JP6241969B2 - 血管閉塞器具及びその使用方法 - Google Patents
血管閉塞器具及びその使用方法 Download PDFInfo
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- JP6241969B2 JP6241969B2 JP2016569451A JP2016569451A JP6241969B2 JP 6241969 B2 JP6241969 B2 JP 6241969B2 JP 2016569451 A JP2016569451 A JP 2016569451A JP 2016569451 A JP2016569451 A JP 2016569451A JP 6241969 B2 JP6241969 B2 JP 6241969B2
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- braided
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- catheter
- diameter
- braid
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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
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Description
[000152] 血管閉塞押込可能及び回収可能装置(例えばインプラント)は、押込可能な内側部材(例えばコイル)と、編組が一端、例えば近位端で取り付けられる柔軟で拡張可能な管状編組部材と、を含んでもよい。編組部材は通常、5cmより大きい長さを有してもよく、これらの複数の編組部材は、各編組部材が内側コイルの周囲に同軸に位置決めされるように内側部材の長さに沿って位置決めされる。編組部材の一端は通常、自由であるか又は解放されている(最大の拡張を可能にする)一方で、反対端は内側部材に結合されるか/取り付けられている。従って、編組部材の遠位端は当該遠位端で自由浮遊している。
[000172] A.内側部材上の摩擦要素
[000173] 本明細書で説明される血管閉塞器具のいずれかは、編組部材が、折畳構成にある時、例えば送達器具のカテーテル内腔内にある時、押込可能部材(例えばコイル)と拡張可能で柔軟な編組部材との間の摩擦を増大させるように作用する1以上の(例えば複数の)摩擦要素を有してもよい。さらに、摩擦要素は、カテーテル内腔の内面に接触しない又は内面との摩擦を増大させないように構成されてもよい。
[000205] 本明細書では、押込可能部材(例えばコイル)及び拡張可能編組部材が対称的に同軸上に配列されないが、代わりに、それらの長さに沿って軸外し構成で接続される、血管閉塞器具をさらに説明する。この例は図26A及び図26Bに示される。図26Aでは、拡張可能で細長い柔軟な編組部材2607が、概略的に図示されており、その長さに沿って細長い押込可能部材(例えばコイル)に取り付けられる。図26Aでは、編組部材2607は外側面に沿って押込可能部材2605に接続される。押込可能部材の長さは、編組部材の長さよりも通常は長く、及び従って、上述のように編組部材の複数の領域が含まれてもよい。さらに、編組部材の端部は、自由であってストランド端を露出させてもよく、ある変形例では、編組部材の近位端が押込可能部材に取り付けられ、そのことが、インプラントがカテーテル内に引き出されることをより容易にする。
[000209] 概して、本明細書で説明される装置のいずれかは、動脈瘤を塞栓することを意図して血管の動脈瘤内に挿入されてもよい。別個のインプラント(ステント)が動脈瘤の頸部を横切って配置されてもよい。送達システム又は展開ツールの外側に展開されると拡張するそれらの性能によれば、これらのインプラントは、非拡張コイル器具よりも短い長さで動脈瘤を充填するという利点を有している。さらに、ステントコイルのステント部分によって形成された多孔質構造が、その固有の隙間によって、動脈瘤内止血を達成することにおいて、コイルのような固体構造よりもより効果的であることができる。
[000258] 本明細書で説明される器具及びシステムのいずれかでは、内側部材が送達カテーテルを通じて押し込まれている時、編組の内側でくねるため(例えば正弦波形状を形成するため)に十分な柔軟性及び可撓性を有してもよい。カテーテルを通じて及びカテーテルの外に編組/コイル器具を押し込む時に展開摩擦が構築されるので、柔軟な内側部材はその長さに沿って様々な場所でくねってもよい。内側部材(コイルタイプ内側部材を含む)のこのくねりは、内側部材の外側と内側部材の内側との間、特に、結果として生じる正弦波形状の内側部材の頂部及び谷部に複数の接触点又は接触領域を生じさせる。内側部材が押し込まれてカテーテルの内側にコイルのくねりを生じさせる時、内側部材は、当該内側部材と編組との間に2以上の摩擦点を生成し得る。これらの接触点/摩擦点の各々は、カテーテルを通じた編組/コイルアセンブリの押込性を高めることができる。
[00260] 本明細書で説明される血管閉塞システム及び器具のいずれかは、コイル上に1以上の柔軟で拡張可能な編組を含み、コイルは、送達カテーテルを用いて動脈瘤内からの挿入のために、開口した遠位対向端前方部とともに、押し込まれてもよく、回収するために近位に引かれてもよい。
Claims (18)
- 動脈瘤を閉塞する血管閉塞システムであって、前記システムは、
近位端から遠位端に延在する送達カテーテルと、
前記送達カテーテル内の血管閉塞器具であって、前記血管閉塞器具が、前記送達カテーテルの前記遠位端の外に押し出されて前記送達カテーテルの遠位端内に回収され戻されるように適応され、前記血管閉塞器具が、
直径を有する細長い内側部材と、
0.0010インチ以下の直径である厚さを有するニチノールワイヤを備える約24〜36個のストランドから形成された柔軟な外側編組管状部材であって、前記編組管状部材は、前記編組管状部材の近位端で前記内側部材に取り付けられて固定され、前記内側部材上で長手方向軸内に延在するが、前記編組管状部材の遠位端で前記内側部材に取り付けられず、さらに、前記編組管状部材は、5cmよりも大きい長さを有し、前記送達カテーテル内で保持された時に前記長手方向軸の方向に交差するストランド同士の間に約35度以下の編組角度を形成し、かつ、前記内側部材に対して、前記送達カテーテルから解放された時に前記内側部材の直径の1.5倍よりも大きい直径に拡張し、前記編組管状部材の遠位端における前記ストランドの剛性が、前記編組管状部材の近位端における前記ストランドの剛性よりも小さい柔軟な外側編組管状部材と、を備える、血管閉塞器具と、を備える血管閉塞システム。 - 前記血管閉塞器具に接続されたプッシャをさらに備える、請求項1に記載の血管閉塞システム。
- 前記ストランドが、約0.0008インチ未満の直径である厚さを有するモノフィラメントワイヤを備える、請求項1に記載の血管閉塞システム。
- 前記ストランドが、約0.0004〜0.00075インチの直径である厚さを有するニチノールワイヤを備える、請求項1に記載の血管閉塞システム。
- 前記内側部材がクローズドピッチコイルを備える、請求項1に記載の血管閉塞システム。
- 前記内側部材が白金コイルを備える、請求項1に記載の血管閉塞システム。
- 前記編組管状部材が、前記送達カテーテル内に保持された時に30度以下の編組角度を含む、請求項1に記載の血管閉塞システム。
- 前記編組管状部材が、約35〜90度の拡張編組角度と、約0.75mm〜約3.0mmの直径と、を有するように構成される、請求項1に記載の血管閉塞システム。
- 前記編組管状部材が、約50度未満の拡張編組角度と、約0.75mm〜約3.0mmの間の直径と、を有するように構成される、請求項1に記載の血管閉塞システム。
- 前記編組管状部材が、前記送達カテーテルから解放されて拡張したときに、ストランド同士の間に形成された約0.1平方mm未満の孔サイズを有する、請求項1に記載の血管閉塞システム。
- 前記編組管状部材が、非円形であるプリセット横断形状を有するように構成される、請求項1に記載の血管閉塞システム。
- 前記編組管状部材が、3D構成のためのプリセットを有するように構成される、請求項1に記載の血管閉塞システム。
- 細長い長さの前記血管閉塞器具がプリセット曲線又は形状を有するように構成される、請求項1に記載の血管閉塞システム。
- 前記編組管状部材の前記近位端がポリマー接合部又は金属溶接部によって内側部材に結合される、請求項1に記載の血管閉塞システム。
- 前記編組管状部材が約45cm未満の長さを有する、請求項1に記載の血管閉塞システム。
- 前記カテーテルが約0.015インチ〜約0.025インチの内径を有する、請求項1に記載の血管閉塞システム。
- 前記カテーテルが約0.015インチ〜約0.018インチの内径を有する、請求項1に記載の血管閉塞システム。
- 動脈瘤を閉塞する血管閉塞器具であって、前記血管閉塞器具は、送達カテーテルの外に押込可能である折畳構成と、拡張構成と、を備え、前記血管閉塞器具は、
直径を有する細長い内側部材と、
直径0.0010インチ以下の厚さを有するニチノールワイヤを備える約24〜36個のストランドから形成された柔軟な外側編組管状部材であって、前記編組管状部材は、前記編組管状部材の近位端で前記内側部材に取り付けられて固定され、かつ、前記内側部材上に長手方向軸内に延在するが、前記編組管状部材の遠位端で前記内側部材に取り付けられ、さらに、前記編組管状部材が、5cmよりも大きい長さを有し、前記送達カテーテル内で折畳構成で前記長手方向軸の方向に交差するストランド同士の間に約35度以下の編組角度を形成し、かつ、前記内側部材に対して、前記送達カテーテルから解放された時に前記拡張構成の前記内側部材の直径の1.5倍よりも大きい直径に拡張し、前記編組管状部材の遠位端における前記ストランドの剛性が、前記編組管状部材の近位端における前記ストランドの剛性よりも小さい柔軟な外側編組管状部材と、をさらに備える、動脈瘤を閉塞する血管閉塞器具。
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US14/289,555 US9060777B1 (en) | 2014-05-28 | 2014-05-28 | Vaso-occlusive devices and methods of use |
US201562159154P | 2015-05-08 | 2015-05-08 | |
US62/159,154 | 2015-05-08 | ||
PCT/US2015/032847 WO2015184075A1 (en) | 2014-05-28 | 2015-05-28 | Vaso-occlusive devices and methods of use |
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WO2015184075A1 (en) | 2015-12-03 |
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EP3148481A4 (en) | 2017-05-03 |
US11633190B2 (en) | 2023-04-25 |
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US20190374228A1 (en) | 2019-12-12 |
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R250 | Receipt of annual fees |
Free format text: JAPANESE INTERMEDIATE CODE: R250 |