JP4837678B2 - カッティングエッジ付きカテーテルを含むシステム - Google Patents
カッティングエッジ付きカテーテルを含むシステム Download PDFInfo
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- JP4837678B2 JP4837678B2 JP2007554097A JP2007554097A JP4837678B2 JP 4837678 B2 JP4837678 B2 JP 4837678B2 JP 2007554097 A JP2007554097 A JP 2007554097A JP 2007554097 A JP2007554097 A JP 2007554097A JP 4837678 B2 JP4837678 B2 JP 4837678B2
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- cutting head
- lumen
- sheath
- heart valve
- elongate
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/32075—Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
-
- 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
- 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
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- 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
- A61B2017/22097—Valve removal in veins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Cardiology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Transplantation (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
Description
本発明の実施形態は最小限侵襲技術を使用する弁の回復、交換かつ/または増強のためのカテーテル、システム、および方法に関する。本発明の実施形態は、心臓弁を受ける心臓組織を作るためのカッティングヘッドを含むカテーテルを有する装置を含む。前記装置の実施形態は、カテーテル上の膨張自在バルーンの少なくとも一部の上方に位置する拡張自在ステントを含んでよく、ステントはカッティングヘッドにより剪断される心臓組織上で展開され得る。
Claims (10)
- 基端(106,206)と先端(108,208,308)との間に延在する第一管孔(104,204)を有する細長いカテーテル本体(102,202,302,502)と、
ブレード(112,212,312,512)および細長い引き部材(114,214,314,514)を有する第一カッティングヘッド(110,210,310,510)であって、前記細長いカテーテル本体の先端(108,208,308)に近接して配置される第一カッティングヘッド(110,210,310,510)と、
ブレード(118,218,318,518)を有する第二カッティングヘッド(116,216,316,516)であって、前記細長いカテーテル本体の先端(108,208,308)と前記第一カッティングヘッド(110,210,310,510)との間であって、かつ前記細長いカテーテル本体の先端(108,208,308)に隣接して配置される第二カッティングヘッド(116,216,316,516)と、
前記細長いカテーテル本体の先端(208,308)に隣接するとともに第二カッティングヘッド(216,316,516)の基端側に配置される膨張自在バルーン(236,336,536)と、
前記膨張自在バルーン(236,336,536)の少なくとも一部の上方に位置する拡張自在ステント(238,338,538)と、
前記カテーテル本体(402,502)の少なくとも一部に隣接するシース(446,546)の管孔(448,548)内に配置される拡張自在フィルタ(470,570)であって、心臓弁(454,554)に近接して配置される拡張自在フィルタ(470,570)と、
を含むシステム(590)において、
前記細長い引き部材(114,214,314,514)は前記第一管孔(104,204)に延在し、かつ同細長い引き部材(114,214,314,514)は同第一管孔(104,204)内を摺動して前記第一カッティングヘッド(110,210,310,510)を前記細長いカテーテル本体の先端(108,208,308)に対して移動させ、
前記第一カッティングヘッドのブレード(112,212,312,512)は前記第二カッティングヘッドのブレード(118,218,318,518)に対して移動して剪断作用を付与し、
前記細長いカテーテル本体(402,502)の少なくとも一部は、前記シース(446,546)の管孔(448,548)内に存在し、
前記シース(446,546)は前記心臓弁(454,554)および前記拡張自在フィルタ(470,570)に対して移動して、同心臓弁(454,554)および同拡張自在フィルタ(470,570)の少なくとも一部を展開させ、かつ
前記心臓弁(454,554)および前記拡張自在フィルタ(470,570)は、前記膨張自在バルーン(536)及び前記拡張自在ステント(538)の基端よりも基端側に配置される、システム。 - 前記第二カッティングヘッド(116,216,316,516)は、細長い押し部材(120,220,320,520)を更に含み、前記細長い押し部材(120,220,320,520)は前記第一管孔(104,204)内を摺動して前記第二カッティングヘッド(116,216,316,516)を前記カテーテル本体の先端(108,208,308)および第一カッティングヘッド(110,210,310,510)に対して移動させ、前記細長い引き部材(114,214,314,514)は第一管孔(104,204)内で前記細長い押し部材(120,220,320,520)と同心に配置されている、請求項1に記載のシステム。
- 前記第一カッティングヘッド(110,210,310,510)は第一端(122,222,322,522)および第二端(124,224)を有し、前記第二端(124,224)はカッティングエッジ(126)を具備したブレード(112,212,312,512)を有し、前記第二カッティングヘッド(116,216,316,516)は第一カッティングヘッド(110,210,310,510)のブレード(112,212,312,512)のカッティングエッジ(126)と整合するカッティングエッジ(128)を具備したブレード(118,218,318,518)を有し、前記第一カッティングヘッド(110,210,310,510)は前記第二カッティングヘッド(116,216,316,516)に対して移動して、同第一カッティングヘッドのブレードのカッティングエッジ(126)を摺動させて同第二カッティングヘッドのブレードのカッティングエッジ(128)を通過する、請求項1に記載のシステム。
- 前記第一カッティングヘッド(110,210,310,510)は円錐形であり、前記第一端(122,222,322,522)は前記第二端(124)よりも小さい直径を有する、請求項3に記載のシステム。
- 前記細長いカテーテル本体(202,302,502)は、前記細長いカテーテル本体(202,302,502)の基端(206)と先端(208,308)との間に延在する第二管孔(234,534)を含み、
前記膨張自在バルーン(236,336,536)は前記第二管孔(234,534)と流体密に連通し、かつ
第一カッティングヘッド(210,310,510)のブレード(212,312,512)は第二カッティングヘッド(216,316,516)のブレード(218,318,518)に対して移動して剪断作用を提供し、かつ前記膨張自在バルーン(236,336,536)は前記拡張自在ステント(238,338,538)を展開させる、請求項1に記載のシステム。 - 前記システムは、前記第二カッティングヘッド(216,316)と前記膨張自在バルーン(236,336)との間に位置する環状プッシュリング(240,340)を含む、請求項1のシステム。
- 前記心臓弁(454,554)は、外面(460)と、管孔(464)を形成する内面(462)と、少なくとも外面(460)上を覆うカバー(458)と、を有する支持フレーム(456)を含み、
前記カバー(458)は前記心臓弁(454,554)の管孔(464)を通る液体の一定方向流のための可逆的封止可能開口(468)を形成する面を含み、前記心臓弁(454,554)は前記シース(446,546)の管孔(448,548)内に取外し自在に位置し、前記細長いカテーテル本体(402,502)は前記シースの管孔(448,548)および可逆的封止可能開口(468)へ延在する、請求項1に記載のシステム。 - 前記心臓弁(454,554)の支持フレーム(456)は、前記シース(446,546)が前記心臓弁(454,554)および前記拡張自在フィルタ(470,570)に対して移動して前記心臓弁(454,554)を展開させるときに、拡張して管孔の直径を拡大する、請求項7に記載のシステム。
- 前記システムは、前記支持フレーム(456)に取外し自在に連結された保持ライン(474)を含み、前記保持ライン(474)は前記シース(446)の管孔から前記細長いカテーテル本体の基端(206)へ延在する、請求項7に記載のシステム。
- 前記シース(446,546)は第一シース端(450,550)および第二シース端(452)を含み、前記第一シース端(450,550)は前記膨張自在バルーン(536)と前記第二シース端(452)との間に位置し、かつ前記拡張自在フィルタ(470,570)は前記第一シース端(450,550)に隣接する第一フィルタ端(472)を含み、前記第一フィルタ端(472)は、前記シース(446,546)と前記細長いカテーテル本体(402,502)との間に配置された場合に第一直径を有し、前記第一直径は、前記シース(446,546)が前記心臓弁(454,554)および前記フィルタ(470,570)に対して移動して少なくとも第一フィルタ端(472)を展開させるときに、第二直径に拡大する、請求項7に記載のシステム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US11/049,000 | 2005-02-01 | ||
US11/049,000 US7854755B2 (en) | 2005-02-01 | 2005-02-01 | Vascular catheter, system, and method |
PCT/US2006/000280 WO2006083476A1 (en) | 2005-02-01 | 2006-01-06 | Catheter with cutting heads |
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JP2008528233A JP2008528233A (ja) | 2008-07-31 |
JP4837678B2 true JP4837678B2 (ja) | 2011-12-14 |
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JP2007554097A Expired - Fee Related JP4837678B2 (ja) | 2005-02-01 | 2006-01-06 | カッティングエッジ付きカテーテルを含むシステム |
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US (1) | US7854755B2 (ja) |
EP (1) | EP1863390A1 (ja) |
JP (1) | JP4837678B2 (ja) |
CA (1) | CA2596319A1 (ja) |
WO (1) | WO2006083476A1 (ja) |
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Also Published As
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EP1863390A1 (en) | 2007-12-12 |
WO2006083476A1 (en) | 2006-08-10 |
US20060173475A1 (en) | 2006-08-03 |
JP2008528233A (ja) | 2008-07-31 |
US7854755B2 (en) | 2010-12-21 |
CA2596319A1 (en) | 2006-08-10 |
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