JP7326527B2 - 血管不全を治療するための装置および方法 - Google Patents
血管不全を治療するための装置および方法 Download PDFInfo
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- 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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/246—Devices for obstructing a leak through a native valve in a closed condition
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
- A61B17/1227—Spring clips
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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
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/083—Clips, e.g. resilient
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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
- A61B17/00234—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
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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
- A61B2017/00831—Material properties
- A61B2017/00862—Material properties elastic or resilient
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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
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
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- 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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
-
- 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0045—Omega-shaped
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Reproductive Health (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Prostheses (AREA)
Description
[付記項1]
弁尖クリップ装置であって、
第1の終端部分および第2の終端部分を有する細長いクリッピング部材であって、形状記憶材料を含み、留置構成で形状設定される、クリッピング部材
を備え、
前記クリッピング部材の前記形状記憶材料が、前記クリッピング部材を前記留置構成に付勢するように構成され、前記留置構成が、前記クリッピング部材の2つの脚部分の間に画定されるクリッピング領域を含む、弁尖クリップ装置。
[付記項2]
前記弁尖クリップ装置が、前記クリッピング部材内に配設された保持機構をさらに備え、前記保持機構が、前記クリッピング部材の形状を前記留置構成で保持する、付記項1に記載の弁尖クリップ装置。
[付記項3]
前記保持機構が、前記留置構成において互いにはまり込む相補的形状を有する対向する縁部を有する第1のロッキング部材および第2のロッキング部材を含む、付記項2に記載の弁尖クリップ装置。
[付記項4]
前記クリッピング部材が、送達構成において、実質的にまっすぐなまたは直線形状に形状設定される、付記項1から3のいずれか一項に記載の弁尖クリップ装置。
[付記項5]
前記クリッピング部材が前記留置構成にあるとき、弁尖のペアを捕らえるための前記クリッピング領域を定めるために、前記2つの脚部分の各々の第1のセクションが、前記クリッピング部材の中間部分のそれぞれの端部から互いに向かって延び、前記2つの脚部分の各々の第2のセクションが、前記クリッピング領域から離れる方向に移動しながら互いから離れて延びる、付記項1から4のいずれか一項に記載の弁尖クリップ装置。
[付記項6]
前記留置構成の前記クリッピング部材が、ギリシャ文字オメガの形状を有する、付記項5に記載の弁尖クリップ装置。
[付記項7]
前記クリッピング部材が、内腔を有する管状本体を備える、付記項1から6のいずれか一項に記載の弁尖クリップ装置。
[付記項8]
複数のクリッピング部材をさらに備える、付記項1から7のいずれか一項に記載の弁尖クリップ装置。
[付記項9]
前記複数のクリッピング部材を有する環状リングをさらに備える、付記項8に記載の弁尖クリップ装置。
[付記項10]
前記環状リングが、互いから約180度の間隔を開けた2つのクリッピング部材または互いから約120度の間隔を開けた3つのクリッピング部材を有する、付記項9に記載の弁尖クリップ装置。
[付記項11]
前記複数のクリッピング部材を有する開放リングをさらに備える、付記項8に記載の弁尖クリップ装置。
[付記項12]
前記開放リングが、互いから約120度の間隔を開けた2つのクリッピング部材を有する、付記項11に記載の弁尖クリップ装置。
[付記項13]
患者の自然弁を修復するための弁修復システムであって、
少なくとも1つの内腔を有する送達機器と、
前記送達装置に結合された弁尖クリップ装置であって、前記弁尖クリップ装置が、
第1の終端部分および第2の終端部分を有する細長いクリッピング部材と、
前記クリッピング部材に結合された張力付与機構と、
前記クリッピング部材の内腔内に配設された1つまたは複数の張力付与部材であって、前記クリッピング部材を送達構成から留置構成に変換するために、前記張力付与機構に動作可能に接続された、1つまたは複数の張力付与部材と、
を備え、前記1つまたは複数の張力付与部材が、
前記張力付与機構に動作可能に接続された近位端部分と前記クリッピング部材の前記第1の終端部分に接続された遠位端部分とを有する第1の張力付与部材と、
前記張力付与機構に動作可能に接続された近位端部分と前記クリッピング部材の前記第2の終端部分に接続された遠位端部分とを有する第2の張力付与部材と、
を備える、
弁尖クリップ装置と、
を備える、弁修復システム。
[付記項14]
前記送達機器の前記内腔が、患者の体を通して送達するための前記送達構成において、前記弁尖クリップ装置を受け入れかつ前記弁尖クリップ装置の前記細長いクリッピング部材を保持するサイズとされている、付記項13に記載の弁修復システム。
[付記項15]
前記送達機器が、前記内腔を通って延在する第1のシャフトおよび第2のシャフトを備えている、付記項14に記載の弁修復システム。
[付記項16]
前記第1のシャフトが、ユーザが前記第1のシャフトを移動させて前記送達機器の前記内腔内で前記弁尖クリッピング装置を移動させることができるように、前記弁尖クリッピング装置に結合され、前記第2のシャフトが、ユーザが前記第2のシャフトを回転させて前記送達構成と前記留置構成との間で前記細長いクリッピング部材を移動させることができるように、前記弁尖クリップ装置の前記張力付与機構に結合される、付記項15に記載の弁修復システム。
[付記項17]
前記第1のシャフトおよび前記第2のシャフトの近位端が、前記送達機器のハンドルに結合される、付記項16に記載の弁修復システム。
[付記項18]
前記弁尖クリップ装置が、前記クリッピング部材の内腔内に配設された保持機構をさらに備え、前記保持機構が、前記クリッピング部材の形状を前記留置構成で保持する、付記項13から17のいずれか一項に記載の弁修復システム。
[付記項19]
前記保持機構が、前記細長いクリッピング部材の形状を前記留置構成で保持するための第1のロッキング部材および第2のロッキング部材を備え、前記細長いクリッピング部材の前記留置構成への変換が、前記第1のロッキング部材および前記第2のロッキング部材の互いに対する移動をもたらす、付記項18に記載の弁修復システム。
[付記項20]
前記細長いクリッピング部材の前記留置構成が、前記細長いクリッピング部材の2つの脚部分の間に画定される一次クリッピング領域を含み、前記一次クリッピング領域が、弁尖のペアを捕らえるように構成され、前記弁尖の隣接面が互いに接触する、付記項13から19のいずれか一項に記載の弁修復システム。
[付記項21]
前記張力付与機構が、前記細長いクリッピング部材の前記第1の終端部分および前記第2の終端部分に対して中央に前記細長いクリッピング部材に結合される、付記項13から20のいずれか一項に記載の弁修復システム。
[付記項22]
前記張力付与機構の少なくとも一部分の回転が、前記1つまたは複数の張力付与部材の張力付与を引き起こす、付記項13から21のいずれか一項に記載の弁修復システム。
[付記項23]
前記1つまたは複数の張力付与部材が、ワイヤ、撚り線、ファイバー又はフィラメントのうちの少なくとも1つを備える、付記項13から22のいずれか一項に記載の弁修復システム。
12 クリッピング部材
14 張力付与機構
16 第1の終端部分
18 第2の終端部分
20 内腔
22 張力付与部材
24 クリッピング領域
26 中間部分
28 脚部分
30 脚部分
32 ねじ
34 ナット
36 遠位端部分
38 遠位端部分
40 近位端部分
42 近位端部分
44 屈曲部
46 保持機構、ロッキング機構
48 ロッキング部材
50 ロッキング部材
54 ハウジング
56 プレート、棒
58 近位端部分
60 穴
68 切欠き
70 突出部
80 ギャップ
82 タブ
84 切欠き
86 ギャップ
88 タブ
90 切欠き
92 縁部
94 縁部
200 自然大動脈弁
210 弁尖
212 弁尖
214 弁尖
216 弁輪
218 交連
220 交連
222 交連
300 弁尖クリップ装置
302 クリッピング部材
304 クリッピング部材
306 クリッピング部材
400 送達機器
402 シース
404 第1のシャフト
406 第2のシャフト
500 弁尖クリップ装置
502 張力付与機構
504 クリッピング部材
506 内腔
508 留め具
510 コード
600 弁尖クリップ装置
602 張力付与機構
604 クリッピング部材
606 内腔
608 留め具
610 滑車システム
612 シーブ
614 コード
616 遠位端部分
700 弁尖クリップ装置
702 張力付与機構
704 クリッピング部材
706 内腔
708 ねじ
710 ナット
712 コード
800 弁尖クリップ装置
802 張力付与機構
804 クリッピング部材
806 内腔
808 ウォームねじ
810 ウォームホイール、歯車
812 コード
900 弁尖クリップ装置
902 張力付与機構
904 クリッピング部材
906 内腔
908 中央かさ歯車
909 軸部分
910 側面歯車
912 コード
914 遠位端部分
916 軸
Claims (11)
- 弁尖クリップ装置であって、
第1の終端部分および第2の終端部分を有する細長いクリッピング部材であって、形状記憶材料を含み、留置構成で形状設定される、クリッピング部材
を備え、
前記クリッピング部材の前記形状記憶材料が、前記クリッピング部材を前記留置構成に付勢するように構成され、前記留置構成が、前記クリッピング部材の2つの脚部分の間に画定されるクリッピング領域を含み、
前記クリッピング部材が前記留置構成にあるとき、弁尖のペアを捕らえるための前記クリッピング領域を定めるために、前記2つの脚部分の各々の第1のセクションが、前記クリッピング部材の中間部分のそれぞれの端部から互いに向かって延び、前記2つの脚部分の各々の第2のセクションが、前記クリッピング領域から離れる方向に移動しながら互いから離れて延びる、弁尖クリップ装置。 - 前記弁尖クリップ装置が、前記クリッピング部材内に配設された保持機構をさらに備え、前記保持機構が、前記クリッピング部材の形状を前記留置構成で保持する、請求項1に記載の弁尖クリップ装置。
- 前記保持機構が、前記留置構成において互いにはまり込む相補的形状を有する対向する縁部を有する第1のロッキング部材および第2のロッキング部材を含む、請求項2に記載の弁尖クリップ装置。
- 前記クリッピング部材が、送達構成において、実質的にまっすぐなまたは直線形状に形状設定される、請求項1から3のいずれか一項に記載の弁尖クリップ装置。
- 前記留置構成の前記クリッピング部材が、ギリシャ文字オメガの形状を有する、請求項1に記載の弁尖クリップ装置。
- 前記クリッピング部材が、内腔を有する管状本体を備える、請求項1から5のいずれか一項に記載の弁尖クリップ装置。
- 複数のクリッピング部材をさらに備える、請求項1から6のいずれか一項に記載の弁尖クリップ装置。
- 前記複数のクリッピング部材を有する環状リングをさらに備える、請求項7に記載の弁尖クリップ装置。
- 前記環状リングが、互いから180度の間隔で配置された2つのクリッピング部材または互いから120度の間隔で配置された3つのクリッピング部材を有する、請求項8に記載の弁尖クリップ装置。
- 前記複数のクリッピング部材を有する開放リングをさらに備える、請求項7に記載の弁尖クリップ装置。
- 前記開放リングが、互いから180度の間隔で配置された2つのクリッピング部材を有する、請求項10に記載の弁尖クリップ装置。
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US10973638B2 (en) | 2021-04-13 |
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EP3481336A4 (en) | 2019-07-24 |
EP3481336A1 (en) | 2019-05-15 |
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