JP7321156B2 - ピールアウェイ式止血弁 - Google Patents
ピールアウェイ式止血弁 Download PDFInfo
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- JP7321156B2 JP7321156B2 JP2020524481A JP2020524481A JP7321156B2 JP 7321156 B2 JP7321156 B2 JP 7321156B2 JP 2020524481 A JP2020524481 A JP 2020524481A JP 2020524481 A JP2020524481 A JP 2020524481A JP 7321156 B2 JP7321156 B2 JP 7321156B2
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- 230000023597 hemostasis Effects 0.000 title claims description 131
- 239000008280 blood Substances 0.000 claims description 19
- 210000004369 blood Anatomy 0.000 claims description 19
- 230000002439 hemostatic effect Effects 0.000 claims description 14
- 238000003780 insertion Methods 0.000 claims description 12
- 230000037431 insertion Effects 0.000 claims description 12
- 210000004204 blood vessel Anatomy 0.000 claims description 8
- 238000000926 separation method Methods 0.000 claims description 2
- 238000000034 method Methods 0.000 description 16
- 241000533950 Leucojum Species 0.000 description 4
- 230000008901 benefit Effects 0.000 description 3
- 238000007789 sealing Methods 0.000 description 3
- 210000001367 artery Anatomy 0.000 description 2
- 230000007423 decrease Effects 0.000 description 2
- 210000003462 vein Anatomy 0.000 description 2
- 238000004873 anchoring Methods 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 239000012141 concentrate Substances 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 210000001105 femoral artery Anatomy 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000005086 pumping Methods 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 210000005166 vasculature Anatomy 0.000 description 1
- 230000003313 weakening effect Effects 0.000 description 1
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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
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
-
- A—HUMAN NECESSITIES
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- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
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- A—HUMAN NECESSITIES
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- A61M39/0606—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof without means for adjusting the seal opening or pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/13—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel by means of a catheter allowing explantation, e.g. catheter pumps temporarily introduced via the vascular system
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- A—HUMAN NECESSITIES
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- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/10—Location thereof with respect to the patient's body
- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/135—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel inside a blood vessel, e.g. using grafting
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- A—HUMAN NECESSITIES
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- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/40—Details relating to driving
- A61M60/403—Details relating to driving for non-positive displacement blood pumps
- A61M60/408—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being mechanical, e.g. transmitted by a shaft or cable
- A61M60/411—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being mechanical, e.g. transmitted by a shaft or cable generated by an electromotor
- A61M60/414—Details relating to driving for non-positive displacement blood pumps the force acting on the blood contacting member being mechanical, e.g. transmitted by a shaft or cable generated by an electromotor transmitted by a rotating cable, e.g. for blood pumps mounted on a catheter
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- A—HUMAN NECESSITIES
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- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
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-
- A—HUMAN NECESSITIES
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- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
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- A61M60/857—Implantable blood tubes
-
- 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
- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
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- A61M60/865—Devices for guiding or inserting pumps or pumping devices into the patient's body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
- A61M60/80—Constructional details other than related to driving
- A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
- A61M60/89—Valves
-
- 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
- A61M25/0668—Guide tubes splittable, tear apart
- A61M2025/0675—Introducing-sheath slitters
-
- 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
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/062—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof used with a 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
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0626—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof used with other surgical instruments, e.g. endoscope, trocar
-
- 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
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
- A61M2039/064—Slit-valve
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- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- Hematology (AREA)
- Animal Behavior & Ethology (AREA)
- Anesthesiology (AREA)
- Cardiology (AREA)
- Mechanical Engineering (AREA)
- Vascular Medicine (AREA)
- Pulmonology (AREA)
- Transplantation (AREA)
- Biophysics (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Materials For Medical Uses (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
Description
本出願は、参照によりその内容全体が本明細書に組み入れられる、2017年11月6日に提出された米国特許仮出願第62/582,075号に対する恩典を主張する。
本開示は、ピールアウェイ式止血弁を実現するためのシステムおよび方法に関する。
心臓ポンプ、ガイドワイヤ、および診断用カテーテルなどの医療用デバイスを患者の動脈または静脈内に経皮的に挿入するため、イントロデューサシースが用いられる。止血弁およびハブはイントロデューサシースの一部であり、それらを通して医療用デバイスが挿入され、かつ、挿入された医療用デバイスからインラインで除去可能であるよう、設計される。医療用デバイスの挿入中、止血弁は、止血を維持しながら引き裂きに耐えるべきである。加えて、止血弁は、イントロデューサシースの剥ぎ取り動作中、許容可能な力によって2つのピースに分かれてもよい。
[本発明1001]
第一表面、および該第一表面の反対にある第二表面;
該第一表面の外周と該第二表面の外周との間に延在する縁部;
該第一表面から該第二表面まで横断する、弁ボディの中央における複数のはすば状スリットであって、血管内への医療用デバイスの挿入中に該医療用デバイスの周りに密封を提供する、はすば状スリット;ならびに
一対の縦方向カットであって、各それぞれの縦方向カットが、該それぞれの縦方向カットの長さの少なくとも一部について、該第一表面から、該弁ボディを部分的に通り、該第二表面に達しない深さまで延在し、該縦方向カットが、剥ぎ取り動作中に該弁ボディが2つの部分に分離することを容易にする、一対の縦方向カット
を具備する、止血弁ボディ。
[本発明1002]
縦方向カットが、はすば状スリットからある距離に位置決めされている、本発明1001の止血弁ボディ。
[本発明1003]
縦方向カットに、はすば状スリットの回転角と同様の角度がつけられている、本発明1001および1002のいずれかの止血弁ボディ。
[本発明1004]
各それぞれの縦方向カットが、弁ボディの反対側に位置決めされている、本発明1001~1003のいずれかの止血弁ボディ。
[本発明1005]
各それぞれの縦方向カットが、縁部付近で、該それぞれの縦方向カットの長さの少なくとも一部について、第一表面から第二表面まで横断している、本発明1001~1004のいずれかの止血弁ボディ。
[本発明1006]
弁の中央から放射方向外向きに延在する、第一表面上に形成された第一線群;および
弁の中央から放射方向外向きに延在する、第二表面上に形成された第二線群
をさらに具備する、本発明1001~1005のいずれかの止血弁ボディ。
[本発明1007]
前記複数のはすば状スリットが、第一線群から第二線群まで横断している、本発明1006の止血弁ボディ。
[本発明1008]
第一線群が第二線群から角度的にオフセットしている、本発明1006および1007のいずれかの止血弁ボディ。
[本発明1009]
縁部からある距離のところにある、第一表面から第二表面まで横断している複数の通し穴をさらに具備する、本発明1001~1008のいずれかの止血弁ボディ。
[本発明1010]
各それぞれの通し穴が、丸みを帯びた縁部、平らな縁部、および非対称形状のうち1つを具備する、本発明1009の止血弁ボディ。
[本発明1011]
前記複数の通し穴のうち少なくともいくつかが、角度的に等間隔である、本発明1009および1010のいずれかの止血弁ボディ。
[本発明1012]
隣接する通し穴間の角度が、25度に等しいかまたはそれより小さい、本発明1011の止血弁ボディ。
[本発明1013]
前記複数の通し穴が、イントロデューサハブの複数のポストを収容するようサイズ決定される、本発明1009~1012のいずれかの止血弁ボディ。
[本発明1014]
前記複数のポストが前記複数の通し穴に挿入される、本発明1013の止血弁ボディ。
[本発明1015]
挿入された前記複数のポストが、剥ぎ取り動作中に止血弁ボディを伸張状態に保つ、本発明1014の止血弁ボディ。
[本発明1016]
第一表面が第二表面に平行である、本発明1001~1015のいずれかの止血弁ボディ。
[本発明1017]
第一表面および第二表面が平面形状を具備する、本発明1001~1016のいずれかの止血弁ボディ。
[本発明1018]
第一表面が、円錐形、テーパー形、および凸形のうち1つを具備する、本発明1001~1015のいずれかの止血弁ボディ。
[本発明1019]
第一表面の浅い点が弁の中央にある、本発明1001~1018のいずれかの止血弁ボディ。
[本発明1020]
ディスク形状、円柱形、および立方形のうち1つを具備する、本発明1001~1019のいずれかの止血弁ボディ。
[本発明1021]
血液ポンプ;ならびに
ハブとシースとを具備するイントロデューサアセンブリであって、該ハブが本発明1001~1020のいずれかの止血弁ボディを具備し、該止血弁ボディおよび該シースが該血液ポンプを受けるようサイズ決定される、イントロデューサアセンブリ
を具備する、患者の血管内に血液ポンプを挿入するためのシステム。
[本発明1022]
(1)(a)互いに反対に位置する第一および第二ウイングと、(b)該第一および第二ウイング間の中点に位置する第一および第二ノッチと、を有するイントロデューサハブ;
(2)該第一および第二ノッチに放射方向にアライメントした第一および第二縦方向カットを有する、該イントロデューサハブ内の止血弁;ならびに
(3)該第一および第二ノッチにアライメントした縦方向スコアリングを有するイントロデューサシース
を有するイントロデューサアセンブリ
を剥ぎ取る方法であって、以下の段階を具備する、方法:
該イントロデューサシースから放射状である第一方向において該イントロデューサハブの該第一ウイングに第一の力を印加し、かつ、該第一方向と反対である第二方向において該イントロデューサハブの該第二ウイングに第二の力を印加する段階;
該第一の力および該第二の力を該イントロデューサハブの該第一および第二ノッチに伝達させ、これにより該第一および第二ノッチを破断させる段階;
該第一および第二縦方向カットに沿って該止血弁を破断させる段階;ならびに
該縦方向スコアリングに沿って該イントロデューサシースを分離する段階。
[本発明1023]
イントロデューサアセンブリを剥ぎ取るためのシステムであって、以下の手段を具備する、システム:
イントロデューサハブの第一ウイングに対する第一の力と、該イントロデューサハブの第二ウイングに対する第二の力とを、受けるための手段;
該第一の力および該第二の力を該イントロデューサハブの第一ノッチおよび第二ノッチに伝達させ、これにより該第一ノッチおよび該第二ノッチを破断させるための手段;
該イントロデューサハブの止血弁を、該止血弁上の第一縦方向カットおよび第二縦方向カットに沿って破断させるための手段であって、該第一縦方向カットが該イントロデューサハブ上の該第一ノッチにアライメントされ、かつ該第二縦方向カットが該イントロデューサハブ上の該第二ノッチにアライメントされている、手段;ならびに
イントロデューサシースを、該イントロデューサシース上の縦方向スコアリングに沿って分離するための手段であって、該縦方向スコアリングが該第一ノッチおよび該第二ノッチにアライメントされている、手段。
良好に密封し、かつ小さい力で止血弁を剥ぎ取ることを可能にする特徴を有する、ピールアウェイ式止血弁に対するニーズが存在する。本明細書に説明するピールアウェイ式止血弁は、止血弁の外径に軸方向にアライメントした円柱状表面と、止血弁の中央にあるはすば状スリットのうち1つのらせん軌道にアライメントした縁部とによって規定される、縦方向カットを組み入れることによって、これを実現する。本発明の縦方向カットの設計は、剥ぎ取り動作中にピールアウェイ式止血弁を端から端まで引き裂くために要する力を小さくする。縦方向カットとはすば状スリットとは一定距離によって分離され、このことは、全体を通してカットされている止血弁と比較して、より良好な止血性能を提供する。加えて、二重破断をきたさずかつ手技中の心臓ポンプシステムの安定性を高める、ピールアウェイ式止血弁に対するニーズも存在する。本明細書に説明するピールアウェイ式止血弁は、止血弁をイントロデューサのハブに接続し、かつ(通し穴を通ってポストが挿入されている時は)剥ぎ取り中に止血弁を伸張状態に保つ、止血弁の周囲に沿った通し穴を組み入れることによって、これを実現する。
Claims (18)
- 第一表面、および該第一表面の反対にある第二表面;
該第一表面の外周と該第二表面の外周との間に延在する縁部;
該第一表面から該第二表面まで横断する、弁ボディの中央における複数のはすば状スリットであって、血管内への医療用デバイスの挿入中に該医療用デバイスの周りに密封を提供する、はすば状スリット;ならびに
一対の縦方向カットであって、各それぞれの縦方向カットが、該それぞれの縦方向カットの長さの少なくとも一部について、該第一表面から、該弁ボディを部分的に通り、該第二表面に達しない深さまで延在し、該縦方向カットが、剥ぎ取り動作中に該弁ボディが2つの部分に分離することを容易にする、一対の縦方向カット
を具備する、止血弁ボディであって、
各縦方向カットの内縁が該縦方向カットの該内縁に最も近いはすば状スリットから一定距離にあるように、各縦方向カットは該はすば状スリットから間隔があり、かつ該一定距離が該第一表面から該第二表面まで延在する該止血弁ボディの厚さにわたって維持される、止血弁ボディ。 - 縦方向カットに、はすば状スリットの回転角と同様の角度がつけられている、請求項1記載の止血弁ボディ。
- 各それぞれの縦方向カットが、弁ボディの反対側に位置決めされている、請求項1又は2記載の止血弁ボディ。
- 各それぞれの縦方向カットが、縁部付近で、該それぞれの縦方向カットの長さの少なくとも一部について、第一表面から第二表面まで横断している、請求項1~3のいずれか一項記載の止血弁ボディ。
- 弁の中央から放射方向外向きに延在する、第一表面上に形成された第一線群;および
弁の中央から放射方向外向きに延在する、第二表面上に形成された第二線群
をさらに具備し、
前記複数のはすば状スリットが、該第一線群から該第二線群まで横断している、
請求項1~4のいずれか一項記載の止血弁ボディ。 - 第一線群が第二線群から角度的にオフセットしている、請求項5記載の止血弁ボディ。
- 縁部からある距離のところにある、第一表面から第二表面まで横断している複数の通し穴をさらに具備し、
各それぞれの通し穴が、丸みを帯びた縁部、平らな縁部、および非対称形状のうち1つを具備する、請求項1~6のいずれか一項記載の止血弁ボディ。 - 前記複数の通し穴のうち少なくともいくつかが、角度的に等間隔である、請求項7記載の止血弁ボディ。
- 隣接する通し穴間の角度が、25度に等しいかまたはそれより小さい、請求項8記載の止血弁ボディ。
- 前記複数の通し穴が、イントロデューサハブの複数のポストを収容するようサイズ決定される、請求項7~9のいずれか一項記載の止血弁ボディ。
- 前記複数のポストが前記複数の通し穴に挿入される、請求項10記載の止血弁ボディ。
- 挿入された前記複数のポストが、剥ぎ取り動作中に止血弁ボディを伸張状態に保つ、請求項11記載の止血弁ボディ。
- 第一表面が第二表面に平行である、請求項1~12のいずれか一項記載の止血弁ボディ。
- 第一表面および第二表面が平面形状を具備する、請求項1~13のいずれか一項記載の止血弁ボディ。
- 第一表面が、円錐形、テーパー形、および凸形のうち1つを具備する、請求項1~14のいずれか一項記載の止血弁ボディ。
- 第一表面の浅い点が弁の中央にある、請求項1~15のいずれか一項記載の止血弁ボディ。
- ディスク形状、円柱形、および立方形のうち1つを具備する、請求項1~16のいずれか一項記載の止血弁ボディ。
- 血液ポンプ;ならびに
ハブとシースとを具備するイントロデューサアセンブリであって、該ハブが請求項1~17のいずれか一項記載の止血弁ボディを具備し、該止血弁ボディおよび該シースが該血液ポンプを受けるようサイズ決定される、イントロデューサアセンブリ
を具備する、患者の血管内に血液ポンプを挿入するためのシステム。
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