JP5547200B2 - 睡眠時無呼吸を治療する経静脈法 - Google Patents
睡眠時無呼吸を治療する経静脈法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3601—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of respiratory organs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/686—Permanently implanted devices, e.g. pacemakers, other stimulators, biochips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/70—Means for positioning the patient in relation to the detecting, measuring or recording means
- A61B5/704—Tables
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4806—Sleep evaluation
- A61B5/4818—Sleep apnoea
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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
- A61F2/82—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
-
- 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
- A61F2/82—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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/37205—Microstimulators, e.g. implantable through a cannula
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- Heart & Thoracic Surgery (AREA)
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- Physiology (AREA)
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Description
Claims (14)
- 胸部移植に適応した移植可能パルス発生器と、
前記パルス発生器に接続され、非心臓血管系の中を通して摺動可能に前進させるように構成された移植可能なリード線と、を備え、
前記リード線は、遠位の刺激部と近位の呼吸努力の検出部とを含んでおり、前記リード線は、舌下神経に最も近い位置に前記刺激部を配置するように構成され、胸部の前記パルス発生器から延設される長さを有し、
前記検出部は、生体を横切る第1のインピーダンスを検出するように、第1の検出要素と、前記リード線の長さに沿って前記第1の検出要素から離間した第2の検出要素とを含んでおり、
前記検出部は、前記刺激部に対して、前記リード線の長さに沿って離間し、且つ近位の位置に配置されている、閉塞性睡眠時無呼吸の治療システム。 - 前記刺激部が、
ベース部と、
前記ベース部から延設され、第1の刺激電極構造を含む第1の部分と、
前記ベース部から延設され、前記第1の部分から分離して、第2の刺激電極構造を含む第2の部分と、を含み、
前記それぞれの第1および第2の部分は、前記第1の部分を第1の舌下神経に隣接した血管内に位置して、そして前記第2の部分を第2の舌下神経に隣接した血管内に位置して、身体の両側に配置できるように構成された長さを有する、請求項1に記載のシステム。 - 前記刺激部が、
前記血管系の中を通って前進させるためのほぼまっすぐな状態と、前記舌下神経の位置で、前記血管系の中の前記刺激部を解放可能に固定するための拡張したコイル状態と、の間で変動可能なコイル構造の少なくとも一部を含む第1の固定装置、または
前記血管系の中を通って前進中においてほぼ折り畳んだ虚脱状態と、前記舌下神経を刺激するための位置で半径方向に拡張した状態と、の間で変動可能なステント構造を含む第2の固定装置、のうちの少なくとも1つを含む、請求項1に記載のシステム。 - 前記刺激部が、少なくとも1つの刺激電極構造と、前記少なくとも1つの刺激電極構造から分離し、前記リード線の外表面のまわりに放射状に配置されたつめ状突起の配列を含む第3の固定装置とを含み、ほぼ折り畳んだ虚脱状態では、前記つめ状突起が前記リード線の前記外表面に対してほぼ平坦に置かれており、拡張した状態では、前記つめ状突起が非心臓血管系内に残った状態で前記リード線の前記外表面から離れてほぼ外方に突き出ている、請求項1に記載のシステム。
- 前記刺激部と前記検出部は、前記刺激部と前記検出部の単一通過の移植を提供するために単一の細長いリード線上に設けられている、請求項1に記載のシステム。
- 前記リード線の前記第1の部分と前記第2の部分との長さは、気道開通性の表示を示す前記第1の刺激電極構造と第2の刺激電極構造との間の第2のインピーダンス測定を提供する前記第1の刺激電極構造と第2の刺激構造を配置する寸法である、請求項2に記載のシステム。
- 前記リード線の前記刺激部、前記リード線の前記呼吸努力の検出部、および前記移植可能なパルス発生器のケースにおける少なくとも2つは、前記のそれぞれの刺激部、呼吸努力の検出部、および移植可能なパルス発生器の間の第2のインピーダンス測定を提供できるように配置されており、
前記第2のインピーダンス測定は、気道開通性の表示であり、そして
前記第2のインピーダンスは、前記呼吸努力の検出部を経由して測定された前記第1のインピーダンス測定から分離され、独立している、請求項2に記載のシステム。 - 前記第1の部分は、身体の第1の側の舌下神経に最も近い位置で血管系の第1の静脈内に配置される第1の刺激電極構造を備え、
前記第2の部分は、身体の前記第1の側の前記舌下神経に最も近い位置で血管系の第2の静脈内に配置される第2の刺激電極構造を備える、請求項2のシステム。 - 前記第1の部分は、身体の第1の側の舌下神経に最も近い位置で血管系の第1の静脈内に配置される第1の刺激電極構造を備え、
前記第2の部分は、身体の前記第1の側の第2の非舌下神経に最も近い位置で血管系の第2の静脈内に配置される第2の刺激電極構造を備え、
前記第2の非舌下神経は、呼吸に関連する筋肉を刺激するよう構成された、請求項2のシステム。 - 前記刺激部が、
前記刺激部の長さに沿って互いに離間した、独立してプログラム可能な複数の電極要素の配列を含み、
前記配列は前記各電極要素の異なる組み合わせを経由して刺激信号を印加するように構成されている、請求項5に記載のシステム。 - 前記単一の細長いリード線は、前記刺激部を前記舌下神経に隣接した舌下静脈内に位置するように、前記刺激部と前記パルス発生器の間に延びる第1の長さを有し、前記検出部は、前記センサ部を鎖骨下静脈内に位置するように、前記第1の長さに沿って前記パルス発生器から離間し、前記第1の長さに沿って前記刺激部から離間した、請求項5に記載のシステム。
- 前記生体インピーダンスは経喉頭生体インピーダンスおよび経咽頭生体インピーダンスの少なくとも1つである請求項6に記載のシステム。
- 前記第2のインピーダンス測定は、前記呼吸努力の検出部を経由して入手可能な前記第1のインピーダンス測定から分離され、独立している請求項6に記載のシステム。
- 前記電極要素のうちの少なくともいくつかが、前記刺激部の外表面上で円周方向に互いに離間している、請求項10に記載のシステム。
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US10195208P | 2008-10-01 | 2008-10-01 | |
US61/101,952 | 2008-10-01 | ||
PCT/US2009/059060 WO2010039853A1 (en) | 2008-10-01 | 2009-09-30 | Transvenous method of treating sleep apnea |
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JP5547200B2 true JP5547200B2 (ja) | 2014-07-09 |
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US (3) | US9889299B2 (ja) |
EP (2) | EP3714771A1 (ja) |
JP (1) | JP5547200B2 (ja) |
WO (1) | WO2010039853A1 (ja) |
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EP2331201B1 (en) | 2020-04-29 |
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US11083899B2 (en) | 2021-08-10 |
EP3714771A1 (en) | 2020-09-30 |
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