JP7160354B2 - 導管の流出部における圧力を低減させるためのシステムおよび方法 - Google Patents
導管の流出部における圧力を低減させるためのシステムおよび方法 Download PDFInfo
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Description
本出願は、2017年3月2日に出願された米国仮出願第62/466,191号に対して優先権を主張する。上記文献の内容は、参照することによって援用される。
本開示は、概して、導管の流出部における圧力を低減させるためのシステムおよび方法に関する。
リンパ系は、動脈系および静脈系と併せて、循環系の一部である。リンパ系の一次機能は、過剰な間質液を、2つの主要な場所、すなわち、それぞれ、左右の鎖骨下静脈の中に排出する、胸管およびリンパ管における静脈系の中に戻すように排出することである。
胸管またはリンパ管および静脈系の他の部分等の導管の流出部における圧力を低減させるための、システムならびに方法が、提供される。静脈圧を低減させるための、システムおよび方法もまた、提供される。留置カテーテルが、患者の静脈内に、リンパ系の導管の流出ポートの近傍に少なくとも部分的に埋め込まれるように構成されることができる。カテーテルは、それを通して制御される、血流のためのトンネルまたは管腔を提供するように構成される。管腔のサイズは、心臓の拡張期の間、心臓により多く血液を送り込み(吸引し)、それによって、心臓内および導管の出口における圧力を低減させるように制御される。
本願明細書は、例えば、以下の項目も提供する。
(項目1)
カテーテルシステムであって、
患者の血管内に部分的に埋め込まれるように構成されたカテーテルシャフトと、
前記カテーテルシャフトの遠位部分に配置されたインペラアセンブリと、
前記インペラアセンブリに接続された可撓性膜と、
前記可撓性膜を介して前記遠位部分に取り付けられた選択的に展開可能な制限器であって、前記制限器の展開は、前記可撓性膜にテーパ状の構成をとらせ、前記制限器、前記可撓性膜、および前記インペラアセンブリの少なくとも一部を通して延在する、テーパ状の管腔を画定する、選択的に展開可能な制限器と
を備える、カテーテルシステム。
(項目2)
少なくとも部分的に前記カテーテルシャフトを通して延在する少なくとも1つの膨張管腔をさらに備え、前記少なくとも1つの膨張管腔は、前記制限器と流体連通している、項目1に記載のシステム。
(項目3)
前記制限器は、前記可撓性膜の外壁に結合された選択的に拡張可能なバルーンを備える、項目2に記載のシステム。
(項目4)
前記制限器は、前記制限器が拡張された構成にあるとき、前記可撓性膜の少なくとも一部を収縮させることによって、前記テーパ状の管腔のサイズを制御する、項目1に記載のシステム。
(項目5)
前記可撓性膜は、前記カテーテルシャフトに略平行であるように配向されている、項目1に記載のシステム。
(項目6)
前記テーパ状の管腔の少なくとも一部は、前記制限器が拡張された構成にあるとき、約1mm~約4mmの直径を有する、項目1に記載のシステム。
(項目7)
前記カテーテルシャフトの直径は、約4Fr~約9Frである、項目1に記載のシステム。
(項目8)
前記血管は、内頸静脈および鎖骨下静脈の一方である、項目1に記載のシステム。
(項目9)
前記制限器は、前記テーパ状の膜の近位端における支持リング上に搭載され、前記支持リングは、前記インペラの駆動シャフトを保持する誘導チャネルを備える、項目3に記載のデバイス。
(項目10)
インペラ筐体は、その遠位部分に沿って1つ以上の窓を備える、項目1に記載のデバイス。
(項目11)
前記遠位部分は、前記血管内にあり、前記制限器は、展開され、前記インペラは、駆動され、前記インペラは、前記テーパ状の管腔を通して血液を引き込む、項目1に記載のデバイス。
(項目12)
インペラ筐体の遠位に延在する非外傷性先端をさらに備える、項目1に記載のデバイス。
(項目13)
少なくとも部分的に伸長部材を通して延在する駆動シャフトをさらに備える、項目1に記載のデバイス。
(項目14)
近位アセンブリをさらに備え、前記近位アセンブリは、それを通して前記伸長部材が摺動可能に配置されている、シースを備える、項目1に記載のデバイス。
(項目15)
前記シースは、第2の制限器を備える、項目14に記載のデバイス。
(項目16)
導管の流出部における圧力を低減させる方法であって、
導管の出力部近傍の血管内に、テーパ状の管腔を備えるデバイスを位置付けることと、
前記テーパ状の管腔の幅広い端部から狭小な端部に血液を圧送し、それによって、前記導管の出力部近傍の圧力を低下させることと
を含む、方法。
(項目17)
前記デバイスは、それを通る開口部を伴う制限器と、筐体部材とを備え、前記テーパ状の管腔は、前記開口部から前記筐体部材までテーパ状になる可撓性膜によって提供され、さらに、前記血液は、前記デバイス内のインペラを動作させることによって圧送される、項目16に記載の方法。
(項目18)
前記制限器は、それを通る前記開口部を除いて、前記血管を閉塞させる、項目17に記載の方法。
(項目19)
前記脈管は、頸静脈または鎖骨下静脈である、項目18に記載の方法。
(項目20)
前記筐体部材は、前記インペラを収容し、前記デバイスはさらに、前記インペラから近位に延在する伸長駆動シャフトを備え、前記血液は、前記筐体部材の側面に沿った1つ以上の開口を介して、前記筐体部材から外に流動する、項目19に記載の方法。
(項目21)
前記制限器は、膨張可能なバルーンを備え、前記方法はさらに、前記デバイスが身体管腔内に位置付けられると、前記バルーンを膨張させることを含む、項目20に記載の方法。
ここで、ある例示的実施形態が、説明され、本明細書に開示されるデバイスおよび方法の構造、機能、製造、ならびに使用の原理の全体的理解を提供するであろう。これらの実施形態の1つ以上の実施例が、添付図面に図示される。当業者は、本明細書に具体的に説明され、かつ添付図面に図示されるデバイスおよび方法が、非限定的な例示的実施形態であり、かつ本発明の範囲が、請求項によってのみ定義されることを理解するであろう。1つの例示的実施形態に関連して図示または説明される特徴が、他の実施形態の特徴と組み合わされてもよい。そのような修正および変形例が、本発明の範囲内に含まれることが意図される。
Claims (13)
- カテーテルシステムであって、
患者の血管内に部分的に埋め込まれるように構成されたカテーテルシャフトと、
前記カテーテルシャフトの遠位部分に配置されたインペラアセンブリと、
前記インペラアセンブリに接続された可撓性膜と、
前記可撓性膜を介して前記遠位部分に取り付けられた選択的に展開可能な制限器であって、前記制限器の展開は、前記可撓性膜にテーパ状の構成をとらせ、前記制限器、前記可撓性膜、および前記インペラアセンブリの少なくとも一部を通して延在する、テーパ状の管腔を画定する、選択的に展開可能な制限器と
を備える、カテーテルシステム。 - 少なくとも部分的に前記カテーテルシャフトを通して延在する少なくとも1つの膨張管腔をさらに備え、前記少なくとも1つの膨張管腔は、前記制限器と流体連通している、請求項1に記載のシステム。
- 前記制限器は、前記可撓性膜の外壁に結合された選択的に拡張可能なバルーンを備える、請求項2に記載のシステム。
- 前記制限器は、前記制限器が拡張された構成にあるとき、前記可撓性膜の少なくとも一部を収縮させることによって、前記テーパ状の管腔のサイズを制御する、請求項1に記載のシステム。
- 前記可撓性膜は、前記カテーテルシャフトに略平行であるように配向されている、請求項1に記載のシステム。
- 前記血管は、内頸静脈および鎖骨下静脈の一方である、請求項1に記載のシステム。
- 前記制限器は、前記テーパ状の膜の近位端における支持リング上に搭載され、前記支持リングは、前記インペラアセンブリの駆動シャフトを保持する誘導チャネルを備える、請求項3に記載のシステム。
- 前記インペラアセンブリは、インペラ筐体を含み、前記インペラ筐体は、その遠位部分に沿って1つ以上の窓を備える、請求項1に記載のシステム。
- 前記インペラアセンブリは、インペラを備え、さらに、前記遠位部分が前記血管内にあり、前記制限器が展開され、前記インペラが駆動されると、前記インペラは、前記テーパ状の管腔を通して血液を引き込む、請求項1に記載のシステム。
- インペラ筐体の遠位に延在する非外傷性先端をさらに備える、請求項1に記載のシステム。
- 少なくとも部分的に伸長部材を通して延在する駆動シャフトをさらに備える、請求項1に記載のシステム。
- 近位アセンブリをさらに備え、前記近位アセンブリは、シースを備え、前記シースを通して前記カテーテルシャフトが摺動可能に配置されている、請求項1に記載のシステム。
- 前記シースは、第2の制限器を備える、請求項12に記載のシステム。
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