JP7015831B2 - 複数の伸縮式カテーテルの導入および操作のための装置 - Google Patents
複数の伸縮式カテーテルの導入および操作のための装置 Download PDFInfo
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- JP7015831B2 JP7015831B2 JP2019522998A JP2019522998A JP7015831B2 JP 7015831 B2 JP7015831 B2 JP 7015831B2 JP 2019522998 A JP2019522998 A JP 2019522998A JP 2019522998 A JP2019522998 A JP 2019522998A JP 7015831 B2 JP7015831 B2 JP 7015831B2
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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
- A61F2/02—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
-
- 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
- A61F2/2436—Deployment by retracting a sheath
-
- 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
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
- A61M25/0052—Localized reinforcement, e.g. where only a specific part of the catheter is reinforced, for rapid exchange guidewire port
-
- 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
-
- 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
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
-
- 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
- A61F2/243—Deployment by mechanical expansion
- A61F2/2433—Deployment by mechanical expansion using balloon catheter
-
- 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
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M2025/0059—Catheters; Hollow probes characterised by structural features having means for preventing the catheter, sheath or lumens from collapsing due to outer forces, e.g. compressing forces, or caused by twisting or kinking
-
- 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
- A61M2025/015—Details of the distal fixation of the movable mechanical means
-
- 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
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
Description
この説明の目的で、本開示の実施形態のいくつかの態様、利点、および新規の特徴について、本明細書で説明する。開示する方法、装置、およびシステムは、決して限定的なものと解釈されるべきではない。代わりに、本開示は、様々な開示する実施形態の新規かつ非自明な特徴および態様すべてを、単独でかつ互いとの様々な組合せおよび部分的組合せで対象とする。方法、装置、およびシステムは、いずれか特定の態様または特徴またはそれらの組合せに限定されず、開示する実施形態は、いずれか1つまたは複数の特定の利点があること、または問題が解決されることを必要としない。
[付記項1]
近位部分、遠位部分、およびプルワイヤ導管を備える操縦可能なシャフトであって、前記プルワイヤ導管が、少なくとも部分的に前記シャフトの前記近位部分および前記遠位部分を通って伸びる、操縦可能なシャフトと、
前記プルワイヤ導管を通って伸び、近位端部分および遠位端部分を有するプルワイヤであって、前記プルワイヤの前記遠位端部分が、前記シャフトの前記遠位部分に固定される、プルワイヤと、
前記プルワイヤの前記近位端部分に動作可能に接続され、前記シャフトの前記遠位部分の湾曲を調整するために前記プルワイヤの張力を増減するように構成された調整機構と、を備える送達装置であって、
前記シャフトの前記遠位部分が、結合部分と、前記結合部分の近位にある操縦可能な部分と、前記結合部分に埋設されかつ前記プルワイヤの前記遠位端部分に結合されたプルリングと、を備え、前記操縦可能な部分が、1つまたは複数の層を有し、かつ前記操縦可能な部分の外側層に組み込まれる圧縮抵抗部分と編組層とを含み、前記外側層が、第1の硬度を有し、前記圧縮抵抗部分が、前記第1の硬度よりも大きい第2の硬度を有し、前記編組層が、前記操縦可能な部分に沿って前記プルリングの近くの前記結合部分から近位に広がる、送達装置。
[付記項2]
前記圧縮抵抗部分が、前記プルワイヤ導管の向かい側に位置している、付記項1に記載の送達装置。
[付記項3]
前記圧縮抵抗部分が、前記外側層の前記断面に沿って10度~180度広がる、付記項1または付記項2に記載の送達装置。
[付記項4]
前記圧縮抵抗部分が、前記外側層の前記断面に沿って60度広がる、付記項3に記載の送達装置。
[付記項5]
前記シャフトが、前記シャフトの内径を定める内側層を備え
る、付記項1から4のいずれか一項に記載の送達装置。
[付記項6]
前記シャフトが、前記内側層と前記外側層との間にらせんコイル状層をさらに備える、付記項5に記載の送達装置。
[付記項7]
前記編組層が、前記らせんコイル状層の少なくとも一部を覆って編組される、付記項6に記載の送達装置。
[付記項8]
前記シャフトが、前記内側層と前記らせんコイル状層との間に、前記プルワイヤ導管を封入するプルワイヤ導管封入層をさらに備える、付記項7に記載の送達装置。
[付記項9]
前記内側層が、前記プルワイヤ導管を収容するように構成された凹部を画定する、付記項5に記載の送達装置。
[付記項10]
前記プルワイヤが第1のプルワイヤであり、
前記プルワイヤ導管が第1のプルワイヤ導管であり、
前記シャフトが、前記凹部に前記第1のプルワイヤ導管に隣接して配置された第2のプルワイヤ導管に収容された第2のプルワイヤをさらに備える、
付記項9に記載の送達装置。
[付記項11]
前記第2の硬度と前記第1の硬度との比が、1.5:1~5:1である、付記項1から10のいずれか一項に記載の送達装置。
[付記項12]
前記比が3:1である、付記項11に記載の送達装置。
[付記項13]
前記シャフトがガイドシースであり、前記送達装置が、前記ガイドシース内に同軸上に配置された埋め込みカテーテルをさらに含み、前記埋め込みカテーテルの遠位端に取り付けられた人工弁を含む、付記項1から12のいずれか一項に記載の送達装置。
102 ハンドル部分
104 ガイドシース
106 操縦可能なカテーテル
108 埋め込みカテーテル
110 人工器官デバイス
112 膨張可能バルーン
114 近位部分
116 遠位部分
118 非外傷性先端部分
120 結合部分
122 操縦可能な部分
124 プルワイヤ
126 プルワイヤ
128 導管
130 導管
132 回転ノブ
134 内側層
135 プルワイヤ導管封入層
136 らせんコイル状層
138 編組層
140 外側層
142 凹部
144 プルリング
146 移行領域
148 プルワイヤ出口
150 圧縮抵抗部分
152 平面
154 プルワイヤ導管部分
156 開口
158 編組層
160 プルワイヤ
162 導管
Claims (17)
- 近位部分、遠位部分、およびプルワイヤ導管を備える操縦可能なシャフトであって、前記プルワイヤ導管が、少なくとも部分的に前記シャフトの前記近位部分および前記遠位部分を通って伸びる、操縦可能なシャフトと、
前記プルワイヤ導管を通って伸び、近位端部分および遠位端部分を有するプルワイヤであって、前記プルワイヤの前記遠位端部分が、前記シャフトの前記遠位部分に固定される、プルワイヤと、
前記プルワイヤの前記近位端部分に動作可能に接続され、前記シャフトの前記遠位部分の湾曲を調整するために前記プルワイヤの張力を増減するように構成された調整機構と、を備える送達装置であって、
前記シャフトの前記遠位部分が、
結合部分と、
前記結合部分の近位にある操縦可能な部分と、
前記結合部分に埋設されかつ前記プルワイヤの前記遠位端部分に結合されたプルリングと、
を備え、
前記操縦可能な部分が、
1つまたは複数の層を有し、かつ
前記操縦可能な部分の1つまたは複数の層のうちの1つの層に組み込まれる圧縮抵抗部分を含み、
前記圧縮抵抗部分が、前記プルリングから間隔を空けて近位にありかつ前記層の断面の一部に沿って角度方向に広がり、
前記圧縮抵抗部分が組み込まれている前記操縦可能な部分の前記層が、第1の硬度を有し、
前記圧縮抵抗部分が、前記第1の硬度よりも大きい第2の硬度を有する、送達装置。 - 前記圧縮抵抗部分が、前記プルワイヤ導管の向かい側に位置している、請求項1に記載の送達装置。
- 前記圧縮抵抗部分が、前記圧縮抵抗部分が組み込まれている前記層の前記断面に沿って10度~180度広がる、請求項1または請求項2に記載の送達装置。
- 前記圧縮抵抗部分が、前記圧縮抵抗部分が組み込まれている前記層の前記断面に沿って60度広がる、請求項3に記載の送達装置。
- 前記シャフトが、前記シャフトの内径を定める内側層を備え、
前記圧縮抵抗部分が組み込まれている前記層が、前記シャフトの外径を定める外側層である、請求項1から4のいずれか一項に記載の送達装置。 - 前記シャフトが、前記内側層と前記外側層との間にらせんコイル状層をさらに備える、請求項5に記載の送達装置。
- 前記シャフトが、前記らせんコイル状層の少なくとも一部を覆って編組された編組層をさらに備える、請求項6に記載の送達装置。
- 前記シャフトが、前記内側層と前記らせんコイル状層との間に、前記プルワイヤ導管を封入するプルワイヤ導管封入層をさらに備える、請求項7に記載の送達装置。
- 前記内側層が、前記プルワイヤ導管を収容するように構成された凹部を画定する、請求項5に記載の送達装置。
- 前記プルワイヤが第1のプルワイヤであり、
前記プルワイヤ導管が第1のプルワイヤ導管であり、
前記シャフトが、前記凹部に前記第1のプルワイヤ導管に隣接して配置された第2のプルワイヤ導管に収容された第2のプルワイヤをさらに備える、
請求項9に記載の送達装置。 - 前記第2の硬度と前記第1の硬度との比が、ショアD硬度において1.5:1~5:1である、請求項1から10のいずれか一項に記載の送達装置。
- 前記比が、ショアD硬度において3:1である、請求項11に記載の送達装置。
- 前記シャフトがガイドシースであり、前記送達装置が、前記ガイドシース内に同軸上に配置された埋め込みカテーテルをさらに含み、前記埋め込みカテーテルの遠位端に取り付けられた人工弁を含む、請求項1から12のいずれか一項に記載の送達装置。
- 近位部分、遠位部分、およびプルワイヤ導管を備える操縦可能なシャフトであって、前記プルワイヤ導管が、少なくとも部分的に前記シャフトの前記近位部分および前記遠位部分を通って伸びる、操縦可能なシャフトと、
前記プルワイヤ導管を通って伸び、近位端部分および遠位端部分を有するプルワイヤであって、前記プルワイヤの前記遠位端部分が、前記シャフトの前記遠位部分に固定される、プルワイヤと、
前記プルワイヤの前記近位端部分に動作可能に接続され、前記シャフトの前記遠位部分の湾曲を調整するために前記プルワイヤの張力を増減するように構成された調整機構と、を備える送達装置であって、
前記シャフトの前記遠位部分が、1つまたは複数の層と、プルリングと、前記遠位部分の1つまたは複数の層のうちの1つの層に組み込まれかつ前記プルリングから間隔を空けて近位にある圧縮抵抗部分と、を備え、
前記圧縮抵抗部分が、前記層の断面の一部に沿って角度方向に広がり、前記圧縮抵抗部分が組み込まれている前記層の硬度よりも大きい硬度を有し、前記圧縮抵抗部分が、前記層の前記断面に沿って前記プルワイヤ導管から角度方向でずれている、送達装置。 - 前記圧縮抵抗部分が、前記プルワイヤ導管の向かい側に位置している、請求項14に記載の送達装置。
- 前記圧縮抵抗部分が、前記圧縮抵抗部分が組み込まれている前記層の前記断面に沿って10度~180度広がる、請求項14または請求項15に記載の送達装置。
- 前記圧縮抵抗部分の前記硬度と、前記圧縮抵抗部分が組み込まれている前記層の前記硬度と、の比が、ショアD硬度において1.5:1~5:1である、請求項14から16のいずれか一項に記載の送達装置。
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JP2022007892A JP7278437B2 (ja) | 2016-11-07 | 2022-01-21 | 複数の伸縮式カテーテルの導入および操作のための装置 |
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US201662418528P | 2016-11-07 | 2016-11-07 | |
US62/418,528 | 2016-11-07 | ||
US15/796,436 | 2017-10-27 | ||
US15/796,436 US10653862B2 (en) | 2016-11-07 | 2017-10-27 | Apparatus for the introduction and manipulation of multiple telescoping catheters |
PCT/US2017/060336 WO2018085812A1 (en) | 2016-11-07 | 2017-11-07 | Apparatus for the introduction and manipulation of multiple telescoping catheters |
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JP2022007892A Active JP7278437B2 (ja) | 2016-11-07 | 2022-01-21 | 複数の伸縮式カテーテルの導入および操作のための装置 |
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