JP6724038B2 - 血流の調節可能な介入的減少のためのステント及びステントのキット - Google Patents
血流の調節可能な介入的減少のためのステント及びステントのキット Download PDFInfo
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- JP6724038B2 JP6724038B2 JP2017550990A JP2017550990A JP6724038B2 JP 6724038 B2 JP6724038 B2 JP 6724038B2 JP 2017550990 A JP2017550990 A JP 2017550990A JP 2017550990 A JP2017550990 A JP 2017550990A JP 6724038 B2 JP6724038 B2 JP 6724038B2
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Description
参考文献2:Hoffman JI,Kaplan S.先天性心臓疾患の発生。J Am Coll Cardiol2002;39:1890−900.
参考文献3:Marelli AJ, Mackie AS, Ionescu−Ittu R,Rahme E, Pilote L.一般人口における先天性心臓疾患:患者数の変化と年齢分布。Circulation 2007;15:163−72.
参考文献4:Jonas RA.発展途上国における先天性心臓疾患。Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2008:3−6.
参考文献5:Bernier PL, Stefanescu A, Samoukovic G, Tchervenkov CI.世界における先天性心臓疾患の変化:疫学的及び人口動態の事実。Semin Tho rae Cardiovasc Surg PediatrCard SurgAnnu 2010;13:26−34.
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1’ 下流端
2 遠位端
2’ 上流端
3 内側管状セグメント
3a メッシュ状の内側管状セグメント
3b カバー
4 内側ルーメン/中央ルーメン/流路ルーメン
5 外側管状セグメント
5a メッシュ状の外側管状セグメント
5b カバー
6 外側ルーメン/ブロックルーメン
7 キャップ状セグメント
7a メッシュ状のキャップ状セグメント
7b カバー
8 内面
9 外面
10 本体
11 オリフィス
12 内側ステント
13 外側ステント
20 第1減少ステント
21 拡大区画
22 狭小区画
23 中間区画
24 中央ルーメン/内側ルーメン/流路ルーメン
30 膨張ステント
34 内側ルーメン
40 第2減少ステント
41 係止手段
42 拡大区画
43 狭小区画
44 中央ルーメン/内側ルーメン/流路ルーメン
45 中間区画
Claims (22)
- 血管内での血流の調節可能な介入的減少のためのステントのキットであって、
拡大形態にて少なくとも1つの拡大区画(21)及び狭小区画(22)を有する第1減少ステント(20)であって、前記狭小区画は、前記第1減少ステント(20)の上流端(2’)と下流端(1’)との間の流体の通流を提供する中央ルーメン(4)を画定している、という第1減少ステント(20)と、
第2中央ルーメン(34)を有し、前記流体の通流を増大させるために前記第1減少ステント(20)の前記中央ルーメン(4)内に挿入可能であり当該中央ルーメン(4)内で拡大可能な、管状の形状を有する少なくとも1つの膨張可能な膨張ステント(30)と、
第3中央ルーメン(44)を有し、前記流体の通流を減少させるために、前記第1減少ステント(20)の前記中央ルーメン(4)内、または、前記膨張ステント(30)の前記中央ルーメン(34)内に挿入可能な、狭小管状区画(43)を有する少なくとも1つの第2減少ステント(40)であって、その上流端に係止手段(41)を有する、少なくとも1つの第2減少ステント(40)と、を備え、
前記係止手段(41)は、前記狭小管状区画(43)よりも大きな最大径を有し、
前記膨張ステント(30)は、前記第1減少ステント(20)の前記中央ルーメン(4)に挿入可能であるとともに、前記第1減少ステント(20)の前記上流端(2’)と前記下流端(1’)との間の流体の通流を提供し、
前記第2減少ステント(40)は、前記第1減少ステント(20)の前記中央ルーメン(4)に挿入可能であるとともに、前記第1減少ステント(20)の前記上流端(2’)と前記下流端(1’)との間の流体の通流を提供する
ことを特徴とするキット。 - 当該キットは、複数の第1及び/または第2減少ステント(40)を有し、その各々が拡大形態にて異なる内径を有している
ことを特徴とする請求項1に記載のキット。 - 前記係止手段(41)は、前記第2減少ステント(40)の前記狭小管状区画(43)の上流端にて、外側に方向付けられたフランジまたは肩の形態である
ことを特徴とする請求項1または2に記載のキット。 - 前記第2減少ステント(40)は、その上流端に拡大区画(42)を有しており、
前記係止手段(41)は、前記狭小管状区画(43)と前記拡大区画(42)との間に中間区画(45)を画定している
ことを特徴とする請求項1乃至3のいずれか一項に記載のキット。 - 前記第1減少ステント(20)は、砂時計、バーベルまたはボトルネックの形状を有している
ことを特徴とする請求項1乃至4のいずれか一項に記載のキット。 - 前記第2減少ステント(40)は、ボトルネックの形状を有している
ことを特徴とする請求項1乃至5のいずれか一項に記載のキット。 - 前記少なくとも1つの第1減少ステント(20)、及び/または、前記少なくとも1つの第2減少ステント(40)、及び/または、前記膨張ステント(30)は、金属またはプラスチックの柔軟なメッシュから作られている
ことを特徴とする請求項1乃至6のいずれか一項に記載のキット。 - 前記金属は、自己拡張型合金である
ことを特徴とする請求項7に記載のキット。 - 前記金属は、ニッケルチタン合金である
ことを特徴とする請求項8に記載のキット。 - 少なくとも、前記第1減少ステント(20)の前記狭小区画(22)と前記拡大区画(21)との間に設けられた中間区画(23)、及び/または前記第2減少ステント(40)の前記中間区画(45)が、生体適合性のあるプラスチック材料によって覆われている
ことを特徴とする請求項1乃至9のいずれか一項に記載のキット。 - 前記プラスチック材料は、伸張可能なポリマーシートであることを特徴とする請求項10に記載のキット。
- 血管内での血流の調節可能な介入的減少のための、調節可能な多ルーメンステントであって、
当該多ルーメンステントは、近位端(1)と遠位端(2)とを有する本体(10)を備え、
前記本体(10)は、当該多ルーメンステントの中央ルーメン(4)を画定する内側管状セグメント(3)と、外側管状セグメント(5)であって、当該外側管状セグメント(5)の内面(8)と前記内側管状セグメント(3)の外面(9)との間にて、当該多ルーメンステントの外側ルーメン(6)を画定する、外側管状セグメント(5)と、を有し、
前記中央ルーメン(4)は、直径が調節可能であり、前記多ルーメンステントの前記近位端(1)と前記遠位端(2)との間で流体の通流を提供し、
前記外側ルーメン(6)は、前記内側管状セグメント(3)と前記外側管状セグメント(5)とを接続する環状のキャップ状セグメント(7)によってその遠位端(2)が閉鎖されており、前記近位端(1)は開放しており、前記外側ルーメン(6)の開放された前記近位端(1)から前記外側ルーメン(6)の閉鎖された前記遠位端までの膨張手段の導入を許容する
ことを特徴とする多ルーメンステント。 - 前記内側管状セグメント(3)は、前記外側管状セグメント(5)の内側に同心にて配置されている
ことを特徴とする請求項12に記載の多ルーメンステント。 - 前記本体(10)または当該本体(10)の前記セグメント(3、5、7)の少なくとも1つは、超弾性の特性を有する材料で作られている
ことを特徴とする請求項12または13に記載の多ルーメンステント。 - 前記材料は、ニチノールである
ことを特徴とする請求項14に記載の多ルーメンステント。 - 前記本体(10)または当該本体(10)の前記セグメント(3、5、7)の少なくとも1つは、不浸透性のセグメント壁を得るために、伸張可能なポリマーシート(3b、5b)で覆われた金属またはプラスチックの柔軟な管状のメッシュ(3a、5a)で作られている
ことを特徴とする請求項12乃至15のいずれか一項に記載の多ルーメンステント。 - 前記本体(10)の前記環状のキャップ状セグメント(7)には、少なくとも2つのオリフィス(11)が設けられている
ことを特徴とする請求項12乃至16のいずれか一項に記載の多ルーメンステント。 - 前記少なくとも2つのオリフィス(11)は、前記本体(10)の中心軸線のまわりに規則的なパターンで配置されている
ことを特徴とする請求項17に記載の多ルーメンステント。 - 前記本体(10)は、1つの覆われた管状のメッシュ状ステントが前記遠位端(2)にてそれ自身の上に折り返されることにより、前記内側管状セグメント(3)、前記外側管状セグメント(5)及び前記キャップ状セグメント(7)を形成している
ことを特徴とする請求項12乃至18のいずれか一項に記載の多ルーメンステント。 - 前記本体は、互いの内部に配置され、伸張可能なプラスチックカバー(3b、5b)で覆われた、2つの管状のメッシュ状ステント(3a、5a)を有しており、
前記カバーは、前記キャップ状セグメント(7)をも形成している
ことを特徴とする請求項12乃至19のいずれか一項に記載の多ルーメンステント。 - 前記本体(10)の前記外側ルーメン(6)内に当該本体(10)の中心軸線まわりに規則的なパターンで配置された、少なくとも2つの外側管状ステント(13)を更に備えた
ことを特徴とする請求項12乃至20のいずれか一項に記載の多ルーメンステント。 - 前記本体(10)の前記中央ルーメン(4)内に配置された内側管状ステント(12)を更に備えた
ことを特徴とする請求項12乃至21のいずれか一項に記載の多ルーメンステント。
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EA201791331A1 (ru) | 2017-09-29 |
IL252856B (en) | 2021-03-25 |
UA125368C2 (uk) | 2022-03-02 |
IL252856A0 (en) | 2017-08-31 |
WO2016096529A1 (en) | 2016-06-23 |
MX2017007894A (es) | 2018-05-04 |
CA2970237C (en) | 2022-11-29 |
BR112017013033B1 (pt) | 2022-08-23 |
SG11201704722XA (en) | 2017-07-28 |
CH710439A1 (de) | 2016-06-30 |
KR102466036B1 (ko) | 2022-11-10 |
JP2018501050A (ja) | 2018-01-18 |
EP3232947B1 (en) | 2024-01-17 |
US10492933B2 (en) | 2019-12-03 |
BR112017013033A2 (pt) | 2018-04-17 |
ZA201704232B (en) | 2020-10-28 |
CN107205744B (zh) | 2021-02-12 |
KR20170095960A (ko) | 2017-08-23 |
EP3232947A1 (en) | 2017-10-25 |
AU2015366584A1 (en) | 2017-06-29 |
EP3232947C0 (en) | 2024-01-17 |
US20170367855A1 (en) | 2017-12-28 |
AU2015366584B2 (en) | 2020-04-30 |
EA033745B1 (ru) | 2019-11-21 |
CA2970237A1 (en) | 2016-06-23 |
CN107205744A (zh) | 2017-09-26 |
NZ733363A (en) | 2022-05-27 |
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