JP7358109B2 - 塞栓用編組体のための渦巻状送達システム - Google Patents
塞栓用編組体のための渦巻状送達システム Download PDFInfo
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- 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
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
- A61B17/12118—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm for positioning in conjunction with a stent
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
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- 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
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12027—Type of occlusion
- A61B17/12031—Type of occlusion complete occlusion
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12027—Type of occlusion
- A61B17/12036—Type of occlusion partial occlusion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/1214—Coils or wires
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- 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
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/1214—Coils or wires
- A61B17/12145—Coils or wires having a pre-set deployed three-dimensional shape
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
- A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
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- A—HUMAN NECESSITIES
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- 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
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- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/18—Materials at least partially X-ray or laser opaque
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- D—TEXTILES; PAPER
- D04—BRAIDING; LACE-MAKING; KNITTING; TRIMMINGS; NON-WOVEN FABRICS
- D04C—BRAIDING OR MANUFACTURE OF LACE, INCLUDING BOBBIN-NET OR CARBONISED LACE; BRAIDING MACHINES; BRAID; LACE
- D04C1/00—Braid or lace, e.g. pillow-lace; Processes for the manufacture thereof
- D04C1/06—Braid or lace serving particular purposes
- D04C1/08—Tulle fabrics
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
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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
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
- A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
- A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device
- A61B2017/12095—Threaded connection
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- D—TEXTILES; PAPER
- D10—INDEXING SCHEME ASSOCIATED WITH SUBLASSES OF SECTION D, RELATING TO TEXTILES
- D10B—INDEXING SCHEME ASSOCIATED WITH SUBLASSES OF SECTION D, RELATING TO TEXTILES
- D10B2509/00—Medical; Hygiene
- D10B2509/06—Vascular grafts; stents
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Description
(1) インプラントを解放するためのシステムであって、
内部を通るルーメンと、近位端と、遠位端と、前記遠位端に近接し渦巻状溝を上に備える外側表面と、を備える送達チューブと、
編組インプラントであって、前記送達チューブを前記インプラントに対して回転させることにより、前記渦巻状溝と係合する送達構成から、前記渦巻状溝と係合解除する展開構成に移行可能な渦巻状セグメントを備える編組インプラントと、を備える、システム。
(2) 前記送達構成にある前記渦巻状セグメントが第1の円形螺旋形状を有し、かつ前記渦巻状溝が第2の円形螺旋形状を有し、
前記渦巻状セグメントが前記渦巻状溝内に配置されている、実施態様1に記載のシステム。
(3) 前記編組インプラントが、
前記送達チューブの前記遠位端の遠位側に配置された折り畳み部と、
前記渦巻状セグメントに取り付けられ、前記送達チューブの前記外側表面の一部分の上に配置された外側折り畳みセグメントと、
前記送達チューブの前記ルーメン内に配置された実質的に管状の構造体を備える内側折り畳みセグメントと、
を備える、実施態様1に記載のシステム。
(4) 前記送達チューブの前記近位端の近位側に延在する近位端と、前記内側折り畳みセグメントの端部に取り外し可能に取り付けられた前記送達チューブの前記ルーメン内に配置される遠位端と、を備える、内側細長部材を更に備える、実施態様3に記載のシステム。
(5) 前記編組インプラントが、開口部を備える閉塞性袋を更に備え、
前記展開構成では、前記開口部が、前記渦巻状セグメントによって少なくとも部分的に塞がれる、実施態様1に記載のシステム。
前記渦巻状セグメントが、前記外周部に近接する前記閉塞性袋に取り付けられた取り付け端部と、前記展開構成において前記開口部の前記中心部に近接して配置される終端部とを備える、実施態様5に記載のシステム。
(7) 前記外側折り畳みセグメント及び前記渦巻状セグメントがそれぞれ、前記外側折り畳みセグメント及び前記渦巻状セグメントの両方に共通の織布繊維を含む織布構造体を備える、実施態様2に記載のシステム。
(8) 前記渦巻状セグメントが不織布構造体を備える、実施態様1に記載のシステム。
(9) 動脈瘤を治療するための装置であって、
内部を通るルーメンと、遠位端と、外側表面と、前記外側表面上の螺旋構造体と、を備える管状送達部材と、
前記管状送達部材の前記ルーメン内で近位方向に延在する管状セグメントと、前記管状送達部材の前記外側表面の一部分を覆う外側折り畳みセグメントと、を備える送達構成から、開口部を備える閉塞性袋を備える留置構成に移行可能な編組管状インプラントと、
前記螺旋構造体と係合する係合構成から、前記閉塞性袋の前記開口部の少なくとも一部分を塞ぐ閉塞構成に移行可能なコイル状要素と、を備える、装置。
(10) 前記係合構成にて、前記コイル状要素は円形螺旋形状のコイル状セグメントを備え、前記コイル状セグメントが前記螺旋構造体と係合する、実施態様9に記載の装置。
(12) 前記閉塞構成にて、前記コイル状要素は円錐状螺旋形状又は平面渦巻形状のコイル状セグメントを備える、実施態様9に記載の装置。
(13) 前記コイル状要素が、前記編組インプラントに固着される固定部分を備え、
前記コイル状セグメントが、
前記コイル状要素の前記固定部分に固着された固定端部と、
終端部と、
前記固定端部から前記終端部の方向に、前記円錐状螺旋又は前記平面渦巻の1周回にわたり、前記コイル状セグメントに沿って測定される第1の円周と、
前記終端部から前記固定端部の方向に、前記円錐状螺旋又は前記平面渦巻の1周回にわたり、前記コイル状セグメントに沿って測定される第2の円周と、を有し、測定した前記第2の円周は前記第1の円周よりも短い、実施態様12に記載の装置。
(14) 前記コイル状要素が、形状記憶金属を含み、
前記コイル状要素は、前記係合構成における変形された形状から、前記閉塞構成における所定の形状に移行する、実施態様9に記載の装置。
(15) 動脈瘤を治療するための方法であって、
渦巻状セグメントを備える編組インプラントと、渦巻状溝を備える送達チューブと、を備える、編組インプラント送達システムを用意する工程と、
前記渦巻状セグメントを前記渦巻状溝と係合させる工程と、
前記編組インプラントを前記動脈瘤に留置する工程と、
前記送達チューブを前記編組インプラントの前記渦巻状セグメントに対して回転させて、前記渦巻状セグメントを前記渦巻状溝から係合離脱させる工程と、
前記送達チューブから前記渦巻状セグメントを解放することにより、前記送達チューブから前記編組インプラントを解放する工程と、を含む方法。
(17) 前記編組インプラントを前記動脈瘤に留置する工程が、開口部を備える閉塞性袋を形成する工程を含み、前記動脈瘤の前記頸部の少なくとも一部分を閉塞する工程が、前記閉塞性袋の前記開口部の前記少なくとも一部分を塞ぐ工程を更に含む、実施態様16に記載の方法。
(18) 前記渦巻状セグメントの一部分を、円形螺旋形状から円錐状螺旋形状に移行させる工程を更に含む、実施態様15に記載の方法。
(19) 前記編組インプラントを前記動脈瘤に留置する工程が、前記動脈瘤内に閉塞性袋を形成する工程を更に含み、
前記方法が、
前記動脈瘤の壁を前記閉塞性袋と接触させる工程と、
前記動脈瘤壁と前記閉塞性袋との間の前記接触を介して、前記送達チューブの前記回転に応じて前記閉塞性袋が回転するのに抵抗する工程と、を更に含む、実施態様15に記載の方法。
(20) 前記編組インプラント送達システムが、内側細長部材を更に備え、
前記送達チューブが内部を通るルーメンを備え、
前記方法が、
前記内側細長部材を前記送達チューブの前記ルーメン内に配置する工程と、
前記編組インプラントを前記内側細長部材に取り付ける工程と、を更に含み、
前記編組インプラントを前記動脈瘤に留置する工程が、
前記内側細長部材を遠位方向に押すことによって、前記編組インプラントを反転させて前記動脈瘤内に閉塞性袋を形成する工程と、
前記編組インプラントを前記内側細長部材から取り外す工程と、を更に含む、実施態様15に記載の方法。
Claims (6)
- インプラントを解放するためのシステムであって、
内部を通るルーメンと、近位端と、遠位端と、前記遠位端に近接し渦巻状溝を上に備える外側表面と、を備える送達チューブと、
編組インプラントであって、
前記送達チューブの前記遠位端の遠位側に配置された折り畳み部と、
前記折り畳み部から近位方向に延在し、前記送達チューブの前記外側表面の一部分の上に配置された外側折り畳みセグメントと、
前記折り畳み部から近位方向に延在し、前記送達チューブの前記ルーメン内に配置された実質的に管状の構造体を備える内側折り畳みセグメントと、
前記外側折り畳みセグメントの近位端に取り付けられた渦巻状セグメントと、
を備える編組インプラントと、を備え、
前記送達チューブを、前記編組インプラントに対して、前記送達チューブの中心軸を中心として回転させることにより、前記渦巻状セグメントは、遠位方向に移動して、前記渦巻状溝と係合する送達構成から、前記渦巻状溝と係合解除する展開構成に移行するように構成され、
前記送達構成にある前記渦巻状セグメントは、前記渦巻状溝内に配置されている円形螺旋形状を有する、システム。 - 前記送達チューブの前記近位端の近位側に延在する近位端と、前記内側折り畳みセグメントの端部に取り外し可能に取り付けられた前記送達チューブの前記ルーメン内に配置される遠位端と、を備える、内側細長部材を更に備える、請求項1に記載のシステム。
- 前記編組インプラントが、開口部を備える閉塞性袋を更に備え、
前記展開構成では、前記開口部が、前記渦巻状セグメントによって少なくとも部分的に塞がれる、請求項1に記載のシステム。 - 前記開口部が外周部及び中心部を備え、
前記渦巻状セグメントが、前記外周部に近接する前記閉塞性袋に取り付けられた取り付け端部と、前記展開構成において前記開口部の前記中心部に近接して配置される終端部とを備える、請求項3に記載のシステム。 - 前記外側折り畳みセグメント及び前記渦巻状セグメントがそれぞれ、前記外側折り畳みセグメント及び前記渦巻状セグメントの両方に共通の織布繊維を含む織布構造体を備える、請求項1に記載のシステム。
- 前記渦巻状セグメントが不織布構造体を備える、請求項1に記載のシステム。
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US20230149023A1 (en) | 2023-05-18 |
AU2019210654A1 (en) | 2020-02-20 |
US10905431B2 (en) | 2021-02-02 |
IL268442A (en) | 2020-02-27 |
US20200038031A1 (en) | 2020-02-06 |
KR20200015429A (ko) | 2020-02-12 |
MX2019009239A (es) | 2020-02-04 |
US11547414B2 (en) | 2023-01-10 |
CA3050932A1 (en) | 2020-02-03 |
CO2019008501A1 (es) | 2021-02-08 |
BR102019016092A2 (pt) | 2020-02-27 |
JP2020018858A (ja) | 2020-02-06 |
RU2019124547A (ru) | 2021-02-02 |
TW202027685A (zh) | 2020-08-01 |
CN110786907A (zh) | 2020-02-14 |
US20210106338A1 (en) | 2021-04-15 |
EP3603540A1 (en) | 2020-02-05 |
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