JP4890463B2 - 閉塞または狭窄を横切るためのガイドワイヤ - Google Patents
閉塞または狭窄を横切るためのガイドワイヤ Download PDFInfo
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- JP4890463B2 JP4890463B2 JP2007543528A JP2007543528A JP4890463B2 JP 4890463 B2 JP4890463 B2 JP 4890463B2 JP 2007543528 A JP2007543528 A JP 2007543528A JP 2007543528 A JP2007543528 A JP 2007543528A JP 4890463 B2 JP4890463 B2 JP 4890463B2
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- drive shaft
- guidewire
- distal
- hollow guidewire
- distal tip
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Description
本出願は、米国連邦規則集37セクション1.78の下に、2000年4月6日に出願された「Guidewire For Crossing Occlusions or Stenoses」という名称の米国特許仮出願第60/195,154号の利益を請求した、2000年8月22日に出願された「Guidewire For Crossing Occlusions or Stenoses」という名称の米国特許出願第09/644,201号の一部継続出願で、現在の米国特許第6,824,550号である、2004年11月29日に出願された「Guidewire For Crossing Occlusions or Stenoses」という名称の米国特許出願第10/999,457号の一部継続出願であり、これらの特許出願の開示は、その全体が参照によって本明細書に組み込まれる。
本発明は一般に、医療装置、キットおよび方法に関する。より詳細には本発明は、患者の体の狭窄、部分閉塞または全閉塞を横切るためのガイドワイヤシステムを提供する。
本発明は、閉塞物質を除去し、体管腔内の閉塞、狭窄、血栓、斑、石灰化物質および他の物質を貫通するためのシステムおよび方法を提供する。より具体的には、本発明を使用して、神経、心臓および末梢体管腔の狭窄または閉塞を貫通させることができる。本発明は一般に、体管腔の中を前進させ、閉塞または狭窄に隣接して配置する、中空ガイドワイヤなどの細長い部材を含む。閉塞を開口させるために、中空ガイドワイヤの遠位先端またはその近くに、閉塞物質(例えば斑)除去アセンブリが配置される。一実施形態では、斑除去アセンブリが、中空ガイドワイヤの軸方向ルーメン内で振動させ、往復運動させ(例えばつつき)、かつ/または回転、前進させる遠位先端を有するドライブシャフトを含む。ガイドワイヤが病変に到達した後、中空ガイドワイヤの前方に経路を生成し、閉塞または狭窄の中に経路を形成するために、露出した振動、往復運動および/または回転ドライブシャフトとともにガイドワイヤを、病変の中へ前進させる(または、ガイドワイヤを固定位置に置き、ドライブシャフトを前進させる)ことができる。閉塞または狭窄の貫通を容易にするため、中空ガイドワイヤの遠位端を操縦可能にして、閉塞または狭窄を貫く経路生成の制御をより良好にすることができる。任意選択で、閉塞を貫く経路の生成の前、最中および後に、標的部位に注入および/または吸引を実施することができる。
本発明に基づくシステム、装置および方法は一般に、粥状、狭窄、血栓または他の閉塞物質で閉塞または狭窄した患者の体管腔、通常は冠状動脈または末梢血管内の標的部位の管腔内処置用に適合される。しかし、これらのシステム、装置および方法はさらに、体管腔の狭窄、ならびに尿管、胆管、呼吸道、膵管、リンパ管などの他の体管腔の他の過形成および新生物形成状態を治療するのに適している。新生物性細胞増殖は、体管腔を取り囲み、貫入する腫瘍の結果としてしばしば起こる。したがって、このような物質の除去は、体管腔の開存性を維持するのに有利であることがある。以下の議論は、冠状動脈の粥状または血栓閉塞物質を貫通することを対象とするが、本発明のシステムおよび方法を使用して、様々な体管腔の様々な閉塞、狭窄または過形成物質を除去しかつ/または貫通することができることが理解されよう。
Claims (12)
- 体管腔内の閉塞または狭窄を横切るための偏向可能な中空ガイドワイヤ装置であって、
遠位端と、近位端と、細長い本体を貫く通路とを有する細長い本体と、
該通路を通って延び、遠位先端を有するコア要素であって、該遠位先端は、該細長い本体の遠位端から延びる、コア要素と、
該細長い本体の通路内で、かつ該細長い本体の遠位端に固定されたチューブであって、該チューブの遠位部分にわたって先細になっている、チューブと、
該細長い本体の近位端にあるハンドルであって、該ハンドルは、該コア要素を回転および/または振動させるために接続可能なモータを備える、ハンドルと、
を含み、該細長い本体の遠位端は、偏向を維持するように適合され、該偏向が、該コア要素の遠位先端を該細長い本体の軸から離すように方向付ける、装置。 - 前記細長い本体が予め成形されている、請求項1に記載の装置。
- 前記チューブは、該細長い本体の偏向を維持する張力を付与する、請求項1または2に記載の装置。
- 前記チューブは、前記細長い本体に対して引かれて前記遠位端を偏向させ得る、請求項3に記載の装置。
- 前記細長い本体が、少なくとも比較的剛性の近位領域、剛性が低い中間領域、および比較的可撓性の遠位領域を有する、請求項1〜4のいずれか1項に記載の装置。
- 前記比較的剛性の近位領域が、金属チューブを備え、前記剛性が低い中間領域が、コイル、スロット付きチューブ、または螺旋状カットを有するチューブを備え、そして前記可撓性の遠位領域が、コイル、スロット付きチューブ、リブ構造体、または螺旋状カットを有するチューブのうちの少なくとも1つを備える、請求項5に記載の装置。
- 前記コア要素の遠位先端が、弾丸、みぞ付き弾丸、扁平へら、ドリルまたはラグビーボールの形状の要素を含む、請求項1〜6のいずれか1項に記載の装置。
- 前記細長い本体に前記コア要素の遠位先端を固定するロッキング機構をさらに含む、請求項1〜7のいずれか1項に記載の装置。
- 前記ハンドルが、前記細長い本体および前記コア要素に取外し不可能に結合されている、請求項1〜8のいずれか1項に記載の装置。
- 前記ハンドルが、前記細長い本体および前記コア要素に取外し可能に結合されている、請求項1〜8のいずれか1項に記載の装置。
- さらに、フィードバック制御を提供する回路を含む、請求項1〜10のいずれか1項に記載の装置。
- 前記回路が前記ハンドル内にある、請求項11に記載の装置。
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US10/999,457 | 2004-11-29 | ||
US10/999,457 US20050119615A1 (en) | 2000-04-06 | 2004-11-29 | Guidewire for crossing occlusions or stenoses |
US11/236,703 | 2005-09-26 | ||
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JP2008521503A JP2008521503A (ja) | 2008-06-26 |
JP2008521503A5 JP2008521503A5 (ja) | 2008-12-25 |
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US (1) | US20060074442A1 (ja) |
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Also Published As
Publication number | Publication date |
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EP1824552A4 (en) | 2009-12-30 |
US20060074442A1 (en) | 2006-04-06 |
JP2008521503A (ja) | 2008-06-26 |
WO2006058223A2 (en) | 2006-06-01 |
EP1824552A2 (en) | 2007-08-29 |
WO2006058223A3 (en) | 2009-05-14 |
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