JP4928449B2 - 管腔内プロテーゼ - Google Patents
管腔内プロテーゼ Download PDFInfo
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- 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
- A61F2/07—Stent-grafts
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- 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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- 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
- A61F2/9517—Instruments specially adapted for placement or removal of stents or stent-grafts handle assemblies therefor
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- 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
- A61F2/848—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having means for fixation to the vessel wall, e.g. barbs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61F2/89—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
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- 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
- A61F2/07—Stent-grafts
- A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
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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
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
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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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
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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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
- A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
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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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
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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
- 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
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/005—Rosette-shaped, e.g. star-shaped
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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
- 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
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0054—V-shaped
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0067—Three-dimensional shapes conical
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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
- 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
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
- A61F2250/0063—Nested prosthetic parts
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- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
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- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
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- Prostheses (AREA)
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Description
1.技術分野
この発明は、医療用装置に関し、特に、管腔内の動脈瘤、解離、または壁内血腫の修復のために人または動物の体内に埋込むためのプロテーゼに関する。
この明細書の全体にわたって、大動脈または他の血管について論じるとき、プロテーゼに関して、遠位の(distal)および遠位に(distally)という用語は、血液の流れの方向で心臓から最も遠いプロテーゼの端部を指すことが意図される。同様に、近位の(proximal)および近位に(proximally)という用語は、埋込まれたときに、心臓に最も近いであろうプロテーゼの端部を意味することが意図される。
、拡張可能なステント、動脈瘤上方の頭部ステント、および静脈瘤下方の尾部ステントのような装着装置によって、動脈壁の内面に取付けられる。
特に角のある解剖学的構造で有用性を有する、管腔を強化するための管腔内プロテーゼが提供される。このプロテーゼは、目標の角のある解剖学的構造に適合するために十分に柔軟な中空の本体を含む管状のグラフトを含む。中空の柔軟な本体の少なくとも一部分を拡張させるために十分な外向きの径方向の力を提供する自己拡張ステントが本体に結合され得る。自己拡張ステントは、目標の解剖学的構造で、またはその近くでプロテーゼの少なくとも一部分を保持するように管腔の壁を把持するための把持手段を含み得る。プロテーゼは管状のステントも含み得る。管状のステントは、第1の直径および第2の拡張された直径を有する。管状のステントは、管状のステントの内側から外向きに拡張する力を適用することにより第2の直径に形成可能である。第2の直径は、管腔内プロテーゼが用いられるべき目標の解剖学的構造の内径に少なくとも等しいことが望ましい。この発明の管腔内プロテーゼの他の特徴および利点は以下の詳細な説明から明らかであろう。
この発明のプロテーゼ20の切欠図が図1に示される。自己拡張プロテーゼ20は、プロテーゼ20が導入器から解放されたことに続いて拡張できるように、弾力のあるステント19が取付けられ得る管状のグラフト50を有する。「グラフト」という用語は、人工血管として作用する一般にカニューレ状または管状の部材を意味する。グラフトそれ自身または他の要素を付加したグラフトは管腔内部プロテーゼであり得る。「ステント」という用語は、堅さ、拡張力または支持をプロテーゼに付加するあらゆる装置または構造を意味する。
開示されるタイプのGianturco-Ruebenタイプのバルーン−拡張可能ステントであり得る。自己拡張ステント19は、プロテーゼが導入器から解放されたことに続いてプロテーゼ20を拡張させる。自己拡張ジグザクステント18が解放されると、かえし23はプロテーゼ20の近位端を管腔に留める。ワイヤステント17は、大きく角度を付けられた管腔に非常に適しており、封止を形成するために管腔に沿ったすべての点でプロテーゼ20の十分な拡張を提供する。プロテーゼ20の自己拡張部分は、プロテーゼ20を管腔の内面の近傍に拡張させるのに十分な径方向の力を提供するステント19を使用し、一方でワイヤステント17はプロテーゼ20を管腔の内面へと封止するために力を提供することが好ましい。
つ径方向外側にある。壁の厚いプラスチックチューブ41および鞘30は、図1および図5に示されるように、操作領域1に対して遠位に延在する。鞘30は、図5に詳細に示されるように、外部操作セクション1の把持カラー26および止血封止アセンブリ35に対して遠位に延在する。
とともにのみ動くことができ、したがって、壁の薄いチューブ15は壁の厚いチューブ41とともにのみ動くことができる。スクリューキャップ46が締められていると、図5に示されるように、外部スリーブ30およびそこに取付けられる構造を除いて、アセンブリ全体は1つとして動かされなければならない。図7は、金属チューブ15への試薬の導入を容易にするためにシリンジを受入れるように適合されたコネクタ16も示す。金属チューブ15は、流体を通すように柔軟な延在部11のアパーチャ12と通じている。したがって、コネクタ16へと導入された試薬は、アパーチャ12を通って流れ、横方向の開口部14から出ることができる。
囲まなくなったとき、自己拡張ステント18は、図10に示されるように拡張する。自己拡張ステント18が拡張するとき、自己拡張ステント18上のフックまたはかえし23は、プロテーゼ20の近位端を定位置に保持するために管腔の壁に把持する。
の近くに固定された、近位端138を含み得る。スリーブ116は、特定の用途に対してあるものが他のものより適している、さまざまな材料のうちのどれを含んでもよい。スリーブ116は、膨張性でない(indistensable)材料を含んでもよい。スリーブ116は、生理学的に不活性であるかまたは生分解性であり得る医療用材料を含んでもよい。図示されていないが、別の管腔がカテーテルを通ってその遠位端と近位カップリング132の1つとの間で縦方向に延在する。この管腔は、典型的には既に血管に位置付けられているワイヤガイド上でカテーテルを通すために利用される。
Claims (15)
- 管腔を強化するための管腔内プロテーゼ(20)であって、
近位端(51)、遠位端(42)、外面、および内面を有する中空の柔軟な本体を含む管状のグラフト(50)と、
前記本体の外面に結合される少なくとも1つのジグザグ形の自己拡張ステント(19)と、
前記少なくとも1つの自己拡張ステント(19)とは別個の、バルーンにより拡張可能な管状のステント(17)とを含み、
前記管状のステント(17)は、第1の直径および第2の拡張された直径を有するとともに、前記近位端(51)と前記少なくとも1つの自己拡張ステント(19)との間で前記本体の内面に結合され、
前記自己拡張ステント(19)は管腔内プロテーゼ(20)を管腔の内面の近傍に拡張させるのに十分な径方向の力を供給し、
前記管状のステント(17)は、前記管腔内プロテーゼ(20)の周に沿って巻くように、かつ、当該周方向に突き出すように湾曲したセクションを、前記管腔内プロテーゼ(20)の長手方向に複数含み、複数の前記セクションは、隣接するセクション同士が接続されているとともに、それぞれの湾曲の先端の向きが、隣接するセクション同士で互いに向き合うように、交互に反転して配置され、
前記管状のステント(17)はさらに、内部からの外向きに拡張する力の適用によって前記第2の直径へと拡張可能であり、前記第2の直径は前記中空の柔軟な本体の内径以上であり、前記管状のステント(17)は管腔内プロテーゼ(20)を管腔の内面へと封止する力を提供する、管腔内プロテーゼ(20)。 - 前記少なくとも1つの自己拡張ステント(19)は、前記中空の柔軟な本体の一部分の長さに沿って結合される複数の自己拡張ステント(19)を含む、請求項1に記載の管腔内プロテーゼ。
- 前記バルーンにより拡張可能な管状のステント(17)は、そこを通って縦方向に延在する通路を備えた細長い部材を含む、請求項1または2に記載の管腔内プロテーゼ。
- 前記バルーンにより拡張可能な管状のステント(17)はステンレス鋼を含む、請求項1、2または3に記載の管腔内プロテーゼ。
- 前記管状のグラフト(50)は誘導コラーゲン材料を含む、請求項1から4のいずれかに記載の管腔内プロテーゼ。
- 前記誘導コラーゲン材料は細胞外マトリックスである、請求項5に記載の管腔内プロテーゼ。
- 前記細胞外マトリックスは小腸粘膜下組織である、請求項6に記載の管腔内プロテーゼ。
- 前記細胞外マトリックスは胃粘膜下組織である、請求項6に記載の管腔内プロテーゼ
。 - 前記細胞外マトリックスは心膜である、請求項6に記載の管腔内プロテーゼ。
- 前記細胞外マトリックスは肝臓基底膜である、請求項6に記載の管腔内プロテーゼ。
- 前記細胞外マトリックスは膀胱粘膜下組織である、請求項6に記載の管腔内プロテーゼ。
- 前記管状のグラフト(50)は合成材料を含む、請求項1から4のいずれかに記載の管腔内プロテーゼ。
- 合成材料はポリエステルである、請求項12に記載の管腔内プロテーゼ。
- 合成材料はポリテトラフルオロエチレンである、請求項12に記載の管腔内プロテーゼ。
- 合成材料は延伸ポリテトラフルオロエチレンである、請求項12に記載の管腔内プロテーゼ。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US58531404P | 2004-07-02 | 2004-07-02 | |
US60/585,314 | 2004-07-02 | ||
PCT/US2005/023491 WO2006014347A1 (en) | 2004-07-02 | 2005-06-30 | Balloon / self-expanding stent graft |
Publications (2)
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JP2008504899A JP2008504899A (ja) | 2008-02-21 |
JP4928449B2 true JP4928449B2 (ja) | 2012-05-09 |
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JP2007519476A Active JP4928449B2 (ja) | 2004-07-02 | 2005-06-30 | 管腔内プロテーゼ |
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---|---|
US (1) | US8864813B2 (ja) |
EP (1) | EP1763327B1 (ja) |
JP (1) | JP4928449B2 (ja) |
AU (1) | AU2005270090C1 (ja) |
CA (1) | CA2570431C (ja) |
WO (1) | WO2006014347A1 (ja) |
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WO2021193955A1 (ja) | 2020-03-27 | 2021-09-30 | 川澄化学工業株式会社 | 留置装置 |
US11471310B2 (en) | 2018-03-19 | 2022-10-18 | SB-Kawasumi Laboratories, Inc. | Indwelling device and cylindrical treatment tool |
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US9814611B2 (en) | 2007-07-31 | 2017-11-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US20110190697A1 (en) * | 2010-02-03 | 2011-08-04 | Circulite, Inc. | Vascular introducers having an expandable section |
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US9827093B2 (en) | 2011-10-21 | 2017-11-28 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
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US11439396B2 (en) | 2014-05-02 | 2022-09-13 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
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WO2021193955A1 (ja) | 2020-03-27 | 2021-09-30 | 川澄化学工業株式会社 | 留置装置 |
Also Published As
Publication number | Publication date |
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EP1763327B1 (en) | 2018-09-12 |
CA2570431A1 (en) | 2006-02-09 |
AU2005270090A1 (en) | 2006-02-09 |
CA2570431C (en) | 2012-11-27 |
EP1763327A1 (en) | 2007-03-21 |
AU2005270090C1 (en) | 2012-09-20 |
US8864813B2 (en) | 2014-10-21 |
WO2006014347A1 (en) | 2006-02-09 |
US20080039927A1 (en) | 2008-02-14 |
JP2008504899A (ja) | 2008-02-21 |
AU2005270090B2 (en) | 2010-09-16 |
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