JP7440496B2 - 反転血栓除去装置および使用方法 - Google Patents
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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
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
-
- 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
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320725—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/32075—Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
-
- 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
- A61M25/0043—Catheters; Hollow probes characterised by structural features
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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
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
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- A—HUMAN NECESSITIES
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- 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
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0082—Catheter tip comprising a tool
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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
- 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
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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
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
- A61B2017/22034—Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320004—Surgical cutting instruments abrasive
- A61B2017/320008—Scrapers
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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
- A61B17/34—Trocars; Puncturing needles
- 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
Description
本特許出願は、2018年9月10日に出願された米国仮特許出願第62/729,276号「INVERTING THROMBECTOMY APPARATUSES FOR REMOVAL OF LARGE CLOTS」の優先権を主張するものであり、その全体が引用により本明細書に援用されるものとする。
本明細書に記載の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引用により援用されることが具体的かつ個別に示されている場合と同様に、その全体が引用により本明細書に援用されるものとする。
を遠位端に形成することを示している。この圧縮力は、拡張可能なファネルを開く(かつ開くのを保持する)のに役立つ可能性がある。
Claims (17)
- 血栓除去システムであって、
細長い可撓性のカテーテル本体と、カテーテルルーメンと、前記カテーテル本体の遠位端に配置された拡張可能なファネルとを有する反転支持カテーテルであって、前記ファネルが、前記カテーテル本体の遠位端から延びる複数の長手方向のストラットを含み、各長手方向のストラットが遠位端を有しており、前記複数の長手方向のストラットを放射状に接続するように前記複数の長手方向のストラットの遠位端またはその近傍に取り付けられたフィラメントを備え、前記ファネルの遠位端が、前記ファネルの内部および前記カテーテルルーメンとそれぞれ連通する遠位開口部を規定する、反転支持カテーテルと、
前記ファネルの内部に配置される第1の領域と、前記ファネルの外部に延在する第2の領域とを有するように、前記ファネルの遠位端で反転する可撓性チューブとを備え、
前記可撓性チューブが、前記第1の領域を近位方向に引っ張ることにより、前記カテーテルルーメン内に近位方向に引き込まれるように構成され、前記可撓性チューブが前記カテーテルルーメン内に引き込まれる際に、前記第2の領域が前記ファネルの遠位端で回り込むようになっていることを特徴とする血栓除去システム。 - 請求項1に記載のシステムにおいて、
前記可撓性チューブの第2の領域が、前記ファネルよりも近位側の前記カテーテル本体の外面上に延在しており、前記カテーテル本体の外面上に延在する前記第2の領域の内径が、前記ファネルが拡張した形態にあるときの前記ファネルの最大外径よりも小さいことを特徴とするシステム。 - 請求項1または2に記載のシステムにおいて、
前記カテーテル本体の遠位端に隣接する前記ファネルの基部領域が、流体を通過させるように構成された開口部を含むことを特徴とするシステム。 - 請求項1または2に記載のシステムにおいて、
前記ファネルが、前記カテーテル本体の遠位端に隣接する前記ファネルの基部に周方向の多孔質領域を含み、前記多孔質領域が流体を通過させるように構成されていることを特徴とするシステム。 - 請求項1乃至4の何れか一項に記載のシステムにおいて、
前記ファネルが、前記ファネルよりも近位側の前記カテーテル本体の外径の0.3倍未満の最大外径を有する折り畳まれた形態を有することを特徴とするシステム。 - 請求項1乃至5の何れか一項に記載のシステムにおいて、
前記ファネルが、前記ファネルよりも近位側の前記カテーテル本体の外径の2倍より大きい最小外径を有する拡張した形態を有することを特徴とするシステム。 - 請求項6に記載のシステムにおいて、
前記ファネルが、前記拡張した形態において、2~26mmの外径を有することを特徴とするシステム。 - 請求項1乃至7の何れか一項に記載のシステムにおいて、
前記可撓性チューブが、編まれたチューブを含むことを特徴とするシステム。 - 請求項8に記載のシステムにおいて、
前記編まれたチューブが、複数のループを規定する編組材料または織られた材料を含み、前記編まれたチューブの長さ方向に沿って、前記編まれたチューブの横断面あたり10を超えるループを有することを特徴とするシステム。 - 請求項1乃至9の何れか一項に記載のシステムにおいて、
前記ファネルが、前記長手方向のストラットの上に配置された編組材料または織られた材料を含み、前記編組材料または織られた材料が、前記可撓性チューブの第1の領域が近位方向に引っ張られて、前記ファネルの遠位端に軸方向の圧縮力が作用すると、圧縮された形態をとるように構成されていることを特徴とするシステム。 - 請求項10に記載のシステムにおいて、
前記圧縮された形態において、前記ファネルは、前記圧縮された形態ではないときよりも高い剛性を有することを特徴とするシステム。 - 請求項10に記載のシステムにおいて、
前記圧縮された形態において、前記ファネルは、潰れることなく、1200gを超える圧縮力に耐えるように構成されていることを特徴とするシステム。 - 請求項1乃至12の何れか一項に記載のシステムにおいて、
前記長手方向のストラットが、前記ファネルよりも近位側の前記カテーテル本体と連続することを特徴とするシステム。 - 請求項13に記載のシステムにおいて、
前記ファネルが、前記ファネルの遠位端でそれ自体の上に反転するメッシュをさらに含み、前記メッシュの第1の部分が前記ファネルの内部に配置されて内側ファネル表面を形成し、前記メッシュの第2の部分が前記ファネルの外部に配置されて外側ファネル表面を形成し、前記複数の長手方向のストラットが、前記内側ファネル表面と前記外側ファネル表面との間に配置されていることを特徴とするシステム。 - 請求項1乃至14の何れか一項に記載のシステムにおいて、
前記ファネルの少なくとも一部分の上に配置された潤滑性スリーブをさらに含むことを特徴とするシステム。 - 請求項1乃至15の何れか一項に記載のシステムにおいて、
中間カテーテルをさらに含み、前記反転支持カテーテルが、前記中間カテーテルのルーメン内に少なくとも部分的にスライド可能に配置されていることを特徴とするシステム。 - 請求項1乃至16の何れか一項に記載のシステムにおいて、
前記カテーテルルーメン内に配置されたプラーをさらに含み、前記可撓性チューブの第1の領域が前記プラーの遠位端領域に結合されていることを特徴とするシステム。
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US62/729,276 | 2018-09-10 | ||
PCT/US2019/050467 WO2020055908A1 (en) | 2018-09-10 | 2019-09-10 | Inverting thrombectomy apparatuses and methods of use |
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US9463035B1 (en) * | 2015-09-28 | 2016-10-11 | GW Medical LLC | Mechanical thrombectomy apparatuses and methods |
AU2021362245A1 (en) | 2017-10-16 | 2023-05-25 | Retriever Medical, Inc. | Clot removal methods and devices with multiple independently controllable elements |
US20220104839A1 (en) | 2017-10-16 | 2022-04-07 | Retriever Medical, Inc. | Clot Removal Methods and Devices with Multiple Independently Controllable Elements |
US20190110804A1 (en) | 2017-10-16 | 2019-04-18 | Michael Bruce Horowitz | Catheter based retrieval device with proximal body having axial freedom of movement |
US11504151B2 (en) | 2021-02-18 | 2022-11-22 | Boston Scientific Scimed, Inc. | Thrombectomy apparatuses |
WO2023087455A1 (zh) * | 2021-11-17 | 2023-05-25 | 上海腾复医疗科技有限公司 | 血管开通装置 |
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