JP7004765B2 - インプラントを固定するためのシステムおよび方法 - Google Patents
インプラントを固定するためのシステムおよび方法 Download PDFInfo
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- JP7004765B2 JP7004765B2 JP2020082001A JP2020082001A JP7004765B2 JP 7004765 B2 JP7004765 B2 JP 7004765B2 JP 2020082001 A JP2020082001 A JP 2020082001A JP 2020082001 A JP2020082001 A JP 2020082001A JP 7004765 B2 JP7004765 B2 JP 7004765B2
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
-
- 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
- A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
-
- 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0412—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from suture anchor body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0417—T-fasteners
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/042—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/042—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion
- A61B2017/0422—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion by insertion of a separate member into the body of the anchor
- A61B2017/0425—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors plastically deformed during insertion by insertion of a separate member into the body of the anchor the anchor or the separate member comprising threads, e.g. a set screw in the anchor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
- A61B2017/0429—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being expanded by a mechanical mechanism which also locks them in the expanded state
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
- A61B2017/0437—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being resilient or spring-like
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
- A61B2017/0441—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws the shaft being a rigid coil or spiral
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
- A61B2017/0443—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws the shaft being resilient and having a coiled or helical shape in the released state
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
- A61B2017/0488—Instruments for applying suture clamps, clips or locks
-
- 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
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
-
- 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
- A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
- A61F2/2457—Chordae tendineae prostheses
Description
12 近位ハブ
14 縫合糸
16 針
18 クロスピン、クロスバー
20 アンカー駆動装置
22 近位コントロールハンドル
24 トルクノブ
26 縫合糸係止ノブ
28 トルクシャフト、トルク駆動装置、縫合糸係止ノブ
30 遠位チューブ状本体部
32 インプラント
34 クリップ
34A、34B クリップ
36 ワイヤまたは撚り線
38 端圧着部
40 クリップ駆動装置
42 近位コントロールハンドル
44 コントロール部
46 細長い本体部
48 外側スリーブ
50 内側シャフト
52 スネア
54 装填縫合糸
56 アンカー駆動装置
58 トルクシャフト
60 遠位ハウジング
200 アンカー
202 アンカー
204 螺旋
206 鋭利な先端部
208 送達用カテーテル
210 先の尖った端部
212 接合補助デバイス
214 駆動シャフト開口
216 縫合糸またはテープ
218 タップ
220 上縁
222 アンカーカテーテル
224、226、228 アンカー
230 縫合糸
232 プッシャーチューブ
234 縫合糸またはテープ
236 上縁
238 アンカーカテーテル
240 アンカー
242 コイルセクション
244 先の尖った端部
246 アンカーヘッド
248 中心縫合糸
250 ボール
252 送達用カテーテル
254 アンカー
256 遠位係止タブ
258 ハブ
260 ポケット
262 アンカー
264 クリップ
266 縫合糸
268 アンカー
269 中空チューブ
270 クリップ
272 縫合糸
274 小穴
276 アンカー
278 クリップ
280 縫合糸
282 内腔
284 アンカー
286 クリップ
288 縫合糸
290 板バネ
292 アンカー
294 クリップ
296 縫合糸
298 ボール
300 内腔
302 可撓性側壁
304 アンカー
306、308 レバーアーム
310 支点
310 アンカー
312 バネ要素
312 チューブ状本体部
314 内腔
316 二次アーム
318 アンカー
320 クリップ
322 縫合糸
324 ネジ山付き内腔
326 ハブ
328 アンカー
330 クリップ
332 ノブ
334 アンカー
336 縫合糸
338 スロット
340 針状導入器
344 アンカー
346 針
348 鋭利な遠位端
350 縫合糸
352 近位段部
354 アンカー
356 針
358 縫合糸
360 アンカー
362 遠位のバーブまたはフック
364 導入器
364 アンカー
366 縫合糸
368 アンカー
370 近位小穴
372 縫合糸
374 バーブ
376 トグルボルト
378、380 クリップ
382 アンカー
384 アンカー
386 アンカー
390 補強部分
392 ハブ
394 形状記憶クリップ
396 アンカー
398 補強部分
400 ハブ
402 バネ
404 近位キャップ
406 T字型またはトレブルフック
408 バーブ
410 アンカー
412 補強部分
414 ハブ
416 バーブ付き特徴部
418 近位キャップ
420 T字型/トレブルフック特徴部
422 アンカー
424 補強部分、ハブ
426 アンカー
428 補強部分、ハブ
430 縫合糸
432 圧着特徴部
434 アンカー
436 アーム
525 心室突出部
530 遠位端
600 操縦可能なカテーテル
1200 接合補助デバイス
2240 アンカー
Claims (18)
- 患者の組織内に植え込み可能な医療デバイスを固定するためのシステムであって、
近位端および遠位端を備えるアンカーであって、前記遠位端は組織と係合するように構成されており、前記アンカーはクロスピンを備え、前記アンカーは螺旋状シャフトを備える、アンカーと、
植え込み可能な医療デバイスであって、前記アンカーが前記植え込み可能な医療デバイスを組織に固定するように構成され、前記植え込み可能な医療デバイスは心臓弁の自然後尖の上に新しい接合面を配設するように構成された接合補助デバイスを備える、植え込み可能な医療デバイスと、
遠位ハウジング及びトルクシャフトを備えるアンカー駆動装置であって、前記アンカーの前記クロスピンは、前記トルクシャフトの遠位端にある切欠内に嵌合するように構成され、前記アンカーは、送達中に前記遠位ハウジング内に配置され、前記アンカーは、前記トルクシャフトによって前記遠位ハウジングに対して回転されて、前記アンカーを組織内に固定する、アンカー駆動装置と、
前記アンカーが組織内に押し込まれている間、前記アンカー及び前記アンカー駆動装置に結合される縫合糸であって、前記縫合糸は、前記アンカーが組織内に押し込まれている間、前記トルクシャフトに対して前記アンカーを保持する、縫合糸と、
を備えることを特徴とするシステム。 - 前記遠位ハウジングは、先細部分を備える、請求項1に記載のシステム。
- 前記アンカーが固定されると、前記縫合糸が緩められるように構成される、請求項1に記載のシステム。
- 前記アンカーの前記遠位端は、鋭利な先端を備える、請求項1に記載のシステム。
- 前記螺旋状シャフトは、3mm~5mmの外径を備える、請求項1に記載のシステム。
- 前記螺旋状シャフトは、0.254mmから0.762mmの間の直径を有するワイヤを備える、請求項1に記載のシステム。
- 前記螺旋状シャフトは、1mm~2mmのピッチを有する、請求項1に記載のシステム。
- 前記螺旋状シャフトは、0.5mm~2mmのコイル間のギャップを有する、請求項1に記載のシステム。
- 前記アンカーの前記クロスピンは、前記トルクシャフトの分岐した端部に嵌合するように構成される、請求項1に記載のシステム。
- 前記トルクシャフト及び前記アンカーは、前記遠位ハウジング内に配置される、請求項1に記載のシステム。
- 前記トルクシャフト及び前記アンカーは、前記アンカーを組織内に駆動するために、前記遠位ハウジングに対して回転可能である、請求項1に記載のシステム。
- 前記アンカーに順方向圧力がかかると、トルクシャフトコントロール部が回転し、これにより、アンカーを回転させるように構成される、請求項1に記載のシステム。
- 前記接合補助デバイスは、心臓弁の弁尖接合を改善するように構成される、請求項1に記載のシステム。
- 前記植え込み可能な医療デバイスは、血液の逆流が最小になるか、またはなくなるように構成される、請求項1に記載のシステム。
- 前記植え込み可能な医療デバイスは、心拍周期全体を通して弁輪内に留まるように構成される、請求項1に記載のシステム。
- 前記植え込み可能な医療デバイスは、弁尖接合を直接増強するように構成される、請求項1に記載のシステム。
- 前記植え込み可能な医療デバイスは、弁尖の解剖学的構造を壊さない、請求項1に記載のシステムで。
- 組織が環状である、請求項1に記載のシステム。
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2021212699A JP2022031512A (ja) | 2014-06-24 | 2021-12-27 | インプラントを固定するためのシステムおよび方法 |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201462016582P | 2014-06-24 | 2014-06-24 | |
US62/016,582 | 2014-06-24 |
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