JP5634523B2 - ステントグラフト及び導入器アッセンブリ - Google Patents
ステントグラフト及び導入器アッセンブリ Download PDFInfo
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- JP5634523B2 JP5634523B2 JP2012539958A JP2012539958A JP5634523B2 JP 5634523 B2 JP5634523 B2 JP 5634523B2 JP 2012539958 A JP2012539958 A JP 2012539958A JP 2012539958 A JP2012539958 A JP 2012539958A JP 5634523 B2 JP5634523 B2 JP 5634523B2
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- 0 C*C(C)C=NC(C)C(CC1CC1)[C@](C)*(C)C Chemical compound C*C(C)C=NC(C)C(CC1CC1)[C@](C)*(C)C 0.000 description 1
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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
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
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- A—HUMAN NECESSITIES
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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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- A—HUMAN NECESSITIES
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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
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- A—HUMAN NECESSITIES
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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
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- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
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- A—HUMAN NECESSITIES
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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
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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
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- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
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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
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91566—Adjacent bands being connected to each other connected trough to trough
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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
-
- 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
- A61F2002/9534—Instruments specially adapted for placement or removal of stents or stent-grafts for repositioning of stents
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- A—HUMAN NECESSITIES
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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
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
- A61F2002/9665—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- 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
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Prostheses (AREA)
Description
本出願は、2009年11月19日出願の米国仮特許出願第61/262,839号、及び2009年11月18日出願のイギリス特許出願第GB0920235.9号並びに2009年11月19日出願の同第GB0920327.4号に対する優先権を主張し、前記特許出願それぞれをここに参考文献としてそっくりそのまま援用する。
12 下行大動脈
14 大動脈弓
16 腕頭動脈
18 左総頚動脈
20 左鎖骨下動脈
22 上行大動脈
23 大動脈洞
24 心臓開口部
26、28 冠状動脈
30、32 A型解離の輪郭線
40 ステントグラフト
42 グラフト管
44、46、48、50、52 ステントリング (44と52は裸)
54 ステント頂端
56、58、60 縮径縫合糸ループ
56’、58’、60’ 拘束点
62、64 球状領域
70 遠位ステント
72 ステントリング
74 スレッド
80 亀裂
100 導入器
112 外部操作部区間
114 遠位取付部領域
116 近位取付部領域
118 インプラント、人工器官、ステントグラフト
120 拡張器先端
122 ガイドワイヤ受け入れ用の孔
124 ガイドワイヤカテーテル
126 接続装置
128 拡張器先端の開口
130 押出器部材、押出器ロッド
132 シース
134 シースマニピュレータ及び止血シールユニット
136 側管
138 ルアロック
140 118の遠位端
142、144 トリガーワイヤ
146、150 トリガーワイヤ解放機構
148 本体
154 ピン万力
156 ねじ込み口金
160、162 スロット
Claims (20)
- 上行大動脈の欠陥を治療するためのステントグラフトにおいて、
近位端と遠位端の設けられているグラフト材料のグラフト管と、
前記グラフト管に取り付けられている複数のステントリングと、
少なくとも第1と第2の直径拘束装置と
を有し、
前記第1の直径拘束装置は、前記グラフト管の前記近位端に又は前記近位端に近接して置かれて該近位端に取り付けられた第1のステントリングの直径を部分的に拘束するようにされており、
少なくとも1つの前記第2の直径拘束装置は、前記グラフト管に沿った中間の位置に置かれて該中間の位置に取り付けられた第2のステントリングの直径を部分的に拘束するようにされており、
前記第1と第2の直径拘束装置の間で、それら第1と第2の直径拘束装置によって拘束されていない前記グラフト管の領域が、前記第1と第2の直径拘束装置によって前記近位端及び前記中間の位置が拘束されているときに半径方向外側に拡張されて当該グラフト管の前記近位端及び前記中間の位置の間に膨張部分を形成し、それにより当該ステントリングの部分的に展開した形態を生じるようにすることができるステントグラフト。 - 前記グラフト管の近位端から延びる裸ステントを含んでいる、請求項1に記載のステントグラフト。
- 前記グラフト管は長さが65mmである、上記請求項2に記載のステントグラフト。
- 前記グラフト管の前記近位端と前記遠位端の両方に裸ステントが設けられている、上記請求項2又は3に記載のステントグラフト。
- 前記裸ステントは、前記グラフト管に対して外向きに張り出すように設計されている、請求項2乃至4の何れか一項に記載のステントグラフト。
- 前記裸ステントは、グラフト管材料の周りに周方向に配設されていて、湾曲した頂端を有している一連の指状部分を提供する波状のステント構造で形成されている、請求項2乃至5のいずれか一項に記載のステントグラフト。
- 前記裸ステントは、前記グラフト管材料から約10mm延びている、請求項2乃至6の何れか一項に記載のステントグラフト。
- 前記グラフト管の近位端から延びる裸ステントが掛かり(barb)を備えない請求項2乃至7の何れか一項に記載のステントグラフト。
- 前記第2の直径拘束装置は、前記グラフト管に沿った実質的に半分の地点に置かれている、請求項1乃至8の何れか一項に記載のステントグラフト。
- 前記拘束装置は、前記グラフト管の周りに周方向に配置されている直径収縮ループである、請求項1乃至9の何れか一項に記載のステントグラフト。
- 前記グラフト管上に置かれている1つのステント又は前記グラフト管に沿った中間の位置に配置されている複数のステントの近位端と遠位端を拘束する働きをする少なくとも2つの第2の直径拘束装置が設けられている、請求項1乃至10の何れか一項に記載のステントグラフト。
- 前記ステントグラフトには、前記グラフト管材料の前記遠位端から延びるステント区間が設けられている、請求項1乃至11の何れか一項に記載のステントグラフト。
- 前記ステント区間は、前記グラフト区間と一体化されているものと別体構成要素のうちの一方である、請求項12に記載のステントグラフト。
- 掛かりを備えない請求項1乃至13の何れか一項に記載のステントグラフト。
- 請求項1に記載のステントグラフトを配備するための導入器アッセンブリにおいて、前記ステントグラフトを担持するための担持体と、前記担持体を覆う位置から当該担持体を露出する引き込み位置へ動かせる外シースと、を含んでおり、且つ前記シースの引き込み後に前記ステントグラフトの前記拘束装置を半径方向に圧縮された形態に維持するための複数の拘束要素を含んでいる、導入器アッセンブリ。
- 前記拘束要素は、1つ又はそれ以上のトリガーワイヤを含んでいる、請求項15に記載の導入器アッセンブリ。
- 前記トリガーワイヤは、前記ステントグラフトの近位の裸ステント並びに拘束装置を拘束するようにし、そして前記拘束ワイヤが引き込まれるとそれらを最近位の拘束装置から最遠位の拘束装置へ向かう順に従って解放してゆくように、配設されている、請求項16に記載の導入器アッセンブリ。
- 前記拘束ワイヤは、前記ステントグラフトの前記遠位端も保持する、請求項17に記載の導入器アッセンブリ。
- 前記拘束装置がそれぞれ複数のトリガーワイヤを含んでいる、請求項16に記載の導入器アッセンブリ。
- 前記配備処置時に患者の心臓弁を通過させることのできる柔軟な拡張器先端を含んでいる、請求項15に記載の導入器アッセンブリ。
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GB0920327A GB2476451A (en) | 2009-11-19 | 2009-11-19 | Stent Graft |
PCT/US2010/056673 WO2011062858A1 (en) | 2009-11-18 | 2010-11-15 | Stent graft and introducer assembly |
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JP2013511335A5 JP2013511335A5 (ja) | 2013-08-15 |
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US11992219B2 (en) * | 2021-06-10 | 2024-05-28 | Cook Medical Technologies Llc | Implantable medical device and assembly |
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US20110125244A1 (en) | 2011-05-26 |
AU2010322201A1 (en) | 2012-05-24 |
AU2010322201C1 (en) | 2014-08-21 |
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US9757263B2 (en) | 2017-09-12 |
EP2387379A1 (en) | 2011-11-23 |
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