JP6346858B2 - 血管腔に再進入するためのシステム及び方法 - Google Patents
血管腔に再進入するためのシステム及び方法 Download PDFInfo
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Description
(1) 内膜下領域から血管の腔までの通路の形成を容易にするリエントリカテーテルであって、遠位端部及び前記遠位端部に隣接したウィンドウを有する細長い外側の管状部材と、前記ウィンドウ内に長手方向に配置された複数の屈折可能なストラットと、前記外側の管状部材内に同軸状に配置された作動部材と、を含み、前記外側の管状部材に対する前記作動部材の軸運動が前記ストラットを半径方向外側に屈折させるように、前記屈折可能なストラットの近位端部が前記作動部材の遠位端部に作動的に接続される、リエントリカテーテル。
(2) 前記外側の管状部材に前記ウィンドウと対向する位置で側面ポートを更に含む、実施態様1に記載のリエントリカテーテル。
(3) 前記ストラットはニッケルチタン合金から形成される、実施態様1に記載のリエントリカテーテル。
(4) 前記外側の管状部材は円周を有し、前記ウィンドウはほぼ120°〜240°の範囲に相当する前記円周の部分を占める、実施態様1に記載のリエントリカテーテル。
(5) 前記作動部材に加えられた張力は前記細長い管状部材の前記遠位端部で剛性を高くする、実施態様1に記載のリエントリカテーテル。
(7) 前記作動部材内に同軸状に配置された切断部材を更に含む、実施態様2に記載のリエントリカテーテル。
(8) 前記切断部材は前記側面ポートから出て前進するように構成されたカニューレを含む、実施態様7に記載のリエントリカテーテル。
(9) 前記切断部材はニッケルチタン合金から形成される、実施態様8に記載のリエントリカテーテル。
(10) 前記作動部材は、前記作動部材を段階的な量で軸方向に遠位に動かすように構成された機械的ハンドルに作動的に接続される、実施態様1に記載のリエントリカテーテル。
(12) 内膜下領域から血管の腔まで通路を形成する方法であって、
a)遠位端部及び前記遠位端部に隣接したウィンドウを有する細長い外側の管状部材と、前記ウィンドウ内に長手方向に配置された複数の屈折可能なストラットと、前記外側の管状部材内に同軸状に配置された作動部材であって、前記屈折可能なストラットの近位端部が前記作動部材の遠位端部に作動的に接続される、作動部材と、前記ウィンドウに対向して位置する側面ポートと、を備えたリエントリカテーテルを提供するステップと、
b)前記カテーテルの前記遠位端部を内膜下領域を通って前進させるステップと、
c)前記作動部材を遠位方向に動かして前記ストラットを半径方向外側に屈折させるステップと、
d)リエントリ機器を前記側面ポートを通して前進させ前記血管の内膜層を通って前記腔内に前進させるステップと、を含む方法。
(13) 前記作動部材を遠位方向に動かして前記ストラットを半径方向外側に屈折させる前記ステップは、前記血管の外膜層と係合させ前記側面ポートを前記内膜層に押しつけて位置決めさせる、実施態様12に記載の方法。
(14) 機器を前記側面ポートを通して前進させるステップはガイドワイヤーを前進させることを含む、実施態様12に記載の方法。
(15) リエントリカテーテルを提供するステップは、前記作動部材内に同軸状に配置されたカニューレを含むリエントリ機器を備えた前記カテーテルを提供することを更に含み、前記側面ポートを通してリエントリ機器を前進させるステップは、前記作動部材を通して前記カニューレを摺動させることを含む、実施態様12に記載の方法。
(17) リエントリカテーテルを提供するステップは、前記作動部材に作動的に接続された機械的ハンドルを備えた前記カテーテルを提供することを更に含み、前記ハンドルを作動して前記作動部材を段階的な量で軸方向に遠位に動かすステップを更に含む、実施態様12に記載の方法。
(18) 前記ストラットを半径方向外側に屈折させ前記内膜層と外膜層との間に空間を作るために前記作動部材を遠位方向に動かすステップと、前記カテーテルの前記遠位先端部を前記空間の中に前進させるステップとを更に含む、実施態様12に記載の方法。
(19) 前記内膜下領域は前記血管を閉塞する病変に隣接し、前記側面ポートを通してリエントリ機器を前進させるステップは前記病変の少なくとも一部分を貫通することを更に含む、実施態様12に記載の方法。
Claims (7)
- 血管における内膜層と外膜層との間の領域である内膜下領域にて使用される、前記内膜下領域から血管の腔までの通路の形成を容易にするリエントリカテーテルであって、遠位端部及び前記遠位端部に隣接したウィンドウを有する細長い外側の管状部材と、前記ウィンドウ内に長手方向に配置された複数の屈折可能なストラットと、前記外側の管状部材内に同軸状に配置された作動部材と、前記外側の管状部材の前記ウィンドウと対向する位置における側面ポートと、前記作動部材内に同軸上に配置された切断部材と、を含み、前記外側の管状部材に対する前記作動部材の軸運動が前記ストラットを半径方向外側に屈折させるように、前記屈折可能なストラットの近位端部が前記作動部材の遠位端部に作動的に接続され、
前記切断部材は、前記側面ポートから出て前進するように構成されるカニューレを含み、
前記リエントリカテーテルは2mm(6フレンチ)以下の範囲の径を有する、
リエントリカテーテル。 - 前記ストラットはニッケルチタン合金から形成される、請求項1に記載のリエントリカテーテル。
- 前記外側の管状部材は円周を有し、前記ウィンドウはほぼ120°〜240°の範囲に相当する前記円周の部分を占める、請求項1に記載のリエントリカテーテル。
- 前記作動部材に加えられた張力は前記細長い管状部材の前記遠位端部の剛性を高くする、請求項1に記載のリエントリカテーテル。
- 前記ストラットによって支持され前記ストラット間で力を配分するように構成された膜を更に含む、請求項1に記載のリエントリカテーテル。
- 前記切断部材はニッケルチタン合金から形成される、請求項1に記載のリエントリカテーテル。
- 前記作動部材は、前記作動部材を段階的な量で軸方向に遠位に動かすように構成された機械的ハンドルに作動的に接続される、請求項1に記載のリエントリカテーテル。
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JP2014520597A (ja) | 2014-08-25 |
US8920449B2 (en) | 2014-12-30 |
CN106902441B (zh) | 2020-03-13 |
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US10335174B2 (en) | 2019-07-02 |
US20160213386A1 (en) | 2016-07-28 |
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EP3915628A1 (en) | 2021-12-01 |
AU2017202442A1 (en) | 2017-05-04 |
CA2840200A1 (en) | 2013-01-03 |
JP2017164513A (ja) | 2017-09-21 |
AU2019200461B2 (en) | 2019-10-31 |
WO2013003194A1 (en) | 2013-01-03 |
AU2020200739A1 (en) | 2020-02-20 |
AU2019200461A1 (en) | 2019-02-07 |
CN103796705B (zh) | 2017-05-03 |
US20150112374A1 (en) | 2015-04-23 |
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CN103796705A (zh) | 2014-05-14 |
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