JP6980685B2 - カム制御式多方向操向可能ハンドル - Google Patents
カム制御式多方向操向可能ハンドル Download PDFInfo
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- JP6980685B2 JP6980685B2 JP2018549463A JP2018549463A JP6980685B2 JP 6980685 B2 JP6980685 B2 JP 6980685B2 JP 2018549463 A JP2018549463 A JP 2018549463A JP 2018549463 A JP2018549463 A JP 2018549463A JP 6980685 B2 JP6980685 B2 JP 6980685B2
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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
- A61F2/24—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
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
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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
-
- 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
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0136—Handles therefor
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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
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires
-
- 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
- A61F2/9517—Instruments specially adapted for placement or removal of stents or stent-grafts handle assemblies therefor
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- Cardiology (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Hematology (AREA)
- Pulmonology (AREA)
- Biophysics (AREA)
- Anesthesiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Mechanical Engineering (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Description
12 遠位ノーズコーン
14 フレックスコンポーネント
16 カム部材
18 ピン
20 静止スライダーガイド
22 スライダー
25 バックプラグ
26 位置決めコンポーネント
28 ワッシャ
30 スペーサ
32 外側シース
34 クラッチノブ
36 近位ガスケット
38 近位端部キャップ
40 遠位端部
41 近位端部
42 フレックスノブ
44 ボディ
46 近位端面
48 遠位ボディ
50 近位ボディ
52 スライダー溝
54 スライダーピン
56 ディスク部分
58 近位シャフト
60 ポジションノブ
64 近位シリンダー
68 スロット
70 保持リング
100 制御ハンドル
102,103 中心管状シャフト
104 遠位端部
106 近位端部
110 遠位コンポーネント
112 ソケット
114 フレックスノブ
116 カム本体
118 カムフィンガー
120 ボール
124 遠位係合面
126 ノッチ
128,130 溝
200 制御ハンドル
210 ハウジング
212 遠位端部
214 近位内部キャビティ
216 外側ジンバルリング
218 内側ジンバルプレート
219 開口
220 ワイヤ係合部
222 プルワイヤ
224 端部
226 通路
228 遠位開口
230 中心シャフト
232 遠位端部
234 カム部材
240 フレックスノブ
242 ポジションノブ
250 ピボットジョイント
252 ピボットポイント
300 制御ハンドル
310 ハウジング
312 遠位端部
314 近位端部
316 ジンバルリング
318 ジンバルプレート
320 中心シャフト
322 フレックスノブ
324 ポジションノブ
326 カム部材
330 ワイヤガイドプレート
340 自由端部
342,344 ワイヤガイド
400 ハンドルシステム
410 ハウジング
412 ジンバルリング
414 ジンバルプレート
416 固定ラックギア
418 ローリングピニオンギア
420 剛体コネクター部材
422 可動ラックギア
424 プルワイヤ
520 カテーテル
Claims (28)
- 操向可能なカテーテルのための制御ハンドルであって、
遠位および近位方向に延びる長手方向軸線を画定するハウジングと、
前記ハウジングに対して軸方向に動作可能であり、かつ、前記ハウジングに対して前記長手方向軸線の周りに回転方向に動作可能であるカム部材と、
少なくとも一つのフォロアが前記ハウジングに対する前記カム部材の動きに応答して前記ハンドルに対して動作するように前記カム部材と係合させられた少なくとも一つのフォロアと、
前記少なくとも一つのフォロアに対して結合され、かつ、前記ハウジングに対する前記少なくとも一つのフォロアの位置に基づいて前記カテーテルの屈曲をもたらすために前記ハンドルから前記操向可能なカテーテル内へと遠位方向に延びるプルワイヤと
を具備する、制御ハンドル。 - フレックスノブをさらに備え、その回転によって前記カム部材の軸方向調整がなされる、請求項1に記載のハンドル。
- 前記フレックスノブは、前記ハウジングに対する前記フレックスノブおよび中心シャフトの回転を可能とすると共に前記ハウジングに対する前記フレックスノブおよび中心シャフトの軸方向動作を制限するために、前記カム部材を軸方向に貫通して延びる前記中心シャフトに対して固定され、かつ、前記ハウジングと回転方向に係合させられる、請求項2に記載のハンドル。
- 前記中心シャフトは、前記ハウジングに対する前記フレックスノブの回転が前記ハウジングに対する前記カム部材の軸方向動作を引き起こすように、前記カム部材と係合させられる、請求項3に記載のハンドル。
- 前記カム部材に対して固定されたポジションノブをさらに備え、前記ポジションノブの回転によって前記カム部材の回転調整がなされる、請求項1ないし請求項4のいずれか1項に記載のハンドル。
- 前記カム部材は、前記少なくとも一つのフォロアと接する一つの軸方向端部に接触面を備え、前記接触面は、前記ハンドルの前記長手方向軸線を中心とする周方向位置の関数として軸方向位置が変化する斜面を有する、請求項1ないし請求項5のいずれか1項に記載のハンドル。
- 前記カム部材の接触面の傾斜は、前記カム部材が前記ハンドルの前記長手方向軸線を中心として回転させられるとき前記少なくとも一つのフォロアが漸進的に軸方向に動くように、前記接触面の周りを周方向に移動する軸方向位置が漸進的に変化する、請求項6に記載のハンドル。
- 前記カム部材の接触面は、前記ハンドルの中心シャフトの周りに円周方向に延びる環状面を備える、請求項6または請求項7に記載のハンドル。
- 前記カム部材の接触面は、前記ハンドルの前記長手方向軸線に対して平行でも垂直でもない斜面を画定する平面である、請求項6ないし請求項8のいずれか1項に記載のハンドル。
- 前記少なくとも一つのフォロアは、それぞれが前記プルワイヤのそれぞれのものに結合された独立して動作可能な複数のスライダーを備える、請求項1ないし請求項9のいずれか1項に記載のハンドル。
- 前記スライダーは、前記ハウジングに対して軸方向にのみ移動するように拘束される、請求項10に記載のハンドル。
- 前記ハウジングに対して前記カム部材を回転させることにより、前記スライダーの一つ以上が前記ハウジングに対して近位方向に移動させられ、同時に前記スライダーの一つ以上が前記ハウジングに対して遠位方向に移動させられる、請求項10または請求項11に記載のハンドル。
- 前記カム部材の軸方向移動によって、前記スライダーの全てが同じ軸方向に移動させられる、請求項10ないし請求項12のいずれか1項に記載のハンドル。
- 前記少なくとも一つのフォロアが、前記カム部材が前記少なくとも一つのフォロアから離れるように移動するときに前記少なくとも一つのフォロアが前記カム部材と接触したままであるように、前記カム部材に向かって付勢される、請求項1ないし請求項13のいずれか1項に記載のハンドル。
- 前記少なくとも一つのフォロアはジンバル機構を備える、請求項1ないし請求項14のいずれか1項に記載のハンドル。
- 前記ジンバル機構はジンバルリングとジンバルプレートとを備える、請求項15に記載のハンドル。
- 前記ジンバルリングは前記ハウジング内に回動可能に結合され、かつ、前記ジンバルプレートは前記ジンバルリング内に回動可能に結合される、請求項16に記載のハンドル。
- 前記プルワイヤが前記ジンバルプレートに結合される、請求項16または請求項17に記載のハンドル。
- 前記カム部材が前記ジンバルプレートと接触している、請求項16ないし請求項18のいずれか1項に記載のハンドル。
- 前記ジンバルプレートは、そこで前記カム部材が前記ジンバルプレートに接触する一つ以上のバンプまたは谷を備え、前記カム部材が前記一つ以上のバンプまたは谷に接触するときに前記ジンバルプレートに対する前記カム部材の軸方向位置がわずかに調整される、請求項19に記載のハンドル。
- 前記カム部材の位置が前記ジンバル機構の向きを決定し、かつ、前記ジンバル機構の向きが前記プルワイヤの軸方向位置を決定する、請求項15ないし請求項20のいずれか1項に記載のハンドル。
- 前記プルワイヤは、前記ジンバル機構におけるワイヤガイドの周りに巻き付けられる、請求項15ないし請求項21のいずれか1項に記載のハンドル。
- 前記少なくとも一つのフォロアがボール・ソケット機構を備え、前記カム部材が前記ボール・ソケット機構のソケット部分に接触する、請求項1ないし請求項22のいずれか1項に記載のハンドル。
- 前記少なくとも一つのフォロアから前記プルワイヤの少なくとも一つに動作を伝達するラック・ピニオン機構をさらに備える、請求項1ないし請求項23のいずれか1項に記載のハンドル。
- 前記カム部材の前記軸方向および円周方向位置の一つを、前記カム部材の前記軸方向および周方向位置の他方の動きを可能としながら、選択的に固定するよう構成されたクラッチ機構をさらに備える、請求項1ないし請求項24のいずれか1項に記載のハンドル。
- 前記ハンドルは、ユーザーが、取り付けられたカテーテルの半径方向の屈曲の大きさを独立して調整し、かつ、前記半径方向の屈曲が向けられる周方向角度を調整することを可能とすることができる、請求項1ないし請求項25のいずれか1項に記載のハンドル。
- 取り付けられたカテーテルの半径方向屈曲の大きさおよび前記半径方向屈曲が向けられる周方向角度は、前記カテーテルをその長手方向軸線の周りで回転させることなく、前記ハンドルを用いて調節可能である、請求項26に記載のハンドル。
- カテーテルに結合された請求項1に記載のハンドルを備えたアセンブリであって、前記プルワイヤは前記カテーテルの軸方向長さに沿って延在し、かつ、前記ハンドルは、前記カテーテルの半径方向の屈曲の大きさを調整すると共に前記半径方向の屈曲が向けられる周方向角度を調整するよう動作可能である、アセンブリ。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US201662311031P | 2016-03-21 | 2016-03-21 | |
US62/311,031 | 2016-03-21 | ||
US15/453,735 | 2017-03-08 | ||
US15/453,735 US10799675B2 (en) | 2016-03-21 | 2017-03-08 | Cam controlled multi-direction steerable handles |
PCT/US2017/023034 WO2017165229A1 (en) | 2016-03-21 | 2017-03-17 | Cam controlled multi-direction steerable handles |
Publications (3)
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JP2019509135A JP2019509135A (ja) | 2019-04-04 |
JP2019509135A5 JP2019509135A5 (ja) | 2020-04-02 |
JP6980685B2 true JP6980685B2 (ja) | 2021-12-15 |
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JP2018549463A Active JP6980685B2 (ja) | 2016-03-21 | 2017-03-17 | カム制御式多方向操向可能ハンドル |
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US (2) | US10799675B2 (ja) |
EP (2) | EP4154935A1 (ja) |
JP (1) | JP6980685B2 (ja) |
CN (2) | CN108778388B (ja) |
WO (1) | WO2017165229A1 (ja) |
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