JP5149150B2 - 解剖学的なオリフィス又は内腔の内周を制御するための方法及び装置 - Google Patents
解剖学的なオリフィス又は内腔の内周を制御するための方法及び装置 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
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
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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
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
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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
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2472—Devices for testing
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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
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
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Description
したがって、本発明の目的は、内部構造又は内腔の形状及びサイズの少なくとも一方を制御するための移植可能な装置を提供することである。
Claims (89)
- 解剖学的な構造又は内腔の形状及びサイズの少なくとも一方を制御するための器具であって、
自身の内部を通って延びる可撓性部材(1324)を有する中空部材(1320;1322)と、
前記可撓性部材の一部に結合されるスピンドル(1370)と
を有する調整可能で移植可能な装置(1310)を備え、
前記スピンドルは、第1の方向に回転すると前記可撓性部材が該スピンドルの周りに巻き付き、第2の方向に回転すると前記可撓性部材が該スピンドルの周りから解けるように構成され、
前記スピンドルの周りに巻き付く前記可撓性部材の長さが変化すると、前記移植可能な装置の内部の前記可撓性部材が短くなるか又は長くなり、前記移植可能な装置のサイズ又は形状の少なくとも一方が変化する、解剖学的な構造又は内腔の形状及びサイズの少なくとも一方を制御するための器具。 - 前記スピンドルを効果的に回転させる調整ツール(1312)をさらに備える、請求項1に記載の器具。
- 前記調整ツール(1312)は、前記移植可能な装置に取り付け可能又は再取り付け可能であるように構成される、請求項2に記載の器具。
- 前記移植可能な装置(1310)は、前記スピンドル(1370)が前記第1の方向に回転すると縮小し、前記スピンドルが前記第2の方向に回転すると伸張する、請求項1に記載の器具。
- 前記調整ツール(1312)は、前記解剖学的な構造又は内腔を再び開くか又はアクセスする必要がなく、該解剖学的な構造又は内腔の調整が問題ないとみなされた後に、前記移植可能な装置(1310)から取り外されるように構成される、請求項2に記載の器具。
- 前記調整ツール(1312)は、胸部切開部を閉じた後に前記移植可能な装置(1310)に再取り付けされるように構成される、請求項2に記載の器具。
- 前記移植可能な装置(1310)は、少なくとも2次元で調整可能である、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、3次元で調整可能である、請求項1に記載の器具。
- 前記スピンドル(1370)の回転を妨げるロック機構(1386,1396,1404)をさらに備える、請求項1に記載の器具。
- 前記中空部材は、外層(1320)及び内層(1322)を含む、請求項1に記載の器具。
- 前記可撓性部材(1324)は、前記外層(1320)の内部に配置される、請求項10に記載の器具。
- 前記移植可能な装置(1310)は、前記外層(1320)に隣接する内層(1322)を含み、該内層は付加的な部材のための空間をつくる、請求項10に記載の器具。
- 前記外層(1320)は、発泡体製である、請求項10に記載の器具。
- 前記解剖学的な構造又は内腔は、前記移植可能な装置が該解剖学的な構造又は内腔のサイズ及び形状の少なくとも1つを変えることによって軽減される機能不全を有する、請求項1に記載の器具。
- 前記解剖学的な構造又は内腔は、心臓弁、食道、胃食道接合部、胃、幽門、腸、及び肛門から選択される、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、大動脈弁の配置に用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、腹部大動脈瘤装置の配置に用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、大動脈ステント植え込み用途に用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、大動脈エンドグラフ用途に用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、腹部大動脈瘤ステントグラフに用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、大動脈瘤の治療に用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、食道の治療に用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、肥満を制御するための胃での用途に用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、概ね円形の形状である、請求項1に記載の器具。
- 前記解剖学的な構造又は内腔への前記移植可能な装置(1310)の締結を行うように構成される1つ又は複数の締結装置(1712)をさらに備える、請求項1に記載の器具。
- 前記1つ又は複数の締結装置は、前記移植可能な装置(1310)に組み込まれる、請求項25に記載の器具。
- 前記1つ又は複数の締結装置(1712)は、縫合糸、ワイヤ、保持針、及び形状記憶合金の少なくとも1つから選択される、請求項25に記載の器具。
- 前記1つ又は複数の締結装置(1712)はクリップである、請求項25に記載の器具。
- 前記クリップ(1712)は、前記移植可能な装置(1310)を前記解剖学的な構造又は内腔のまわりの組織に固定する、請求項28に記載の器具。
- 前記クリップ(1712)は、形状記憶材料製である、請求項28に記載の器具。
- 前記クリップ(1712)は、4mm〜10mmの長さである、請求項28に記載の器具。
- 前記クリップ(1712)は、該クリップが実質的に直線状となって前記移植可能な装置(1310)の下面に隣接する後退状態を有するように構成される、請求項28に記載の器具。
- 前記クリップ(1712)は、縫合、接着、熱融合、アイレット、及び前記移植可能な装置(1310)への織り込みの少なくとも1つによって前記移植可能(1310)な装置に固定される、請求項28に記載の器具。
- 前記クリップ(1712)は、該クリップの自由端が丸まって重なった針になる通常構成を有するように構成される、請求項32に記載の器具。
- 前記クリップ(1712)は、前記後退状態から解放されると前記通常構成をとる、請求項34に記載の器具。
- 前記可撓性部材(1324)は、可撓性バンドを含む、請求項1に記載の器具。
- 前記可撓性部材(1324)は、形状記憶材料製である、請求項1に記載の器具。
- 前記スピンドル(1370)は、実質的に円筒状である、請求項1に記載の器具。
- 前記1つ又は複数の締結装置(1712)は、前記移植可能な装置(1310)の外周に結合される、請求項25に記載の器具。
- 前記1つ又は複数の締結装置(1712)は、前記移植可能な装置(1310)の異なる場所にあり得る、請求項25に記載の器具。
- 前記1つ又は複数の締結装置(1712)は後退可能である、請求項25に記載の器具。
- 前記1つ又は複数の締結装置(1712)は伸張可能である、請求項25に記載の器具。
- 前記1つ又は複数の締結装置(1712)は、前記解剖学的なオリフィス又は内腔に対して前記移植可能な装置(1310)が適当な向きになるまで伸張されない、請求項42に記載の器具。
- 前記締結装置(1712)は、前記移植可能な装置(1310)の移動によって該締結装置が係合又は解放させるように方向付けられる、請求項27に記載の器具。
- 前記締結装置(1712)は、前記移植可能な装置(1310)の回転移動によって該締結装置が係合又は解放させるように方向付けられる、請求項27に記載の器具。
- 前記移植可能な装置(1310)は、該移植可能な装置を回転させることによって前記締結装置を係合させるときに円滑に組織を通過できるようにする端子フックを含む、請求項27に記載の器具。
- 前記移植可能な装置(1310)は、前記調整ツール(1312)に反転可能に結合されるように構成される係合アセンブリ(1314)を含む、請求項2に記載の器具。
- 前記移植可能な装置(1310)は、患者の解剖学的な構造又は内腔が正常な生理学的状態に戻った後に調整されるように構成される、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、患者の心臓を通る血流が再開した後に調整されるように構成される、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、供給装置(600)に解放可能に取り付けられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、非展開状態で前記供給装置(600)によって供給される、請求項50に記載の器具。
- 前記供給装置(600)は、カテーテル又はトロカール(615)を含む、請求項50
に記載の器具。 - 前記供給装置(600)は、作動カテーテル(610)及び鞘部(605)を含む、請求項50に記載の器具。
- 前記作動カテーテル(610)は、前記移植可能な装置(1310)を非展開状態から展開状態にさせる、請求項53に記載の器具。
- 少なくとも第1のタッチダウン・センサ(648)をさらに備える、請求項1に記載の器具。
- 前記タッチダウン・センサ(648)は、回路を完成させるように構成されるか、又は蛍光透視マーカの提供を補助する、請求項55に記載の器具。
- 前記タッチダウン・センサ(648)は、マイクロスイッチを完成させるように配置され得る、請求項55に記載の器具。
- 前記タッチダウン・センサ(648)は、該タッチダウン・センサが所望の場所にあることを示すように構成される、請求項55に記載の器具。
- 前記タッチダウン・センサ(648)は、電気的トレースを検知するように構成される、請求項55に記載の器具。
- 前記タッチダウン・センサ(648)は、遠位部材(680)、中間部材(682)、及び近位部材(684)を含む、請求項55に記載の器具。
- 前記遠位部材(680)は、ばねによって取り付けられており、前記近位部材(684)とのシームレス接合を達成するために前記中間部材(682)の上で摺動可能で、入れ子状の移動が可能である、請求項60に記載の器具。
- 前記タッチダウン・センサ(648)の少なくとも一部は、放射線不透過材料でカバーされる、請求項55に記載の器具。
- 前記タッチダウン・センサ(648)は、入れ子状又はばね負荷であり得る、請求項55に記載の器具。
- 前記移植可能な装置(1310)は、虚血性環状膨張症及び僧帽弁逆流に用いられる、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、展開傘(642)を用いて配置される、請求項1に記載の器具。
- 前記展開傘(642)及び前記移植可能な装置(1310)は、僧帽弁の領域に対して後方に引かれる、請求項65に記載の器具。
- 少なくとも2つのタッチダウン・センサ(648)が設けられ、該少なくとも2つのタッチダウン・センサは、前記移植可能な装置(1310)の展開が進行され得るときを示す、請求項66に記載の器具。
- 前記移植可能な装置(1310)の再配置を可能にするために、反対の動きによって保持針(646)が該移植可能な器具(1310)に再配置される、請求項1に記載の器具。
- 前記タッチダウン・センサ(648)は、前記移植可能な装置(1310)の適当な位置決めに利用される、請求項67に記載の器具。
- 前記調整ツール(1312)は、カテーテル(615)を通して前記解剖学的な構造又は内腔に向けて進むように構成される、請求項2に記載の移植可能な装置。
- 前記調整ツール(1312)は、オペレータによって舵取り可能なように操作可能である、請求項2に器具。
- 前記調整ツール(1312)は、該調整ツールが前記移植可能な装置(1310)に取り付け可能になるように、磁気、電気、電磁気、及びレーザのうちの少なくとも1つによって案内する装置を含む、請求項2に記載の器具。
- 前記調整ツール(1312)は、遠隔的に制御されるシステムによって駆動されるように構成される、請求項2に記載の器具。
- 前記移植可能な装置(1310)は、直線、曲線、円形、卵形、多角形、及びその組み合わせの少なくとも1つから選択される外形を有する、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、前記解剖学的な構造又は内腔の均一及び非均一な調整を提供するように構成される、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、僧帽弁の調整を提供するように構成される、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、該移植可能な装置が縮小すると前記解剖学的な構造又は内腔も縮小し、該移植可能な装置が伸張すると前記解剖学的な構造又は内腔も伸張するように構成される、請求項4に記載の器具。
- 前記移植可能な装置(1310)の少なくとも一部は、管状の構造である、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、外側部材(1320)及び内側部材(1322)を含む、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、前記調整ツールに係合する係合部材(1378)を含む、請求項2に記載の器具。
- 前記移植可能な装置(1310)は、該移植可能な装置の前記解剖学的な構造又は内腔への縫合糸のない固定を提供するインタフェイスを含む、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、該移植可能な装置を前記解剖学的な構造又は内腔に固定するための縫合糸をさらに備える、請求項1に記載の器具。
- 生物学的に互換性のある物質を用いて、前記移植可能な装置(1310)の前記解剖学的な構造又は内腔への固定が補助される、請求項1に記載の器具。
- 前記移植可能な装置(1310)は、トロカール、鞘部、セルディンガー法、針によって皮下的に、及び自然の体のオリフィス、身体内の空所、又は領域を通して内視鏡によって導入される、請求項1に記載の器具。
- 解剖学的な構造又は内腔の形状及びサイズの少なくとも一方を制御するための器具であって、
長開口を画定する中空部材(1320;1322)を有する調整可能で移植可能な装置(1310)と、
前記中空部材の内部の前記開口を通って延びる可撓性部材(1324)と、
前記開口に連結されて第1の方向及び第2の方向に回転するように構成されるスピンドル(1370)とを備え、
前記可撓性部材の一部は前記スピンドルに巻き付けられ、該スピンドルに巻き付く前記可撓性部材の長さは、該スピンドルが前記第1の方向に回転すると増加し、前記第2の方向に回転すると減少し、
前記中空部材の内部に延びる前記可撓性部材の長さが増減することによって、前記移植可能な装置のサイズ又は形状の少なくとも一方が変化する、解剖学的な構造又は内腔の形状及びサイズの少なくとも一方を制御するための装置。 - 前記移植可能な装置(1310)は、調整可能な弁輪形成リングを備える、請求項85に記載の器具。
- 前記スピンドル(1370)を回転させるための該スピンドルに着脱可能な調整ツール(1312)をさらに含む、請求項85に記載の器具。
- 前記中空部材(1320;1322)は、外層(1320)及び内層(1322)を含む、請求項85に記載の器具。
- 前記可撓性部材(1324)は、前記内層(1320)の内部に設けられる、請求項88に記載の器具。
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2006
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- 2006-03-27 JP JP2008503294A patent/JP5149150B2/ja not_active Expired - Fee Related
- 2006-03-27 US US11/390,984 patent/US9492276B2/en active Active
- 2006-03-27 EP EP06748801.5A patent/EP1861045B1/en not_active Not-in-force
- 2006-03-27 WO PCT/US2006/011275 patent/WO2006105084A2/en active Application Filing
- 2006-03-27 AU AU2006230162A patent/AU2006230162B2/en not_active Ceased
- 2006-03-27 EP EP14167472.1A patent/EP2767260B1/en active Active
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Cited By (2)
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JP2014000417A (ja) * | 2007-08-23 | 2014-01-09 | Direct Flow Medical Inc | インプレース形成支持部を有する経腔的に移植可能な心臓弁 |
JP2011529731A (ja) * | 2008-07-29 | 2011-12-15 | セント ジュード メディカル,カーディオロジー ディビジョン,インコーポレイテッド | 埋め込み可能な装置の長期間の調節のための方法およびシステム |
Also Published As
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EP1861045A2 (en) | 2007-12-05 |
EP2626039B1 (en) | 2015-10-14 |
US20140336756A1 (en) | 2014-11-13 |
JP2012196504A (ja) | 2012-10-18 |
WO2006105084A2 (en) | 2006-10-05 |
AU2006230162A1 (en) | 2006-10-05 |
EP1861045B1 (en) | 2015-03-04 |
EP2626039A1 (en) | 2013-08-14 |
EP2767260B1 (en) | 2019-07-03 |
JP2008534086A (ja) | 2008-08-28 |
EP2767260A1 (en) | 2014-08-20 |
WO2006105084A3 (en) | 2007-11-29 |
EP1861045A4 (en) | 2010-06-30 |
US9492276B2 (en) | 2016-11-15 |
AU2006230162B2 (en) | 2011-09-29 |
US20060241748A1 (en) | 2006-10-26 |
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