JP7463064B2 - 血管閉塞物捕捉装置 - Google Patents
血管閉塞物捕捉装置 Download PDFInfo
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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
- A61B17/221—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
- A61B17/22—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
-
- 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
- A61B17/22032—Gripping instruments, e.g. forceps, for removing or smashing calculi having inflatable gripping elements
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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
- A61F2/01—Filters implantable into blood vessels
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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
- 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
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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
- 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
- A61B2017/22051—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 an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
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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
- A61B2017/22094—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 for crossing total occlusions, i.e. piercing
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- A—HUMAN NECESSITIES
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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
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
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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
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Description
添付の図面と併せて以下の説明を参照して更に考察され、様々な図面において、同様の数字は、同様の構造要素及び特徴を示す。図面は、必ずしも縮尺どおりではなく、代わりに、本発明の原理を例示することに主眼が置かれている。図は、限定としてではなく単なる例示として、本発明の装置の1つ又は2つ以上の実現例を描写している。
(1) 脈管構造内の閉塞物を捕捉するための装置であって、
第1の細長い部材であって、その中を通るルーメン、近位端、及び遠位端を含む、第1の細長い部材と、
前記第1の細長い部材の前記遠位端の近くに位置付けられた拡張可能な要素であって、折り畳まれた送達構成と拡張された構成との間で拡張可能である、拡張可能な要素と、
反転可能な要素であって、前記反転可能な要素が、前記第1の細長い部材の前記遠位端の近くに位置付けられ、前記反転可能な要素が、折り畳まれた送達構成と拡張された構成との間で拡張可能であり、前記反転可能な要素が、前記拡張された構成と反転された構成との間で反転可能であり、前記反転された構成が、ポケットを形成する、反転可能な要素と、
前記拡張可能な要素と前記反転可能な要素との間に位置付けられた間隙であって、前記閉塞物にわたって配置されるようにサイズ決めされている、間隙と、を備える、装置。
(2) 前記拡張可能な要素が、前記第1の細長い部材に沿って前記反転可能な要素の遠位に位置付けられている、実施態様1に記載の装置。
(3) 前記間隙が、前記拡張可能な要素と前記第1の細長い部材とを接合する第1の接合部と、前記反転可能な要素と前記第1の細長い部材とを接合する第2の接合部との間に位置付けられている、実施態様1に記載の装置。
(4) コアワイヤ及び遠位コイルを更に備え、前記コアワイヤが、遠位端及び近位端を含み、前記遠位コイルが、前記コアワイヤの前記遠位端の近くに位置付けられている、実施態様1に記載の装置。
(5) 遠位端及び近位端を含むコアワイヤを更に備え、前記第1の細長い部材に対する前記コアワイヤの移動が、前記拡張可能な要素を拡張する、実施態様1に記載の装置。
(7) 遠位端及び近位端を含む第2の細長い部材を更に備え、前記第2の細長い部材に対する前記第1の細長い部材の第1の移動が、前記反転可能な要素を拡張する、実施態様1に記載の装置。
(8) 前記第2の細長い部材に対する前記第1の細長い部材の第2の移動が、前記反転可能な要素を反転させる、実施態様7に記載の装置。
(9) 前記第2の移動により、前記間隙の少なくとも一部分を前記ポケットによって包囲させる、実施態様8に記載の装置。
(10) 前記拡張可能な要素が、脈管構造の壁に対して拡張可能であり、前記反転可能な要素が、前記脈管構造の壁に対して拡張可能である、実施態様1に記載の装置。
近位端及び遠位端を含む、第1の細長い部材と、
前記第1の細長い部材の前記遠位端の近くに位置付けられた拡張可能な要素であって、折り畳まれた送達構成と拡張された構成との間で拡張可能である、拡張可能な要素と、
反転可能な要素であって、前記第1の細長い部材の前記遠位端の近くに位置付けられ、折り畳まれた送達構成と拡張された構成との間で拡張可能であり、前記拡張された構成と反転された構成との間で反転可能である、反転可能な要素と、
前記拡張可能な要素と前記反転可能な要素との間に位置付けられた血塊係合要素と、を備える、装置。
(12) 前記血塊係合要素が、折り畳まれた送達構成及び拡張された構成を含む前記第1の細長い部材上に位置付けられた拡張可能な構造体であり、前記血塊係合要素が、前記折り畳まれた送達構成から前記拡張された構成へと自己拡張する、実施態様11に記載の装置。
(13) 前記血塊係合要素の少なくとも一部分が、前記拡張された構成において前記血塊に係合し、前記拡張された構成から血塊挟持構成への移動によって、前記血塊を挟持する、実施態様12に記載の装置。
(14) 前記血塊係合要素の少なくとも一部分は、前記反転可能な要素が前記反転された構成にあるときに、前記反転可能な要素によって包囲される、実施態様13に記載の装置。
(15) コアワイヤ及び第2の細長い部材を更に備え、
前記第1の細長い部材に対する前記コアワイヤの移動が、前記拡張可能な要素を拡張し、
前記第2の細長い部材に対する前記第1の細長い部材の第1の移動が、前記反転可能な要素を拡張し、
前記第2の細長い部材に対する前記第1の細長い部材の第2の移動が、前記反転可能な要素を反転させる、実施態様11に記載の装置。
(17) 脈管構造から閉塞物を捕捉する方法であって、
閉塞物捕捉装置を提供する工程であって、前記閉塞物捕捉装置が、コアワイヤ、拡張可能な要素、反転可能な要素、及び前記拡張可能な要素と前記反転可能な要素との間に位置付けられた間隙を備える、工程と、
前記閉塞物にわたって前記間隙を配置する工程と、
少なくとも前記コアワイヤを使用して、前記拡張可能な要素を折り畳まれた送達構成から拡張された構成へと拡張する工程と、
前記反転可能な要素を折り畳まれた送達構成から拡張された構成へと拡張する工程と、
前記反転可能な要素を前記拡張された構成から反転された構成へと反転させて、ポケットを形成する工程と、
前記ポケットによって前記間隙の少なくとも一部分を包囲する工程と、
前記ポケット内に前記閉塞物を捕捉する工程と、を含む、方法。
(18) 前記ポケット及び前記拡張可能な要素の表面によって形成された空洞内に前記閉塞物を包囲することを更に含む、実施態様17に記載の方法。
(19) 前記閉塞物捕捉装置が、コアワイヤ、第1の細長い部材、及び第2の細長い部材を更に含み、前記方法が、
前記コアワイヤを前記第1の細長い部材に対して移動させて、前記拡張可能な要素を拡張させる工程と、
前記第1の細長い部材を前記第2の細長い部材に対して移動させて、前記反転可能な要素を拡張させる工程と、
前記第1の細長い部材を前記第2の細長い部材に対して移動させて、前記反転可能な要素を反転させる工程と、
前記第1の細長い部材を前記第2の細長い部材に対して移動させて、前記間隙の前記少なくとも一部分を包囲させる工程と、
前記第1の細長い部材を前記第2の細長い部材に対して移動させて、前記ポケット内に前記閉塞物を捕捉させる工程と、を更に含む、実施態様17に記載の方法。
(20) 前記閉塞物捕捉装置が、血塊係合要素を更に含み、前記方法が、
前記血塊係合要素を折り畳まれた送達構成から拡張された構成へと拡張し、それによって前記閉塞物に係合する工程と、
前記血塊係合要素を前記拡張された構成から血塊挟持構成へと移動させ、それによって前記閉塞物を挟持する工程と、を更に含む、実施態様17に記載の方法。
Claims (6)
- 脈管構造内の閉塞物を捕捉するための装置であって、
内側管であって、その中を通るルーメン、近位端、及び遠位端を含む、内側管と、
遠位端及び近位端を含む外側管であって、前記内側管がその内側を通って延びている、外側管と、
前記内側管の前記遠位端の近くに位置付けられた拡張可能な要素であって、折り畳まれた送達構成と拡張された構成との間で拡張可能である、拡張可能な要素と、
前記拡張可能な要素とは別体の反転可能な要素であって、前記反転可能な要素が、前記内側管の前記遠位端の近くに位置付けられ、前記反転可能な要素が、折り畳まれた送達構成と拡張された構成との間で拡張可能であり、前記反転可能な要素が、前記拡張された構成と反転された構成との間で反転可能であり、前記反転された構成が、前記拡張可能な要素に面する前記反転可能な要素の遠位部分に開口を有するポケットを形成する、反転可能な要素と、
前記拡張可能な要素と前記反転可能な要素との間に位置付けられた間隙であって、前記閉塞物にわたって配置されるようにサイズ決めされている、間隙と、を備えており、
前記反転可能な要素は、遠位接合部と近位接合部を含み、
前記反転可能な要素は、前記遠位接合部において前記内側管に接合され、前記近位接合部において前記外側管に接合されており、
前記外側管に対する前記内側管の第1の移動が、前記反転可能な要素を拡張し、
前記第1の移動に加えた、前記外側管に対する前記内側管の第2の移動が、前記反転可能な要素を反転させ、その結果、前記ポケットが形成され
前記第1の移動及び前記第2の移動は、前記内側管の長手方向軸に沿った、前記内側管の近位方向への移動であり、
前記装置は遠位端及び近位端を含むコアワイヤを更に備え、前記内側管に対する前記コアワイヤの長手方向近位側への移動が、前記拡張可能な要素を拡張し、
前記コアワイヤは前記内側管を通って延びており、前記拡張可能な要素は遠位接合部と近位接合部とを含み、前記拡張可能な要素は、前記拡張可能な要素の前記遠位結合部において前記コアワイヤと接合されている、装置。
- 前記拡張可能な要素が、前記内側管に沿って前記反転可能な要素の遠位に位置付けられている、請求項1に記載の装置。
- 前記間隙が、前記拡張可能な要素と前記内側管とを接合する第1の接合部と、前記反転可能な要素と前記内側管とを接合する第2の接合部との間に位置付けられている、請求項1に記載の装置。
- 前記拡張可能な要素が、前記内側管に対する前記コアワイヤの前記移動によって拡張可能かつ収縮可能である直径を含む、請求項1に記載の装置。
- 前記間隙が前記内側管の長手方向に沿って延びており、前記第2の移動により、前記間隙が前記ポケット内に格納される、請求項1に記載の装置。
- 前記拡張可能な要素が、脈管構造の壁に対して拡張可能であり、前記反転可能な要素が、前記脈管構造の壁に対して拡張可能である、請求項1に記載の装置。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US16/007,168 US10898216B2 (en) | 2018-06-13 | 2018-06-13 | Vasculature obstruction capture device |
US16/007,168 | 2018-06-13 |
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CN110584742A (zh) | 2019-12-20 |
EP3581122B1 (en) | 2023-08-16 |
CN110584742B (zh) | 2024-06-18 |
EP3581122C0 (en) | 2023-08-16 |
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JP2019213862A (ja) | 2019-12-19 |
US20210113227A1 (en) | 2021-04-22 |
BR102019011690A2 (pt) | 2019-12-17 |
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