JP7246818B2 - 機械的血栓摘出装置および方法 - Google Patents
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- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
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- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
- A61B2017/22042—Details of the tip of the guide wire
- A61B2017/22044—Details of the tip of the guide wire with a pointed tip
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22079—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with suction of debris
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2215—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
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- A—HUMAN NECESSITIES
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- A61B17/30—Surgical pincettes without pivotal connections
- A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
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- A—HUMAN NECESSITIES
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- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3435—Cannulas using everted sleeves
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- A—HUMAN NECESSITIES
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- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
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Description
本特許出願は、以下の仮特許出願のそれぞれに優先権を主張するものであり、その各々は参照によりその全体が本明細書に組み込まれる:2015年9月28日に出願された米国仮特許出願第62/284,300号、2015年10月8日に出願された米国仮特許出願第62/284,752号、および2015年10月23日に出願された米国仮特許出願第62/245,560号。
本明細書で言及されるすべての刊行物および特許出願は、個々の刊行物または特許出願が具体的にかつ個別に参照により組み入れられることが示されているかのように、全体が参照により本書に組み込まれる。
Claims (12)
- 詰まることなく血管から凝血塊(155)を除去するための機械的血栓摘出装置であって、
遠位端(105)、遠位端開口、内径および外径を有するカテーテル(100)と、
前記カテーテル(100)を通って延在して当該カテーテル(100)の遠位端(105)上で折り返される柔軟性チューブ(140)であって、前記柔軟性チューブ(140)の第1の端部が前記カテーテル(100)内で近位に引っ張られると前記遠位端開口上で反転するように構成され、この柔軟性チューブが前記遠位端開口上で反転するのに十分な力でカテーテル内で近位に引っ張られたときに、内径が縮小するとともに、前記カテーテルの内径の半分より大きな直径を有するように、前記柔軟性チューブが低いポアソン比を有し、前記柔軟性チューブ(140)が、拡張可能な端部領域(144)を有する柔軟性チューブ(140)と、
前記カテーテル(100)および前記柔軟性チューブ(140)を貫通し、ガイドワイヤを通すように構成されたガイドワイヤ管腔とを具え、
前記端部領域(144)は、当該端部領域の遠位部分が前記カテーテル(100)の遠位端(105)から遠位かつ半径方向外側に延在してから、前記カテーテル(100)に向かって湾曲して折り返されて前記端部領域の近位部分へと延びており、折り返された当該端部領域の近位部分が、前記カテーテル(100)の外面に向かって半径方向内側にテーパー状に先細になってから前記カテーテルの外面に沿って近位方向に延在するような剛性を前記端部領域(144)が有することにより、遠位方向に向いたリップが形成されて、当該リップにおいて、前記端部領域のテーパー状に先細になっている近位部分が前記カテーテルの外径の長軸に対して10°~60°のロール角度(Φ)を画定していることを特徴とする機械的血栓摘出装置。 - 請求項1に記載の装置において、前記柔軟性チューブが編まれたチューブを含むことを特徴とする装置。
- 請求項1に記載の装置において、前記柔軟性チューブ(140)が前記カテーテルを通って延在し当該カテーテル(100)の遠位端(105)上で折り返された場合の、カテーテルの遠位5cmの剛性を、前記柔軟性チューブ(140)がカテーテル(100)の遠位端(105)上で折り返されていない場合のカテーテルの遠位5cmの剛性に対して、15%未満だけ増加させることを特徴とする装置。
- 請求項1に記載の装置において、前記柔軟性チューブ(140)は5cmより大きい長さを有し、前記カテーテルの遠位端から前記カテーテルの外側を近位に延在する柔軟性チューブの領域に対して、前記カテーテルの内側へと近位に1000グラム以下の力をかけることにより前記柔軟性チューブが前記カテーテル(100)内に引き込まれることを特徴とする装置。
- 請求項1に記載の装置において、前記柔軟性チューブ(140)は解放可能に保持されており、前記柔軟性チューブが所定の0.01Nの力閾値よりも大きな力で引っ張られたときに解放されるように構成されていることを特徴とする装置。
- 請求項1に記載の装置において、前記柔軟性チューブを前記カテーテル内で近位に引っ張るように構成されたプラーをさらに具え、前記プラーは、前記柔軟性チューブを通るガイドワイヤ管腔と連続する内腔を有するハイポチューブを含むことを特徴とする装置。
- 請求項1に記載の装置において、前記カテーテルの近位端領域に結合された駆動ハンドルをさらに具え、当該駆動ハンドルは、作動時に、前記カテーテルの遠位方向への前進を調整しつつ前記柔軟性チューブを近位方向へ引き戻すように構成された制御を有することを特徴とする装置。
- 請求項1に記載の装置において、前記柔軟性チューブの遠位端領域の周囲に、前記カテーテルに対して前記柔軟性チューブを保持するように構成された保持リングをさらに具えることを特徴とする装置。
- 請求項1に記載の装置において、前記柔軟性チューブ(140)が3~50cmであることを特徴とする装置。
- 請求項1に記載の装置において、前記ガイドワイヤ管腔を真空に連結し、そこを通して真空を適用するように構成された真空接続をさらに具えることを特徴とする装置。
- 請求項1に記載の装置において、前記カテーテル(100)と前記柔軟性チューブ(140)との間の空間に連結され前記カテーテルの内壁と前記柔軟性チューブとの間で前記カテーテルの管腔内に真空を適用するように構成された真空ポンプをさらに具えることを特徴とする装置。
- 請求項1に記載の装置において、前記柔軟性チューブがカテーテルの軸方向近位に引っ張られたときに、前記柔軟性チューブは半径方向に5~20%圧縮するように構成されていることを特徴とする装置。
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Application Number | Priority Date | Filing Date | Title |
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US201562284300P | 2015-09-28 | 2015-09-28 | |
US62/284,300 | 2015-09-28 | ||
US201562284752P | 2015-10-08 | 2015-10-08 | |
US62/284,752 | 2015-10-08 | ||
US201562245560P | 2015-10-23 | 2015-10-23 | |
US62/245,560 | 2015-10-23 |
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JP2020146487A JP2020146487A (ja) | 2020-09-17 |
JP7246818B2 true JP7246818B2 (ja) | 2023-03-28 |
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US (5) | US9463035B1 (ja) |
EP (4) | EP3741315B1 (ja) |
JP (2) | JP2018529495A (ja) |
CN (2) | CN108348319B (ja) |
ES (2) | ES2836686T3 (ja) |
WO (1) | WO2017058280A1 (ja) |
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EP4079237A1 (en) | 2022-10-26 |
US9463035B1 (en) | 2016-10-11 |
CN108348319A (zh) | 2018-07-31 |
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