JP6853312B2 - 内腔プロテーゼおよび胃腸インプラントデバイス - Google Patents
内腔プロテーゼおよび胃腸インプラントデバイス Download PDFInfo
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- 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
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/0003—Apparatus for the treatment of obesity; Anti-eating devices
- A61F5/0013—Implantable devices or invasive measures
- A61F5/0076—Implantable devices or invasive measures preventing normal digestion, e.g. Bariatric or gastric sleeves
- A61F5/0079—Pyloric or esophageal obstructions
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- 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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
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- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
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- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
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- 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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2002/044—Oesophagi or esophagi or gullets
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- 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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2002/045—Stomach, intestines
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- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
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- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2002/9528—Instruments specially adapted for placement or removal of stents or stent-grafts for retrieval of stents
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- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
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- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/001—Figure-8-shaped, e.g. hourglass-shaped
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- Child & Adolescent Psychology (AREA)
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Description
米国特許出願12/488,037(米国2010−0121462として公開)
米国特許出願12/488,016(現在、米国特許8029557)
米国特許出願12/487,991(米国2010−0121461として公開)
米国特許出願12/971,458(米国2011−0190905として公開)
米国特許出願13/493,904(米国2012−0310138として公開)
米国特許出願13/329,728(米国2012−0158026として公開)
これらの全ての内容全体が参照によって本明細書に組み入れられる。
本明細書に開示される発明は以下の態様を含む。
<態様1>
ステントを備える自己拡張内腔プロテーゼであって、
前記ステントは、
遠位球状領域を備え、内腔内で保持されるように構成された第1の部分と、
柔軟な領域を備え、弁を取り付けるように構成された第2の部分と、
近位フレア部と、を備え、
前記ステントは、さらに、前記第2の部分に加えられる力が少なくとも部分的に前記第1の部分から切り離されるように、前記第1の部分と第2の部分との間のコネクタを備え、前記柔軟な領域は、弁の同軸接続を可能にする手段を有し、前記遠位球状領域は拡張され、それにより前記ステントの保持を強化することが可能である、自己拡張内腔プロテーゼ。
<態様2>
前記コネクタは、少なくとも一つのテザ−、および/または、少なくとも一つのストラット、および/または、少なくとも一つのワイヤを備える、請求項1に記載の自己拡張内腔プロテーゼ。
<態様3>
前記ステントは、人体の内腔と接触するための外側領域と、弁と接触するための内側領域と、前記内側領域を前記外側領域の近位部分に接続するための接続部品とを有する、請求項1に記載の自己拡張内腔プロテーゼ。
<態様4>
前記内側領域および前記外側領域は、同軸の内側領域および外側領域を形成するように折り畳まれた一つの連続的なステントによって形成される、請求項3に記載の自己拡張内腔プロテーゼ。
<態様5>
前記内側領域は、間接接続の領域を形成する前記コネクタによって前記外側領域から少なくとも部分的に切り離される、請求項3に記載の自己拡張内腔プロテーゼ。
<態様6>
前記近位フレア部は、オープンメッシュ構造を有し、前記近位フレア部は、前記自己拡張内腔プロテーゼの軸線方向の移動に抵抗するように構成される、請求項1から5の何れか一項に記載の自己拡張内腔プロテーゼ。
<態様7>
前記近位フレア部は、少なくとも部分的に被覆され、前記近位フレア部は、被覆された表面領域を有する、請求項1から6のいずれか一項に記載の自己拡張内腔プロテーゼ。
<態様8>
前記遠位球状領域は、部分的に被覆されている、請求項1から7のいずれか一項に記載の自己拡張内腔プロテーゼ。
<態様9>
前記近位フレア部と前記遠位球状領域との間の前記柔軟な領域は、オープンメッシュ柔軟構造を有する、請求項1から8のいずれか一項に記載の自己拡張内腔プロテーゼ。
<態様10>
編み上げられたメッシュ構造を有する、請求項1から9のいずれか一項に記載の自己拡張内腔プロテーゼ。
2…リム
3…弁尖
3a…脚部
6…主本体領域
7…遠位端面
20…ステント
21…縫合糸
30…ステント
31…スリーブ
62…弁
100…弁
102…支持構造
103…遠位先端部
110…弁
111…遠位先端部
120…弁
121…近位先端部
130…移送カテーテル
131…遠位ポッド
132…遠位先端
140…ステント
150…フック状部材
151…弁デバイス
155…突出部
170…遠位引紐
171…近位引紐
172…小穴
173…引張紐
175…小穴
177…引張紐
200…弁デバイス
201…近位端
202…遠位端
300…弁
301…弁
302…支持リム
303…弁尖
306…主本体領域
333…弁尖
500…弁デバイス
501…スリーブ
502…胃
503…十二指腸
505…骨格
550…弁
551…幽門括約筋
552…アンカー
600…胃腸インプラントデバイス
601…スリーブ
601…デバイス
602…弁
603…幽門
604…胃
605…ステント
606…内腔プロテーゼ
606…ステント
607…突出部
609…突出部
611…引紐
611a…第1の引紐
611b…第2の引紐
612…ループ
620…近位フレア部
621…遠位球状領域
622…骨格受入領域
630…近位領域
631…領域
632…縫合糸
640…外側支持領域
641…弁尖
643…主本体領域
650…保持リング
660…移送カテーテル
662…近位バルーン
662…シール部
663…遠位バルーン
664…近位端
665…遠位バルーン
666…遠位オリーブ
667…遠位端
669…遠位カプセル
680…外側シャフト
681…後退ハブ
682…内側シャフト
683…近位スリーブ膨張ポート
684…遠位先端バルーン膨張ポート
685…プランジャーバルーン膨張ポート
686…ガイドワイヤポート
687…ガイドワイヤ
688…可撓性チューブ
689…内腔
690…水注入内腔
691…近位バルーン膨張内腔
692…遠位先端バルーン膨張内腔
693…ガイドワイヤ内腔
695…接続
750…スリーブ
751…長手方向ポケット
760…ポケット
800…ステント
801…漏斗状領域
801…近位フレア部
802…領域
803…球状領域
804…筒状領域
820…ループ
825…ステント
826…弁デバイス
851…外側領域
852…内側領域
853…構造
900…内腔プロテーゼ
901…幽門通過領域
925…内腔プロテーゼ
928…内腔プロテーゼ
930…テザー
935…先行ステント
950…プロテーゼ
951…球状部分
952…近位フレア部分
960…肥満治療デバイス
961…外部支持体
962…弁
963…内部支持体
964…スリーブ
970…近位フレア部分
971…球状領域
972…一体フープ
Claims (22)
- 内腔プロテーゼであって、
体の内腔内で保持されるように構成された第一部分であって、前記内腔プロテーゼの出口開口を形成する遠位端を有する遠位部分及び前記内腔プロテーゼの入口開口を形成する近位端を備える近位部分と、前記遠位部分及び前記近位部分との間に接続された球状領域とを備え、前記球状領域が前記遠位部分の幅よりも大きく且つ前記近位部分の幅よりも大きい横方向の幅を有し、前記遠位部分が前記球状領域の遠位側に第一筒状領域として形成され、前記近位部分が前記球状領域の近位側に第二筒状領域として形成される、第一部分と、
前記第一部分の近位部分の近位端にコネクタによって接続される第二部分と、
前記第一部分を通って且つ前記第二部分を通って前記内腔プロテーゼ内に形成される貫通内腔と、
前記内腔プロテーゼの前記貫通内腔内に配置された弁と、を備え、
前記第二部分は前記第一部分から径方向に前記第二部分の外周部まで延在し、前記第二部分の外周部の幅が前記内腔プロテーゼの最大幅を形成する、内腔プロテーゼ。 - 前記第二部分は、前記第一部分の近位部分に接続される内周部を有し、前記第二部分は前記第一部分から前記外周部まで径方向に離れる方向に延在し、前記第二部分の前記外周部は前記第二部分の前記内周部よりも前記第一部分の前記遠位端まで近い、請求項1に記載の内腔プロテーゼ。
- 前記コネクタはテザーを備える、請求項1に記載の内腔プロテーゼ。
- 前記コネクタはストラットを備える、請求項1に記載の内腔プロテーゼ。
- 前記コネクタはワイヤを備える、請求項1に記載の内腔プロテーゼ。
- 前記第一部分及び前記第二部分は単一の先行体から形成される、請求項1に記載の内腔プロテーゼ。
- 前記先行体は、折り畳まれて前記第一部分及び前記第二部分を形成する一つの連続的なステントを備える、請求項6に記載の内腔プロテーゼ。
- 前記第二部分はオープンメッシュ構造である、請求項1に記載の内腔プロテーゼ。
- 前記第二部分は、前記内腔プロテーゼが体の内腔内に配置されるときに前記内腔プロテーゼの軸線方向の移動に抵抗するように構成される、請求項1に記載の内腔プロテーゼ。
- 前記第二部分は少なくとも部分的に材料で被覆される、請求項1に記載の内腔プロテーゼ。
- 前記第二部分は材料で被覆される表面領域を備える、請求項1に記載の内腔プロテーゼ。
- 前記球状領域は少なくとも部分的に材料で被覆される、請求項1に記載の内腔プロテーゼ。
- 装着中の径方向の圧縮を容易にし且つインプラント後の径方向の拡張を制限する補強部を有する、請求項1に記載の内腔プロテーゼ。
- 前記補強部は前記第一部分及び前記第二部分の周囲の少なくとも一部の周りに延在する、請求項13に記載の内腔プロテーゼ。
- 前記補強部はループである、請求項14に記載の内腔プロテーゼ。
- 前記補強部は、非伸張性である、請求項13に記載の内腔プロテーゼ。
- 前記補強部は、単繊維、編み上げられたポリプロピレン縫合糸、及びステンレス鋼ワイヤのうちの一つを備える、請求項13に記載の内腔プロテーゼ。
- 前記コネクタはテザー、ストラット及びワイヤのうちの一つであり、前記内腔プロテーゼの前記第一部分及び前記第二部分から分かれて提供される、請求項1に記載の内腔プロテーゼ。
- 前記第一部分及び前記第二部分は組み合わされて自己拡張性の内腔プロテーゼを提供する、請求項1に記載の内腔プロテーゼ。
- 前記内腔プロテーゼは体の内腔に接触するように構成された外側領域と、前記弁を受容するように構成された内側領域と、前記内側領域を前記外側領域に接続するコネクタとを有する、請求項1に記載の内腔プロテーゼ。
- 前記遠位部分及び前記近位部分のそれぞれは編み込まれたメッシュであり、前記遠位部分の編み込まれたメッシュの織り模様は前記近位部分の編み込まれたメッシュの織り模様よりも高密度である、請求項1に記載の内腔プロテーゼ。
- 内腔プロテーゼであって、
前記内腔プロテーゼの遠位部分と近位部分との間に接続された球状領域であって、前記遠位部分の幅よりも大きく且つ前記近位部分の幅よりも大きい横方向の幅を有する、球状領域と、
前記球状領域の遠位側に形成された第一筒状領域及び前記球状領域の近位側に形成された第二筒状領域と、
コネクタによって前記第二筒状領域の近位端に接続されたフレア部であって、前記第二筒状領域の前記近位端から径方向に延在して前記内腔プロテーゼの最大幅を画定する外周部を形成する、フレア部と、
前記第二筒状領域、前記球状領域及び前記第一筒状領域を通って前記内腔プロテーゼ内に形成された貫通内腔と、
前記内腔プロテーゼの貫通内腔内に配置された弁と、
前記第一筒状領域の周囲の少なくとも一部の周りに延在する補強ループと、を備える内腔プロテーゼ。
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EP3888602A1 (en) | 2021-10-06 |
JP6175069B2 (ja) | 2017-08-02 |
AU2012357751A1 (en) | 2014-07-03 |
AU2018201323A1 (en) | 2018-03-15 |
WO2013092715A3 (en) | 2013-08-22 |
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JP2015500705A (ja) | 2015-01-08 |
BR112014014025B1 (pt) | 2021-05-04 |
RU2014123537A (ru) | 2016-02-10 |
JP2017170238A (ja) | 2017-09-28 |
JP2019202184A (ja) | 2019-11-28 |
CN104114128A (zh) | 2014-10-22 |
CN106963530A (zh) | 2017-07-21 |
EP2793765B1 (en) | 2021-02-17 |
US10195066B2 (en) | 2019-02-05 |
WO2013092715A2 (en) | 2013-06-27 |
CN106963530B (zh) | 2020-08-21 |
US20180338849A1 (en) | 2018-11-29 |
CA2858301A1 (en) | 2013-06-27 |
CA3100305A1 (en) | 2013-06-27 |
CA2858301C (en) | 2021-01-12 |
US20140350694A1 (en) | 2014-11-27 |
AU2012357751B2 (en) | 2017-12-14 |
BR112014014025A2 (pt) | 2017-06-13 |
AU2018201323B2 (en) | 2018-10-18 |
RU2626885C2 (ru) | 2017-08-02 |
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