JP7113820B2 - 経中隔挿入装置 - Google Patents
経中隔挿入装置 Download PDFInfo
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- JP7113820B2 JP7113820B2 JP2019521811A JP2019521811A JP7113820B2 JP 7113820 B2 JP7113820 B2 JP 7113820B2 JP 2019521811 A JP2019521811 A JP 2019521811A JP 2019521811 A JP2019521811 A JP 2019521811A JP 7113820 B2 JP7113820 B2 JP 7113820B2
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/50—Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/50—Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body
- A61B17/52—Magnets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- 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
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3413—Needle locating or guiding means guided by ultrasound
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00273—Anchoring means for temporary attachment of a device to tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
- A61B2018/00369—Heart valves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/036—Abutting means, stops, e.g. abutting on tissue or skin abutting on tissue or skin
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Pathology (AREA)
- Physics & Mathematics (AREA)
- Plasma & Fusion (AREA)
- Otolaryngology (AREA)
- Cardiology (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- External Artificial Organs (AREA)
Description
101 長手方向軸
102 装置ハウジング
104 ハウジング外壁
106 ハウジング内壁
108 環状ハウジング間隙
110 ハウジング内部
112 102の先端
114 102の基端
116 前方ハウジング開口
118 後方ハウジング開口
120 摺動体
122 プッシャー
124 前方プッシャーリング
126 後方プッシャーリング
128 プッシャーロッド
132 網状のガイド要素
133 内部空間
134 長手方向のウェビング要素
136 横方向のウェビング要素
138 アンカー
200 経中隔挿入装置
202 装置ハウジング
204 ハウジング壁
212 202の先端
214 202の基端
216 前方ハウジング開口
220 摺動体
222 プッシャー
228 プッシャーロッド
232 環状のガイド要素
233 内部空間
260 凹状の座部領域
262 プッシャーチャネル
300 経中隔挿入装置
302 装置ハウジング
306 ハウジング内壁
310 ハウジング内部
370 中間カテーテル
372 内部空間
374 超音波トランスデューサ
400 経中隔挿入装置
402 装置ハウジング
420 摺動体
422 プッシャー
424 前方プッシャーリング
480 超音波トランスデューサ
500 カテーテル
502 カテーテル本体
504 カテーテル先端
510 右心房
512 左心房
520 心房中隔
522 520の目標点
530 520の開口
Claims (21)
- 心房中隔を通るカテーテル又は針の精密で安全な経中隔挿入を容易にすることに適している経中隔挿入装置であって、前記経中隔挿入装置が、
装置ハウジングと、
前記装置ハウジング内に摺動可能に配置された摺動体と、
を有し、
前記摺動体が、プッシャーと、前記プッシャーから伸びているガイド要素と、を有し、
前記ガイド要素が、前記装置ハウジングの先端から伸縮可能であり、
前記装置ハウジングが、ハウジング内部を規定するハウジング壁と、前記ハウジング内部に対して大体平行に隣接する前記ハウジング壁を通って伸びているプッシャーチャネルと、を有することを特徴とする経中隔挿入装置。 - 左心房インターベンションを実施する為に左心房へのアクセスを提供することを特徴とする請求項1に記載の経中隔挿入装置。
- 前記経中隔挿入装置は細長いが、比較的短い長さを有し、心房中隔に向かって正しい配向を達成する為に、前記経中隔挿入装置は心房内で回転することができる構成となっていることを特徴とする請求項1又は2に記載の経中隔挿入装置。
- 前記ガイド要素がニチノール製であることを特徴とする請求項1から3のいずれか1つに記載の経中隔挿入装置。
- 前記ガイド要素が網状に形成されることを特徴とする請求項1から4のいずれか1つに記載の経中隔挿入装置。
- 前記装置ハウジングが、ハウジング内部と、前記ハウジング内部を包囲する環状ハウジング間隙と、を有し、前記ガイド要素が、前記環状ハウジング間隙内に摺動可能に配置されることを特徴とする請求項1から5のいずれか1つに記載の経中隔挿入装置。
- 前記装置ハウジングが、
ハウジング外壁と、
ハウジング内壁と、
前記ハウジング内壁により形成されたハウジング内部と、
前記ハウジング内部を包囲する環状ハウジング間隙と、
を有することを特徴とする請求項1から6のいずれか1つに記載の経中隔挿入装置。 - 前記プッシャーが、
前方プッシャーリングと、
前記前方プッシャーリングから間隔をあけて配置されている後方プッシャーリングと、
前記前方プッシャーリング及び前記後方プッシャーリングの間に伸びている少なくとも1つのプッシャーロッドと、
を有することを特徴とする請求項1から7のいずれか1つに記載の経中隔挿入装置。 - 1つ以上の前記プッシャーロッドが、前記前方プッシャーリング及び前記後方プッシャーリングの間に伸びていることを特徴とする請求項8に記載の経中隔挿入装置。
- 前記ガイド要素が、前記プッシャーの前記前方プッシャーリングから伸びていることを特徴とする請求項8に記載の経中隔挿入装置。
- 前記ガイド要素が、複数の平行で間隔のあいた長手方向のウェビング要素と、前記長手方向のウェビング要素に沿って互いに間隔をあけて配置されている複数の環状の横方向のウェビング要素と、を有することを特徴とする請求項1から10のいずれか1つに記載の経中隔挿入装置。
- さらに、複数のアンカーを有し、中隔内の開口を通る針又はカテーテルの挿入における心房中隔に対する衝突の為に、前記ガイド要素の各々の前記長手方向のウェビング要素が複数のアンカーによって終わっていることを特徴とする請求項11に記載の経中隔挿入装置。
- 前記プッシャー及び前記ガイド要素の少なくとも1つが膨張可能であることを特徴とする請求項1から12のいずれか1つに記載の経中隔挿入装置。
- 前記ガイド要素が、プッシャーを有し、前記プッシャーが、前記プッシャーチャネル内に摺動可能に配置された膨張可能なプッシャーロッドと、前記プッシャーロッドと流体連通するように配置された膨張可能なプッシャーリングと、を有し、前記プッシャーロッドが前記プッシャーリングで終わっていることを特徴とする請求項1から13のいずれか1つに記載の経中隔挿入装置。
- 前記ガイド要素が、円錐形に膨張可能であり、網状の前記ガイド要素の先端が、網状の前記ガイド要素の基端よりも大きな直径を有することを特徴とする請求項1から14のいずれか1つに記載の経中隔挿入装置。
- 前記摺動体が、患者の体から移植された僧帽弁調整装置を除去する為に使用されることを特徴とする請求項1から15のいずれか1つに記載の経中隔挿入装置。
- 前記摺動体が、患者の僧帽弁の前尖及び後尖上に固定する為に使用され、一度固定されると、前記移植された僧帽弁調整装置に取り付けられる機械的、磁性又は電磁性レバーとして機能することを特徴とする請求項16に記載の経中隔挿入装置。
- 前記摺動体が、前記僧帽弁を安定させ、そして、エネルギーが前記僧帽弁に伝達され、前記前尖及び前記後尖が切除され、それにより、前記移植された僧帽弁調整装置が解放されて前記患者の体から除去されることを特徴とする請求項17に記載の経中隔挿入装置。
- 前記摺動体が、左心室流出路の閉塞を防止する為に、僧帽弁移植前に前記僧帽弁の前尖を切除する為に使用されることを特徴とする請求項17又は18のいずれか1つに記載の経中隔挿入装置。
- 前記摺動体が、前記摺動体内に収容されている一組の安定装置により、前記僧帽弁の前尖を安定させることを特徴とする請求項17から19のいずれか1つに記載の経中隔挿入装置。
- 前記安定装置がまず、前記僧帽弁の前尖を安定させ、その後、前記摺動体が、前記僧帽弁の前尖を切除する為にエネルギーを伝達することを特徴とする請求項20に記載の経中隔挿入装置。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201662409448P | 2016-10-18 | 2016-10-18 | |
US62/409,448 | 2016-10-18 | ||
US15/784,792 US11660121B2 (en) | 2016-10-18 | 2017-10-16 | Transseptal insertion device |
US15/784,792 | 2017-10-16 | ||
PCT/US2017/056843 WO2018075426A1 (en) | 2016-10-18 | 2017-10-17 | Transseptal insertion device |
Publications (2)
Publication Number | Publication Date |
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JP2019531829A JP2019531829A (ja) | 2019-11-07 |
JP7113820B2 true JP7113820B2 (ja) | 2022-08-05 |
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Application Number | Title | Priority Date | Filing Date |
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JP2019521811A Active JP7113820B2 (ja) | 2016-10-18 | 2017-10-17 | 経中隔挿入装置 |
Country Status (11)
Country | Link |
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US (1) | US11660121B2 (ja) |
EP (1) | EP3528711B1 (ja) |
JP (1) | JP7113820B2 (ja) |
CN (1) | CN110022779B (ja) |
AU (1) | AU2017346559B2 (ja) |
BR (1) | BR112019008072B1 (ja) |
CA (1) | CA3041032C (ja) |
CL (1) | CL2019001078A1 (ja) |
MX (1) | MX2019004586A (ja) |
SG (2) | SG11201903448YA (ja) |
WO (1) | WO2018075426A1 (ja) |
Cited By (2)
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US11666733B2 (en) | 2019-10-04 | 2023-06-06 | East End Medical Llc | Directional balloon transseptal insertion device for medical procedures with improved handle |
US12016614B2 (en) | 2019-09-20 | 2024-06-25 | East End Medical Llc | Directional balloon transseptal insertion device for medical procedures with improved transseptal puncture system with puncture member balloon seal |
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US11660121B2 (en) | 2016-10-18 | 2023-05-30 | East End Medical Llc | Transseptal insertion device |
BR112021024901A2 (pt) | 2019-06-11 | 2022-04-26 | East End Medical Llc | Dispositivo de inserção transeptal de balão direcional para procedimentos médicos com sistema de punção transeptal aprimorado com vedação de balão de membro de punção |
EP4106853A2 (en) | 2020-02-18 | 2022-12-28 | East End Medical LLC | Deflectable anchor balloon catheter for vascular procedures |
US11826075B2 (en) * | 2020-04-07 | 2023-11-28 | Boston Scientific Medical Device Limited | Elongated medical assembly |
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CA3041032A1 (en) | 2018-04-26 |
US20180103985A1 (en) | 2018-04-19 |
SG11201903448YA (en) | 2019-05-30 |
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CA3041032C (en) | 2023-12-05 |
EP3528711A1 (en) | 2019-08-28 |
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MX2019004586A (es) | 2020-02-07 |
JP2019531829A (ja) | 2019-11-07 |
EP3528711A4 (en) | 2020-06-10 |
SG10202103891VA (en) | 2021-06-29 |
CN110022779B (zh) | 2022-08-26 |
EP3528711B1 (en) | 2023-09-13 |
BR112019008072A2 (pt) | 2019-07-02 |
US11660121B2 (en) | 2023-05-30 |
BR112019008072B1 (pt) | 2023-10-24 |
AU2017346559B2 (en) | 2023-04-13 |
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