JP6700278B2 - 心臓弁を修復するための経皮的クリップ - Google Patents
心臓弁を修復するための経皮的クリップ Download PDFInfo
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- JP6700278B2 JP6700278B2 JP2017529669A JP2017529669A JP6700278B2 JP 6700278 B2 JP6700278 B2 JP 6700278B2 JP 2017529669 A JP2017529669 A JP 2017529669A JP 2017529669 A JP2017529669 A JP 2017529669A JP 6700278 B2 JP6700278 B2 JP 6700278B2
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- leaflet
- clip
- clipping
- end portion
- elongate member
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Classifications
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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
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/083—Clips, e.g. resilient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
- A61B17/1227—Spring clips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2463—Implants forming part of the valve leaflets
-
- 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
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- 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
- A61B2017/00349—Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0649—Coils or spirals
Description
102、1006、1106、1202、1402、1502、2110、2202、2624 細長部材、シャフト
104、2204、2408 第1のクリッピングアーム
106、2206、2410 第2のクリッピングアーム
108、1010、1316、2108、2208、2618 管状部材
110、120、1702、2210、2404 近位端部分
112、906、908、1704、2212、2406 遠位端部分
114 管腔
116 環状カラー
118、163、165、2118、2120、2614、2616 タブ
122 第1の延長部分
124 第2の延長部分
126 スロット
128、130、1108、1110、1312、1314、1420、1422、1522、1524、2411 弁尖受け領域
132 ロック機構、保持機構
134、1512 突起
136 ノッチ
138、1410 覆い
150、1902、2002、2102 送達システム
152 主要ハンドル本体
154、2608 外側導管、シャフト
156、158 制御ボタン
160 把持部分
162 アクチュエータ部材、アクチュエータ導管、シャフト
260 アクチュエータ導管
163A、165A 角度付き部分
165、1602、2122、2124、2132、2134 開口部
168、1802 内側シャフト、内側部材
200、400 大動脈弁
210、212、214、504、506、604、606、1302、1304、1416、1418、1518、1520、2302、2416、2418、2510、2512 弁尖
216 弁輪
218 第1の交連部
220 第2の交連部
222 第3の交連部
300、1306 心臓弁
408 支持リング
410 円柱部
500 僧帽弁
508、702、704、802、804、902、9041002、1004、1102、1104、1204、1206、1308、1310、1404、1406、1504、1506、1600、1700、1800、1904、1906、2004、2006、2104、2106、2204、2206、2306、2408、2410、2504、2506、2510、2512、2626、2628 クリッピングアーム
600 三尖弁
802、804 クリッピングポイント
806、808、1006、1008、2636 遠位部分
1604、1804 覆い
1606 縫合糸
1208、1510 チューブ、スリーブ、管状部材
1408 能動弁尖係合機構
1412 近位保持部材
1414 遠位保持部材
1516 エッジ部分
1526 シース
2112 アクチュエータ部材
2114 結合デバイス
2128、2130 タブ、延長部分
2214、2215、2314 組織収集領域
2220、2222 組織圧縮領域
2224、2226、2304 自由端部分
2310 弁尖圧縮領域
2312 中央部分
2402 中央部材
2412 外側部材
2414、2514 螺旋部材
2602、2630 ハンドル本体、ハンドル部分
2604 近位ハンドル部分
2606 遠位ハンドル部分
2610 中間導管、クリップ解放導管
2612 クリップ保持導管
2614、2616 タブ部分
2622 内側シャフト、導管
2632 突出部
2634 トラック、ガイド
2638 中間部分
2640 近位部分
Claims (11)
- 弁尖クリップであって、
近位端部分および遠位端部分を含む細長部材と、
開位置と閉位置との間で移動可能な第1のクリッピングアームおよび第2のクリッピングアームであって、前記第1及び第2のクリッピングアームは、前記細長部材の前記近位端部分に結合されたそれぞれの近位端部分と、前記細長部材に対し遠位方向かつ径方向に外側に延びるそれぞれの遠位端部分とを含む、第1のクリッピングアームおよび第2のクリッピングアームと、
前記細長部材の周りに同軸で配置された管状部材と、
前記細長部材の前記遠位端部分に配置されたポリマーまたは布地の覆いであって、前記覆いは、前記第1及び第2のクリッピングアームが前記開位置から前記閉位置まで動かされるときに、心臓弁の生来の弁尖に係合するように構成され、前記覆いは、第2の保持部材の近位の前記細長部材上に固定して配置された第1の保持部材によって前記細長部材上に保持され、前記第2の保持部材は、前記第1の保持部材に対する前記第2の保持部材の近位方向の動きによって、前記覆いの径方向の拡張が生じるように、前記第1の保持部材に対して移動可能である、ポリマーまたは布地の覆いと、
を備え、前記細長部材に対する前記管状部材の軸方向運動または前記管状部材に対する前記細長部材の軸方向運動によって、前記開位置と前記閉位置との間で前記第1及び第2のクリッピングアームの対応する動きが生じることを特徴とする弁尖クリップ。 - 前記管状部材の近位端部分は、送達デバイスへ取り付けるように構成される、請求項1に記載の弁尖クリップ。
- 前記覆いは、天然材料または合成繊維材料から構成され、織られるか、編まれるか、またはそれらの任意の組み合わせである、請求項1に記載の弁尖クリップ。
- 前記覆いは、前記細長部材の前記遠位端部分に配置され、互いから離間された1つ以上の突起を含む、請求項1に記載の弁尖クリップ。
- 前記細長部材の前記近位端部分は、前記管状部材を前記細長部材に対し遠位方向に延びた位置に保持するように構成された保持機構を備え、前記遠位方向に延びた位置において、前記管状部材は前記第1及び第2のクリッピングアームの上に延び、前記第1及び第2のクリッピングアームを前記閉位置に保持する、請求項1から4のいずれか一項に記載の弁尖クリップ。
- 前記第1及び第2のクリッピングアームは、前記細長部材の前記近位端部分上に配置されたカラーと一体形成される、請求項1から5のいずれか一項に記載の弁尖クリップ。
- 前記管状部材は、前記管状部材の軸方向に動くときに、それぞれ前記第1のクリッピングアームおよび前記第2のクリッピングアームに接触するように構成された第1の延長部分および第2の延長部分を含む、請求項1から6のいずれか一項に記載の弁尖クリップ。
- 前記細長部材の前記近位端部分は、送達デバイスに取り付けるように構成される、請求項1から7のいずれか一項に記載の弁尖クリップ。
- 前記細長部材は、ガイドワイヤを受けるように構成された管腔を画定する、請求項1から8のいずれか一項に記載の弁尖クリップ。
- 前記弁尖クリップは、僧帽弁、大動脈弁、三尖弁またはそれらの任意の組み合わせと共に使用するように構成される、請求項1から9のいずれか一項に記載の弁尖クリップ。
- 組織圧縮領域および組織収集領域を更に備える、請求項1から10のいずれか一項に記載の弁尖クリップ。
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
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JP2019208759A JP6974416B2 (ja) | 2014-12-04 | 2019-11-19 | 心臓弁を修復するための経皮的クリップ |
JP2021180173A JP7331064B2 (ja) | 2014-12-04 | 2021-11-04 | 心臓弁を修復するための経皮的クリップ |
JP2023129238A JP2023157925A (ja) | 2014-12-04 | 2023-08-08 | 心臓弁を修復するためのクリップおよびアセンブリ |
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US201462087530P | 2014-12-04 | 2014-12-04 | |
US62/087,530 | 2014-12-04 | ||
PCT/US2015/064096 WO2016090308A1 (en) | 2014-12-04 | 2015-12-04 | Percutaneous clip for repairing a heart valve |
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JP2019208759A Division JP6974416B2 (ja) | 2014-12-04 | 2019-11-19 | 心臓弁を修復するための経皮的クリップ |
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JP2018500978A JP2018500978A (ja) | 2018-01-18 |
JP6700278B2 true JP6700278B2 (ja) | 2020-05-27 |
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JP2017529669A Active JP6700278B2 (ja) | 2014-12-04 | 2015-12-04 | 心臓弁を修復するための経皮的クリップ |
JP2019208759A Active JP6974416B2 (ja) | 2014-12-04 | 2019-11-19 | 心臓弁を修復するための経皮的クリップ |
JP2021180173A Active JP7331064B2 (ja) | 2014-12-04 | 2021-11-04 | 心臓弁を修復するための経皮的クリップ |
JP2023129238A Pending JP2023157925A (ja) | 2014-12-04 | 2023-08-08 | 心臓弁を修復するためのクリップおよびアセンブリ |
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JP2019208759A Active JP6974416B2 (ja) | 2014-12-04 | 2019-11-19 | 心臓弁を修復するための経皮的クリップ |
JP2021180173A Active JP7331064B2 (ja) | 2014-12-04 | 2021-11-04 | 心臓弁を修復するための経皮的クリップ |
JP2023129238A Pending JP2023157925A (ja) | 2014-12-04 | 2023-08-08 | 心臓弁を修復するためのクリップおよびアセンブリ |
Country Status (5)
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US (3) | US10524792B2 (ja) |
EP (1) | EP3226810A4 (ja) |
JP (4) | JP6700278B2 (ja) |
CN (3) | CN111437068B (ja) |
WO (1) | WO2016090308A1 (ja) |
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