JP6586172B2 - 水頭症の治療方法およびシステム - Google Patents
水頭症の治療方法およびシステム Download PDFInfo
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- JP6586172B2 JP6586172B2 JP2017542811A JP2017542811A JP6586172B2 JP 6586172 B2 JP6586172 B2 JP 6586172B2 JP 2017542811 A JP2017542811 A JP 2017542811A JP 2017542811 A JP2017542811 A JP 2017542811A JP 6586172 B2 JP6586172 B2 JP 6586172B2
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Description
本出願は、2014年10月31日出願の米国仮出願第62/073,766号、2015年4月3日出願の第62/142,895号、2015年5月1日出願の第62/156,152号について、米国特許法第119条に基づく利益を主張する。前述の出願は、ここに、参照によりその全体が本出願に組み入れられる。
送達組立体300は、送達組立体300と着脱可能に連結するシャント200を含む。送達組立体300およびシャント200は、好適な生体適合性材料より成りうる。送達組立体300は、脈管構造の遠隔位置に到達するように寸法され、シャント200を経皮的に標的位置(例えば、下錐体静脈洞)に送達するように構成される。送達組立体300は、外部管状部材320(すなわち、誘導カテーテル)と、外部管状部材320内に同軸上に配置され、かつ、外部管状部材320に対して移動可能である内部管状部材304(すなわち、送達カテーテル/マイクロカテーテル)とを有する管状部材インタフェースを含む。送達組立体300は、誘導カテーテル320および/または送達カテーテル304内に同軸上に配置されるガイドワイヤ302を含みうる。ガイドワイヤ302は、直径が例えば0.035インチ(0.889mm)とすることが可能である。送達組立体300は、ガイドワイヤ302に加えて、送達カテーテル304内に配置される送達ガイドワイヤ308を含みうる。送達ガイドワイヤ308は、ガイドワイヤ302と比べて小さい直径(例えば、約0.010インチ(0.254mm)から0.018インチ(0.4572mm)を有する。
Claims (17)
- 患者の下錐体静脈洞(IPS)に配備されるシャントであって、
前記IPSを介して患者の小脳橋(CP)角槽へ導入されて配置される遠位部であって、該CP角槽が脳脊髄液(CSF)を含んでいる遠位部と、
患者の頸静脈(JV)内に配置される近位部と、
前記遠位部から前記近位部まで延びるルーメンであって、前記遠位部内の1以上のCSF取り入れ開口と、前記近位部内のCSF流出開口とに連通するルーメンとを具え、
前記シャントの遠位部がCP角槽内に配置され、且つ前記シャントの近位部がJV内に配置された状態で前記シャントがIPS内に配備されたときに、CSFがCP角槽から前記1以上のCSF取り入れ開口、ルーメンおよびCSF流出開口をそれぞれ通ってJVに流れることを特徴とするシャント。 - 請求項1に記載のシャントにおいて、さらに、前記ルーメン内に配置されるか、または前記CSF流出開口に連結されるバルブを具え、前記CP角槽から前記ルーメンを通ってJV内へと流れるCSFは前記バルブを通って流れることを特徴とするシャント。
- 請求項2に記載のシャントにおいて、前記バルブおよびルーメンは、患者のCP角槽とJVの間における5−12cmH 2 O(490.3325〜1176.798Pa)の差圧条件下で、前記ルーメンを通る毎時5mlから毎時15mlのCSFの目標流速を達成するように構成され寸法決めされることを特徴とするシャント。
- 請求項2に記載のシャントにおいて、前記バルブは、3mmHgから5mmHgの範囲のCP角槽とJVの間の差圧で開くように構成されることを特徴とするシャント。
- 請求項1に記載のシャントにおいて、前記シャントがさらに、前記遠位部から前記近位部まで延びる管状の本体部分をさらに備え、当該管状の本体部分は、ポリマー材料で形成されていることを特徴とするシャント。
- 請求項1に記載のシャントにおいて、前記シャントの前記遠位部は、CP角槽に導入された後に、折り畳まれた送達構成から拡張した展開構成へと自己拡張することを特徴とするシャント。
- 請求項1に記載のシャントにおいて、前記シャントの遠位部は、当該シャントの遠位部をCP角槽内に固定するように構成された遠位固着機構を具えることを特徴とするシャント。
- 請求項7に記載のシャントにおいて、前記遠位固着機構は、前記1以上のCSF取り入れ開口をCP角槽のクモ膜層から分離し、離し、および/または離れる方へ向けて維持するように構成されていることを特徴とするシャント。
- 正常圧水頭症を含む水頭症および/または高い頭蓋内圧の治療システムであって、前記システムは、
患者の下錐体静脈洞(IPS)に配備されるシャントであって、
前記IPSを介して患者の小脳橋(CP)角槽へ導入されて配置される遠位部であって、前記CP角槽が脳脊髄液(CSF)を含んでいる遠位部と、
患者の頸静脈(JV)内に配置される近位部と、
前記遠位部から前記近位部まで延びるルーメンであって、前記遠位部内の1以上のCSF取り入れ開口と、前記近位部内のCSF流出開口とに連通するルーメンとを具え、
前記シャントの遠位部がCP角槽内に配置され、且つ前記シャントの近位部がJV内に配置された状態で前記シャントがIPS内に配備されたときに、CSFがCP角槽から前記1以上のCSF取り入れ開口、ルーメンおよびCSF流出開口をそれぞれ通ってJVに流れる、シャントと、
静脈アクセスポイントを介して患者の体内に導入し、前記シャントをIPS内へと操縦するための送達システムとを具えることを特徴とするシステム。 - 請求項9に記載のシステムにおいて、前記送達システムが組織貫通遠位先端を有する送達カテーテルを具え、当該送達カテーテルは、送達カテーテルルーメンと、当該送達カテーテルルーメンと連通する開放遠位端とを具え、前記送達カテーテルルーメンは前記シャントをIPS内に配備するために運ぶように構成されていることを特徴とするシステム。
- 請求項10に記載のシステムにおいて、さらに、前記送達カテーテルの遠位部に連結され、前記組織貫通遠位先端がCP角槽内で遠位に進められる距離を制限する貫通止めを具えることを特徴とするシステム。
- 請求項10に記載のシステムにおいて、前記送達カテーテルは、前記組織貫通遠位先端を硬膜組織と30度から90度の範囲の角度で接触させるように誘導する、IPS内の湾曲構造をとるように構成された遠位部を具えることを特徴とするシステム。
- 請求項10に記載のシステムにおいて、前記送達カテーテルは、前記組織貫通遠位先端の軌道を示すように設けられ寸法決めされた1以上のX線不透過性マーカーを含むことを特徴とするシステム。
- 請求項9に記載のシステムにおいて、さらに、前記ルーメン内に配置されるか、または前記CSF流出開口に連結されるバルブを具え、前記CP角槽から前記ルーメンを通ってJV内へと流れるCSFは前記バルブを通って流れることを特徴とするシステム。
- 請求項14に記載のシステムにおいて、前記バルブおよびルーメンは、患者のCP角槽とJVの間における5−12cmH 2 O(490.3325〜1176.798Pa)の差圧条件下で、前記ルーメンを通る毎時5mlから毎時15mlのCSFの目標流速を達成するように構成され寸法決めされることを特徴とするシステム。
- 請求項14に記載のシステムにおいて、前記バルブは、3mmHgから5mmHgの範囲のCP角槽とJVの間の差圧で開くように構成されることを特徴とするシステム。
- 請求項9に記載のシステムにおいて、前記シャントがさらに、前記遠位部から前記近位部まで延びる管状の本体部分をさらに備え、当該管状の本体部分は、ポリマー材料で形成されていることを特徴とするシステム。
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CN107148293B (zh) | 2020-08-11 |
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JP2017538562A (ja) | 2017-12-28 |
US20170157375A1 (en) | 2017-06-08 |
CN107148293A (zh) | 2017-09-08 |
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