JP6537200B2 - 血管内閉塞をバイパスするための変動可撓性を有する閉塞バイパス装置及び方法 - Google Patents
血管内閉塞をバイパスするための変動可撓性を有する閉塞バイパス装置及び方法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0194—Tunnelling catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00309—Cut-outs or slits
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22054—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation with two balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22065—Functions of balloons
- A61B2017/22069—Immobilising; Stabilising
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22094—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing
- A61B2017/22095—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing accessing a blood vessel true lumen from the sub-intimal space
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3966—Radiopaque markers visible in an X-ray image
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0082—Catheter tip comprising a tool
- A61M2025/0095—Catheter tip comprising a tool being one or more needles protruding from the distal tip and which are not used for injection nor for electro-stimulation, e.g. for fixation purposes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0194—Tunnelling catheters
- A61M2025/0197—Tunnelling catheters for creating an artificial passage within the body, e.g. in order to go around occlusions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1047—Balloon catheters with special features or adapted for special applications having centering means, e.g. balloons having an appropriate shape
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2210/00—Anatomical parts of the body
- A61M2210/12—Blood circulatory system
Description
Claims (20)
- 血管内閉塞をバイパスするための装置であって、
その遠位端の近位にある側面ポートを有する外側シャフトコンポーネントと、
前記外側シャフトコンポーネント内に配置され、かつそこを通じる連続ルーメンを定義する内側シャフトコンポーネントであって、前記内側シャフトコンポーネントは、前記装置の長手方向軸線に対して実質的に平行に延びる本体部、及び前記本体部の遠位端から遠位方向に延びるニードルハウジングを有し、前記ニードルハウジングは前記装置の前記長手方向軸線から曲がり、かつ前記外側シャフトコンポーネントの前記側面ポートで終わる湾曲遠位部及び前記内側シャフトコンポーネントの本体部と前記ニードルハウジングの前記遠位部の間に配置される移行部を含み、前記移行部は遠位方向に向けて減少する長さに沿う可変可撓性を有する、前記内側シャフトコンポーネントと、
前記内側シャフトコンポーネントの前記連続ルーメン内にスライド可能に配置され、かつそこから取り外し可能なように構成されたニードルコンポーネントであって、前記ニードルハウジングの前記湾曲遠位部と同じ曲率の湾曲遠位端を有する、前記ニードルコンポーネントと、を備えていることを特徴とする、
血管内閉塞をバイパスするための装置。 - 前記外側シャフトコンポーネントが、その前記遠位端の近位に配置された少なくとも1つのバルーン及び前記少なくとも1つのバルーンと流体連通する膨張ルーメンを含む、
請求項1に記載の前記装置。 - 前記外側シャフトコンポーネントの前記側面ポートが、前記少なくとも1つのバルーンの長さに沿って中間に配置される、
請求項2に記載の装置。 - 前記少なくとも1つのバルーンが、前記外側シャフトコンポーネントの対向する側面上に平行に配置された第1側部バルーン及び第2側部バルーンを含む、
請求項2に記載の装置。 - 前記内側シャフトコンポーネントの前記本体部が、ポリマーチューブを含み、前記ニードルハウジングが形状記憶材料のチューブから形成される、
請求項1に記載の装置。 - 前記ニードルハウジングの近位端が、前記内側シャフトコンポーネントの前記本体部の遠位端に取り付けられた2つの対向するタブを含む、
請求項5に記載の装置。 - 前記移行部が、前記移行部に前記可変可撓性を供給するよう構成された複数の開口部を含む、請求項5に記載の装置。
- 隣接する開口部間の空間が遠位方向に向って増加する、
請求項7に記載の装置。 - 隣接する開口部の幅が遠位方向に向って減少する、
請求項7に記載の装置。 - 前記移行部が、他の方向ではなく前記装置の前記長手方向軸線を通じて通る垂直面に沿ってのみ、前記内側シャフトコンポーネントに屈曲性を与える、
請求項7に記載の装置。 - 前記複数の開口部が、前記ニードルハウジングの横軸に沿って互いに並ぶ開口部のペアを含み、並んだ開口部の各ペアにおける各開口部が砂時計形である、請求項7に記載の装置。
- 前記複数の開口部がそれぞれ、上部領域と下部領域の間に配置された胴体部領域のある砂時計形であり、各砂時計形開口部が前記ニードルハウジングの外面周囲に延び、その上部領域と下部領域の間に定義されたブリッジ領域を有し、かつ隣接する砂時計形開口部が第1砂時計形開口部のブリッジ領域が第2砂時計形開口部の胴体領域と縦方向に並ぶように位置する、請求項7に記載の装置。
- 形状記憶材料から形成された前記チューブの一部が、形状記憶材料から形成された前記チューブと同じ内径及び同じ外径のX線不透過性マーカーと取り替えられる、請求項5に記載の装置。
- 前記外側シャフトコンポーネントが、その遠位部に少なくとも沿って延びるガイドワイヤルーメンを含む、請求項1に記載の装置。
- 血管内閉塞をバイパスするための装置であって、
その遠位端の近位にある側面ポートを有する外側シャフトコンポーネントと、
前記外側シャフトコンポーネント内に配置され、かつそこを通じる連続ルーメンを定義する内側シャフトコンポーネントであって、この内側シャフトコンポーネントが前記装置の長手方向軸線と実質的に平行に延びる本体部及び前記本体部の遠位端から遠位方向に延びるニードルハウジングを有し、このニードルハウジングが前記装置の前記長手方向軸線から曲がり、かつ前記外側シャフトコンポーネントの前記側面ポートで終わる湾曲遠位部及び前記内側シャフトコンポーネントの本体部と前記ニードルハウジングの前記湾曲遠位部の間に配置される移行部を含み、前記移行部は前記ニードルハウジングの前記湾曲遠位部に沿うよりも前記内側シャフトコンポーネントの前記本体部に沿う方がより可撓性を有し、かつ前記移行部は遠位方向に向けて減少するその長さに沿う可変可撓性を有する前記内側シャフトコンポーネントと、
前記内側シャフトコンポーネントの前記連続ルーメン内にスライド可能に配置され、かつそこから取り外し可能なように構成されたニードルコンポーネントと、を備える前記装置であり、
前記ニードルコンポーネントは湾曲遠位端を有し、前記装置の第1構成では、前記ニードルコンポーネントの前記湾曲遠位端が前記内側シャフトコンポーネントの前記ニードルハウジング内で真っ直ぐに伸ばされた形状で収容され、かつ前記装置の第2構成では、前記ニードルコンポーネントの前記湾曲遠位端は前記外側シャフトコンポーネントの前記側面ポートから延び、前記装置の前記長手方向軸線から曲がる、
ことを特徴とする血管内閉塞をバイパスするための装置。 - 前記ニードルコンポーネントの前記湾曲遠位端が、前記内側シャフトコンポーネントの前記湾曲遠位部と同じ曲率を持ち、かつ前記ニードルコンポーネントの遠位チップが前記血管の壁を突き通るよう構成される、
請求項15に記載の装置。 - 前記外側シャフトコンポーネントが、その前記遠位端の近位に配置された少なくとも1つのバルーン及び前記少なくとも1つのバルーンと流体連通する膨張ルーメンを含む、
請求項15に記載の装置。 - 血管内閉塞をバイパスするための装置であって、
その遠位端の近位にある側面ポート及びその前記遠位端の近位に配置された少なくとも1つのバルーンを有する外側シャフトコンポーネントであって、前記外側シャフトコンポーネントは前記少なくとも1つのバルーンと流体連通する膨張ルーメン及びその遠位部に少なくとも沿って延びるガイドワイヤルーメンを定義する、前記外側シャフトコンポーネントと、
前記外側シャフトコンポーネント内に配置され、かつそこを通じる連続ルーメンを定義する内側シャフトコンポーネントであって、前記内側シャフトコンポーネントは前記装置の長手方向軸線と実質的に平行に延びる本体部及び前記本体部の遠位端から遠位方向に延びるニードルハウジングを有し、前記ニードルハウジングは前記装置の前記長手方向軸線から曲がり、かつ前記外側シャフトコンポーネントの前記側面ポートで終わる湾曲遠位部及び前記内側シャフトコンポーネントの本体部と前記ニードルハウジングの前記遠位部の間に配置される移行部を含み、前記移行部は遠位方向に向けて減少するその長さに沿う可変可撓性を有する、前記内側シャフトコンポーネントと、
前記内側シャフトコンポーネントの前記連続ルーメン内にスライド可能に配置され、かつそこから取り外し可能なように構成されたニードルコンポーネントであって、前記ニードルコンポーネントは前記内側シャフトの前記湾曲遠位部と同じ曲率の湾曲遠位端を有する、前記ニードルコンポーネントと、を備える、
血管内閉塞をバイパスするための装置。 - 前記少なくとも1つのバルーンが、前記外側シャフトの対向する側面上に平行に配置された第1側部バルーン及び第2側部バルーンを含む、
請求項18に記載の装置。 - 前記内側シャフトコンポーネントの前記本体部がポリマーチューブであり、かつ前記ニードルハウジングが形状記憶材料のチューブから形成され、前記ニードルハウジングの前記移行部が前記移行部に前記可変可撓性を供給するよう構成された複数の開口部を含む、 請求項18に記載の装置。
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US14/460,048 | 2014-08-14 | ||
US14/460,048 US10456557B2 (en) | 2014-08-14 | 2014-08-14 | Occlusion bypassing apparatus with varying flexibility and methods for bypassing an occlusion in a blood vessel |
PCT/US2015/044239 WO2016025324A1 (en) | 2014-08-14 | 2015-08-07 | Occlusion bypassing apparatus with varying flexibility |
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JP2017523880A JP2017523880A (ja) | 2017-08-24 |
JP6537200B2 true JP6537200B2 (ja) | 2019-07-03 |
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