の端部領域及び第二の端部領域を更に含み、前記ステント装着領域は前記マンドレルの第一の端部領域と前記マンドレルの第二の端部領域との間に配置され、前記マンドレルの第一の端部領域と前記マンドレルの第二の端部領域との少なくとも一方は前記ステントの第二の直径と少なくとも等しい直径を有する請求項14に記載のシステム。
- 前記マンドレルの第一の端部領域は前記チャンバの第一の端部開口部の外側にあるとともに該開口部に直接隣接しており、かつ前記マンドレルの第二の端部領域は前記チャンバの第二の端部開口部の外側にあるとともに該開口部に直接隣接している請求項15に記載のシステム。
- 前記マンドレルの第一の端部領域は前記チャンバの第一の開口端部に密封して係合される請求項16に記載のシステム。
- 前記マンドレルの第二の端部領域は前記チャンバの第二の開口端部に密封して係合される請求項16に記載のシステム。
- 前記マンドレルの第一の端部領域は前記チャンバの第一の開口端部に密封して係合され、かつ前記マンドレルの第二の端部領域は前記チャンバの第二の開口端部に密封して係合される請求項16に記載のシステム。
- 前記マンドレルの第一の端部領域及び前記マンドレルの第二の端部領域の少なくとも一方の少なくとも一部はテーパ状である請求項15に記載のシステム。
- 前記マンドレルは流体注入内腔を画定し、前記流体注入内腔に第二の流体が注入される請求項14に記載のシステム。
- 前記第二の流体は冷却剤である請求項21に記載のシステム。
- 前記第二の流体は前記流体源からの流体と同じである請求項22に記載のシステム。
- 前記マンドレルのステント装着領域の少なくとも一部は少なくとも一つの灌流ポートを画定し、前記少なくとも一つの灌流ポートは前記流体注入内腔と流体連通している請求項21に記載のシステム。
- 前記流体は、空気、水、二酸化炭素、亜酸化窒素、窒素ガス及びそれらの任意の組み合わせからなる群の構成要素から選択される請求項1に記載のシステム。
- 前記流体は−60℃乃至−80℃の温度まで冷却される請求項25に記載のシステム。
- 前記ステントの少なくとも一部は少なくとも一つの治療剤で被覆される請求項1に記載のシステム。
- 前記少なくとも一種の治療薬が、ヘパリン、ヘパリン誘導体、ウロキナーゼ、及びPPack(デキストロフェニルアラニン プロリン アルギニン クロロメチルケトン)などの抗血栓性治療薬;エノキサパリン、アンギオペプチン、平滑筋細胞の増殖を防止することのできるモノクローナル抗体、ヒルジン、及びアセチルサリチル酸などの抗増殖剤;デキサメタゾン、プレドニゾロン、コルチコステロン、ブデソニド、エストロゲン、スルファサラジン、及びメサラミンなどの抗炎症薬;パクリタキセル、5−フルオロウラシル、シスプラチン、ビンブラスチン、ビンクリスチン、エポチロン、エンドスタチン、アンギオスタチン、及びチミジンキナーゼ阻害剤などの抗悪性腫瘍薬/抗増殖剤/抗縮瞳薬;リドカイン、ブピバカイン及びロピバカインなどの麻酔薬;D−Phe−Pro−Argクロロメチルケトン、RGDペプチド含有化合物、ヘパリン、抗血栓化合物、血小板受容体拮抗薬、抗血栓抗体、抗血小板受容体抗体、アスピリン、プロスタグランジン阻害剤、血小板阻害剤、及びマダニ抗血小板ペプチドなどの抗凝固薬;増殖因子阻害剤、増殖因子受容体拮抗薬、転写活性化因子、及び翻訳促進因子などの血管細胞増殖促進剤、増殖因子阻害剤、増殖因子受容体拮抗薬、転写リプレッサー、翻訳リプレッサー、複製阻害剤、阻害抗体、増殖因子を対象とする抗体などの血管細胞増殖阻害剤、増殖因子及びサイトトキシンからなる二機能性分子;抗体及びサイトトキシンからなる二機能性分子;コレステロール低下剤;血管拡張薬;及び内因性血管活性メカニズムと干渉する薬剤、及びそれらの任意の組合せからなる群の少なくとも一種の構成要素から選択される、少なくとも一種の非遺伝子治療薬である、請求項27に記載のシステム。
- 前記少なくとも一種の治療薬が、アンチセンスDNA及びRNA;欠損又は欠乏した内因性分子を置換するためのアンチセンスRNA、tRNA、又はrRNAをコードするDNA;酸性及び塩基性線維芽細胞増殖因子、血管内皮増殖因子、上皮増殖因子、形質転換増殖因子α及びβ、血小板由来内皮増殖因子、血小板由来増殖因子、腫瘍壊死因子α、肝細胞増殖因子、及びインスリン様増殖因子などの増殖因子を含む血管形成因子;CD阻害剤、チミジンキナーゼ(TK)及び細胞増殖を干渉するのに有用な他の薬剤を含む細胞周期阻害剤;BMP−2、BMP−3、BMP−4、BMP−5、BMP−6(Vgr−1)、BMP−7(OP−1)、BMP−8、BMP−9、BMP−10、BMP−11、BMP−12、BMP−13、BMP−14、BMP−15、及びBMP−16などの骨形態形成タンパク質のファミリー(「BMP's」)の少なくとも一種;BMP−2、BMP−3、BMP−4、BMP−5、BMP−6及びBMP−7のいずれか;単独又は他の分子と結合したホモダイマー、ヘテロダイマー又はそれらの組合せなどの二量体タンパク質;ヘッジホッグタンパク質などのBMPの上流又は下流効果の誘導、又はDNAによるそれらのコード化が可能な分子、及びその任意の組合せからなる群の少なくとも1種の構成要素から選択される、少なくとも一つの遺伝子治療薬である、請求項27に記載のシステム。
- 前記少なくとも一種の治療薬が、ヒト由来の細胞(自己又は同種);非ヒト由来の細胞(異種)、及びそれらの任意の組合せからなる群の少なくとも一種の構成要素から選択される、少なくとも一種の細胞材料である、請求項27に記載のシステム。
- 前記細胞材料が、亜集団細胞;系譜陰性細胞;系譜陰性CD34−細胞;系譜陰性CD34+細胞;系譜陰性−cKit+細胞;間葉幹細胞;臍帯血細胞;心臓又は他の組織由来の幹細胞;全骨髄;骨髄単核細胞;内皮前駆細胞;衛星細胞;筋由来細胞;go細胞;内皮細胞;成人の心筋細胞;線維芽細胞;平滑筋細胞;心筋細胞へと分化させる5−アザを用いた間葉幹細胞の培養物;成人の心臓線維芽細胞+5−アザ;遺伝子改変細胞;組織工学移植片;MyoD scar線維芽細胞;ペーシング細胞;胚幹細胞クローン;胚幹細胞;胎児又は新生児細胞;免疫的にマスキングされた細胞;組織工学移植片;遺伝子改変細胞;奇形腫由来細胞、及びそれらの任意の組合せからなる群の少なくとも一種の構成要素から選択される、請求項30に記載のシステム。
- 前記少なくとも一種の治療薬が少なくとも一種のポリマー被覆を含み、前記少なくとも一つの被覆が、ポリカルボン酸;酢酸セルロース及び硝酸セルロースを含むセルロースポリマー;ゼラチン;ポリビニルピロリドン;架橋ポリビニルピロリドン;マレイン酸無水物ポリマーを含むポリ無水物;ポリアミド;ポリビニルアルコール;EVAなどのビニルモノマーのコポリマー;ポリビニルエーテル;ポリビニル芳香族;酸化ポリエチレン;グリコサミノグリカン;多糖類;ポリエチレンテレフタレートを含むポリエステル;ポリアクリルアミド;ポリエーテル;ポリエーテルスルホン;ポリカーボネート;ポリプロピレン、ポリエチレン、及び高分子量ポリエチレンを含むポリアルキレン;ポリテトラフルオロエチレンを含むハロゲン化ポリアルキレン;ポリウレタン;ポリオルトエステル;タンパク質;ポリペプチド;シリコーン;シロキサンポリマー;ポリ乳酸;ポリグリコール酸;ポリカプロラクトン;ポリヒドロキシブチレート吉草酸塩及びその混合物及びコポリマー;ポリウレタン分散液(BAYHDROL(登録商標)など)などのポリマー分散液に由来する被覆、フィブリン、コラーゲン及びその誘導体;セルロース、デンプン、デキストラン、アルギン酸塩及び誘導体などの多糖類;ヒアルロン酸;スクアレンエマルジョン;ポリアクリル酸、ポリ乳酸及びポリカプロラクトンのコポリマー;PGA−TMC、チロシン由来ポリカーボネート、及びアクリレートなどの医療用生分解性材料;ポリカプロラクトンコブチルアクリレート及び他のコポリマー;DL−乳酸及びポリ−L−乳酸の混合物;ポリ(乳酸−コ−グリコール酸);ポリカプロラクトンコPLA;ポリカプロラクトンコブチルアクリレート及び他のコポリマー;チロシン由来ポリカーボネート、及びアクリレート;ポリアミノ酸;ポリホスファゼン;ポリイミノカーボネート;ポリジメチルトリメチルカーボネート;生分解性CA/PO4's;シアノアクリレート;50/50DLPLG;ポリジオキサノン;ポリプロピレンフマレート;ポリデプシペプチド;キトサン及びヒドロキシルプロピルメチルセルロースなどの高分子;表面浸食性材料;マレイン酸無水物コポリマー;亜鉛−リン酸カルシウム;無定形ポリ無水物;糖;炭水化物;ゼラチン;生分解性ポリマー;及び体液に可溶性のポリマー;Aブロックコポリマー;Bブロックコポリマー及びそれらの任意の組合せからなる群の少なくとも一種の構成要素から選択される、請求項27に記載のシステム。
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- 2004-01-12 US US10/755,752 patent/US7284401B2/en active Active
- 2004-11-17 AT AT04811192T patent/ATE457708T1/de not_active IP Right Cessation
- 2004-11-17 CA CA2541217A patent/CA2541217C/en not_active Expired - Fee Related
- 2004-11-17 EP EP04811192A patent/EP1703857B1/en not_active Not-in-force
- 2004-11-17 WO PCT/US2004/038383 patent/WO2005070335A1/en active Application Filing
- 2004-11-17 JP JP2006549253A patent/JP4685796B2/ja not_active Expired - Fee Related
- 2004-11-17 DE DE602004025621T patent/DE602004025621D1/de active Active
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JP2017056478A (ja) * | 2015-09-17 | 2017-03-23 | 日本ゼオン株式会社 | 縮径装置 |
Also Published As
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EP1703857A1 (en) | 2006-09-27 |
US20050154450A1 (en) | 2005-07-14 |
US7284401B2 (en) | 2007-10-23 |
DE602004025621D1 (de) | 2010-04-01 |
WO2005070335A1 (en) | 2005-08-04 |
JP2007517587A (ja) | 2007-07-05 |
CA2541217A1 (en) | 2005-08-04 |
ATE457708T1 (de) | 2010-03-15 |
CA2541217C (en) | 2012-03-27 |
EP1703857B1 (en) | 2010-02-17 |
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