JPH02174859A - 伸張可能な管腔内移植片 - Google Patents
伸張可能な管腔内移植片Info
- Publication number
- JPH02174859A JPH02174859A JP1257987A JP25798789A JPH02174859A JP H02174859 A JPH02174859 A JP H02174859A JP 1257987 A JP1257987 A JP 1257987A JP 25798789 A JP25798789 A JP 25798789A JP H02174859 A JPH02174859 A JP H02174859A
- Authority
- JP
- Japan
- Prior art keywords
- tubular member
- graft
- prosthesis
- tubular
- diameter
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 230000002792 vascular Effects 0.000 claims description 35
- 230000001419 dependent effect Effects 0.000 claims description 6
- 239000000463 material Substances 0.000 abstract description 15
- 229910001220 stainless steel Inorganic materials 0.000 abstract description 9
- 239000010935 stainless steel Substances 0.000 abstract description 6
- 229920003023 plastic Polymers 0.000 abstract description 3
- 239000004033 plastic Substances 0.000 abstract description 3
- 229910052709 silver Inorganic materials 0.000 abstract description 2
- 239000004332 silver Substances 0.000 abstract description 2
- 229910052715 tantalum Inorganic materials 0.000 abstract description 2
- GUVRBAGPIYLISA-UHFFFAOYSA-N tantalum atom Chemical compound [Ta] GUVRBAGPIYLISA-UHFFFAOYSA-N 0.000 abstract description 2
- 239000007943 implant Substances 0.000 description 39
- 238000002399 angioplasty Methods 0.000 description 12
- 210000004204 blood vessel Anatomy 0.000 description 11
- 208000031481 Pathologic Constriction Diseases 0.000 description 9
- 210000001367 artery Anatomy 0.000 description 9
- 238000000034 method Methods 0.000 description 8
- 208000037804 stenosis Diseases 0.000 description 8
- 230000036262 stenosis Effects 0.000 description 8
- 210000004351 coronary vessel Anatomy 0.000 description 7
- 230000010339 dilation Effects 0.000 description 7
- 238000000576 coating method Methods 0.000 description 6
- 210000003038 endothelium Anatomy 0.000 description 6
- 230000003628 erosive effect Effects 0.000 description 6
- 210000001519 tissue Anatomy 0.000 description 5
- 210000003462 vein Anatomy 0.000 description 5
- 238000004519 manufacturing process Methods 0.000 description 4
- 238000005452 bending Methods 0.000 description 3
- 239000011248 coating agent Substances 0.000 description 3
- 238000002513 implantation Methods 0.000 description 3
- 230000003902 lesion Effects 0.000 description 3
- 229920000642 polymer Polymers 0.000 description 3
- 230000008439 repair process Effects 0.000 description 3
- 230000002966 stenotic effect Effects 0.000 description 3
- 238000007631 vascular surgery Methods 0.000 description 3
- 206010016654 Fibrosis Diseases 0.000 description 2
- 206010028980 Neoplasm Diseases 0.000 description 2
- 239000004809 Teflon Substances 0.000 description 2
- 229920006362 Teflon® Polymers 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 210000001124 body fluid Anatomy 0.000 description 2
- 239000010839 body fluid Substances 0.000 description 2
- 201000011510 cancer Diseases 0.000 description 2
- 238000010276 construction Methods 0.000 description 2
- 238000007796 conventional method Methods 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 201000010099 disease Diseases 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 238000002224 dissection Methods 0.000 description 2
- 239000003814 drug Substances 0.000 description 2
- 229940079593 drug Drugs 0.000 description 2
- 230000004761 fibrosis Effects 0.000 description 2
- 238000003780 insertion Methods 0.000 description 2
- 230000037431 insertion Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000003014 reinforcing effect Effects 0.000 description 2
- 210000002254 renal artery Anatomy 0.000 description 2
- 208000037803 restenosis Diseases 0.000 description 2
- 230000003319 supportive effect Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 210000005166 vasculature Anatomy 0.000 description 2
- 206010051268 Anastomotic stenosis Diseases 0.000 description 1
- 201000001320 Atherosclerosis Diseases 0.000 description 1
- 206010016717 Fistula Diseases 0.000 description 1
- AEMRFAOFKBGASW-UHFFFAOYSA-N Glycolic acid Polymers OCC(O)=O AEMRFAOFKBGASW-UHFFFAOYSA-N 0.000 description 1
- 208000009905 Neurofibromatoses Diseases 0.000 description 1
- 229920000954 Polyglycolide Polymers 0.000 description 1
- 208000001106 Takayasu Arteritis Diseases 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 206010057469 Vascular stenosis Diseases 0.000 description 1
- 230000002745 absorbent Effects 0.000 description 1
- 239000002250 absorbent Substances 0.000 description 1
- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 210000000013 bile duct Anatomy 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 229920001577 copolymer Polymers 0.000 description 1
- 230000006813 corneocyte desquamation Effects 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 230000002950 deficient Effects 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000000502 dialysis Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000013171 endarterectomy Methods 0.000 description 1
- 210000003238 esophagus Anatomy 0.000 description 1
- 230000001747 exhibiting effect Effects 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 230000003176 fibrotic effect Effects 0.000 description 1
- 230000003890 fistula Effects 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 238000002594 fluoroscopy Methods 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 229910052737 gold Inorganic materials 0.000 description 1
- 239000010931 gold Substances 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 238000001990 intravenous administration Methods 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 201000004931 neurofibromatosis Diseases 0.000 description 1
- 229920000747 poly(lactic acid) Polymers 0.000 description 1
- 229920002635 polyurethane Polymers 0.000 description 1
- 239000004814 polyurethane Substances 0.000 description 1
- 208000007232 portal hypertension Diseases 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000000306 recurrent effect Effects 0.000 description 1
- 230000002787 reinforcement Effects 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 229910052719 titanium Inorganic materials 0.000 description 1
- 239000010936 titanium Substances 0.000 description 1
- 210000000626 ureter Anatomy 0.000 description 1
- 210000003708 urethra Anatomy 0.000 description 1
- 230000009278 visceral effect Effects 0.000 description 1
Classifications
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
-
- 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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
-
- 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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
-
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- 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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- 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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
- A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2002/826—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents more than one stent being applied sequentially
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2002/828—Means for connecting a plurality of stents allowing flexibility of the whole structure
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/91533—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other characterised by the phase between adjacent bands
- A61F2002/91541—Adjacent bands are arranged out of phase
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
-
- 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
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0013—Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Cardiology (AREA)
- Public Health (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Prostheses (AREA)
- Graft Or Block Polymers (AREA)
- Materials For Medical Uses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Polysaccharides And Polysaccharide Derivatives (AREA)
- Dental Preparations (AREA)
Abstract
め要約のデータは記録されません。
Description
又は管(auct)内で使用するための伸張可能な管腔
内移植片(expandable intralumi
nal graft)に関するものであり、更に特定的
には疾患により狭くなった又は閉塞した血管を修復する
ために特にを用な伸張可能な管腔内脈管移植片(exp
andable vasculargraft)移植片
及び伸張可能な管腔内移植片を移植するだめの方法及び
装置に関する。
ovasculargraf t ing)は慣用の脈
管手術に替わるものとして可能であることが実験により
示されてきた。管腔内臓管内移植には管状プロテーゼ移
植片の血管への経皮挿入及びその脈管系内の所望の位置
にカテーテルを介してそれを送り込むことが含まれる。
血管を外科的に露出させ、切開し、除去し、取り替え、
又はバイパスを付ける必要をなくすることを含む。
、ステンレス鋼コイルバネ;伸張可能な感熱性材料から
製造された螺旋状に巻かれたコイルバネ;及びジグザグ
パターンにステンレス鋼ワイヤから形成された伸張性ス
テンレス鋼ステント(scents)が包含されていた
。一般に、上記の構造は共通した1つの重要な欠点を有
している。身体通路を通過するためには、これらの構造
物はしぼんだ(collapsed)状態で所定の身体
通路内の所望の位置に送られなければならないので、各
構造物の最終の伸張した形状に対する有効な制御ができ
なかった。例えば、特定のコイルバネ型移植片の伸張は
、コイルバネ構造物を製造するのに使用された特定の材
料のバネ定数及び弾性率によって予め決定される。これ
らの同じファクターは、ステンレス鋼ワイヤからジグザ
グパターンに形成されたしぼんだステントの伸張量を予
め決定する。加熱すると伸張する感熱性材料から形成さ
れた管腔内移植片又はプロテーゼの場合には、伸張量は
管腔内移植片の製造に使用された特定の合金の熱膨張特
性により同様に予め決定される。
ば動脈又は静脈内の所望の位置で伸張させられると、移
植片の伸張した寸法は変えることができない。所望の身
体通路の直径を間違えて計算すると、寸法が足りない移
植片は身体通路の内側表面にしっかりと取り付けられる
ように身体通路の内側表面に接触するのに十分には伸張
されないことがある。その場合にはそれは身体通路内の
所望の位置から移動して離れることがある。同様に、寸
法が大き過ぎる移植片は、身体通路に対して移植片によ
り及ぼされるバネ力又は伸張力が身体通路の破壊を引き
起こす程に伸張することがある。更に、身体通路の内表
面に及ぼされる一定の半径方向外向きの力は、動脈又は
身体通路の内表面又は内膜の侵食(eros 1on)
を引き起こすことがある。
に取り付けられた血管形成術バルーンの使用による弾性
脈管狭窄症(elastic vascular 5t
enoses)又は遮断障害(blockages)の
経皮バルーン拡大(percutaneous bal
loon dilation)であつた。この方法にお
いては、血管の壁成分に剪断力をかけて血管の壁成分を
崩壊させて(disrupt)拡大された内腔を得るた
めに、血管形成術バルーンは狭窄血管又は身体通路内で
膨らまされる。アテローム性動脈硬化症に関しては、身
体通路のより弾性の内側(medial)及び外膜(B
dventitial)層はブレーク(plaque)
の回りに伸びるが、比較的圧縮不能なブレークは変化し
ないままである。この方法は動脈又は身体通路の切り裂
き(dissection)又は裂け(splitti
ng)及び引き裂き(tearing)を生じ、動脈又
は身体通路の脈管内膜(int ima)又は内側表面
はき裂(f issuring)を生じる。この切り裂
きは下にある組織の「フラップJ (flap)を形成
し、フラップは内腔を通る血流を減少させたり内腔を閉
塞することがある。典型的には、身体通路内の拡張する
(d is tand ing)管腔内圧力が、崩壊し
た層又はフラップを所定の位置に保持することができる
。
された脈管内膜に対して所定の位置に保持されていない
ならば、脈管内膜フラップは内腔内に折れそして内腔を
ふさぐことがあり又は離れたり身体通路に入ったりする
ことすらある。脈管内膜フラップが身体通路をふさぐ場
合には、この問題を直すために直ちに手術が必要である
。
cathetarization Jab)で行なわれ
るけれども、前記の問題のため、脈管内膜7ラツプが血
管又は身体通路をふさぐ場合に備えて外科医を待機させ
ることが常に必要である。更に、脈管内膜フラップが血
管から引き裂けたり内腔をふさいだりする可能性がある
ため、バルーン拡大は成る極めて重要な身体通路、例え
ば心臓に通じている左主冠状動脈に対して行うことはで
きない。バルーン拡大法により形成された脈管内膜フラ
ップが急に左主冠状動脈の如き重要身体通路に落ち込み
そしてそれをふさぐならば患者は手術を行う前に死亡す
ることがある。
狭窄性病変(stenotic 1esion)の弾性
跳ね返り(elastic recoil)のために多
くが失敗するということである。これは通常病変におけ
る高いフィブロコラーゲン含有率により起こり、そして
時には拡大されるべき区域の成る機械的特性に起因する
。故に、身体通路は最初はバルーン拡大法により都合良
く伸張させられうるけれども、身体通路の以前に伸張さ
せられた内腔の寸法を減少させる身体通路の跳ね返り(
recoil)によりその後の早期の再発狭窄症(re
stenosis)が起こることがある。例えば、入口
(ost ium)における腎臓動脈の狭窄症は、前記
拡大力が腎臓動脈自体にかかるよりはむしろ大動脈壁に
かかるため、バルーン拡大による治療がしにくいことが
知られている。例えば透析路フイステル(dialys
is−access fistulas)においてみら
れるような、新生内膜線維症(neointimal
fibrosis)により引き起こされる脈管狭窄症は
、拡大するのが困難であり、そのため高い拡大圧力及び
より大きいバルーン直径を必要とすることが証明された
。同様な困難が、移植動脈吻合狭窄症(graft−a
rtery anastomotic 5trictu
res)及び動脈内膜切除後の再発狭窄症(poste
ndarterectomy recurrent 5
tenoses)の血管形成術において観察された。高
安動脈炎(Takayasu arteritis)及
び神経線維腫症動脈狭窄症(neurof ibrom
atos 1sarterial 5tenoses)
の経皮血管形成術は、不十分な初期応答及びこれらの病
変の線維症の性質(fibrotic nature)
によると考えられる再発を示すことがある。
、又は他の身体通路を修復するために、管状プロテーゼ
移植片の挿入などにより修復を必要とする身体通路の長
さは、必要な移植片の長さがカテーテルにより移植片が
通される身体通路の曲がり部又は湾曲部を乗り越えるこ
とができない場合には、問題となることがある。換言す
れば、多くの場合に、移植片によって身体通路内の成る
長さの組織を支持することが必要であり、この場合、必
要とされる移植片の長さが、脈管内の所望の位置にカテ
ーテルを介して容易に送ることができる移植片の長さを
超える。移植片には、脈管系内に存在する曲がり部及び
湾曲部を乗り越えるのに必要な曲がる能力を持たないも
のがあり、特に比較的硬質で長手方向軸線に対する曲が
りに抵抗するプロテーゼ又は移植片はそうである。
症の再発を防止し;患者の心臓の左主冠状動脈のような
極めて重要な身体通路に使用することができ;身体通路
壁の跳ね返りを防止し;そして管腔内移植片が可変寸法
に伸張させられて移植片が所望の位置から離れるように
移動するのを防止することを可能としそして伸張させら
れた移植片による身体通路の破壊及び/又は侵食を防止
することを可能とし;身体通路の細長い区域の組織が細
長い移植片により支持されることを可能とし;そして脈
管系における曲がり部及び湾曲部を乗り越えるのに必要
な柔軟性を与える、身体通路の管腔を伸張させるための
伸張可能な管腔的脈管移植片はなかった。故に、当業界
では、身体通路における狭窄症の再発を防止し;心臓の
左主冠状動脈のような極めて重要な身体通路に使用する
ことができると考えられ;身体通路の跳ね返りを防止し
;身体通路内で可変寸法に伸張させられて移植片が所望
の位置から離れるように移動するのを防止しそして伸張
させられた移植片による身体通路の破壊及び/又は侵食
を防止することができ;身体通路の細長い区域の組織が
細長い移植片により支持されることを可能とし;そして
脈管系における曲がり部及び湾曲部を乗り越えるのに必
要な柔軟性を与える、伸張可能な管腔的脈管移植片が探
し求められてきた。
的脈管移植片により達成された。本発明は、複数の薄肉
管状部材、 ここで、該管状部材の各々は第1の端部、第2の端部及
び該第1の端部と第2の端部との間に配置されている壁
表面を有し、該壁表面は実質的に均一な厚さを有してお
りそして該壁表面には複数のスロットが形成されており
、該スロットは各管状部材の長手方向軸線に実質的に平
行に配置されており;及び、 隣接管状部材間に配置されていて隣接管状部材を柔軟に
接続する単一のコネクタ部材、ここで、該単一のコネク
タ部材は、管状部材の長手方向軸線に対して実質的に平
行な関係にてそして各管状部材と同一平面に配置されて
おり; とを備えて成り; 各管状部材は、管腔を持った身体通路内への前記管状部
材の管腔内送り込みを可能とする第1の直径を有し; 前記管状部材は、該管状部材の内側から半径方向外向き
に伸張させる力を加えられたとき伸張しそして変形した
第2の直径を有し、該$2の直径は可変でありそして該
管状部材に及ぼされる力の量に依存しており、それによ
り、該管状部材は身体通路の管腔を伸張させるように伸
張及び変形することができる。
細長い棒状部材とすることができそして隣接する管状部
材と同一平面とすることができるということである。本
発明の付加的な特徴は、第1のコネクタ部材を、第1の
管状部材の第2の端部と第2の管状部材の第1の端部と
の間に配置することができ;第2のコネクタ部材を、第
2の管状部材の第2の端部と第3の管状部材の第1の端
部との間に配置することができ;第1及び第2のコネク
タ部材は、管状部材の長手方向軸線に対して互いに角度
的にずれていることにある。
提唱された先行技術の管腔内移植片と比較したとき、狭
窄症の再発を防止し;心臓の左主冠状動脈におけるよう
な極めて重要な身体通路における移植片の移植を可能と
すると考えられ;身体通路の跳ね返りを防止し;伸長さ
せられた移植片による身体通路の侵食を防止し;身体通
路内の条件に依存して変動可能な寸法に移植片を伸張さ
せることを可能とし:身体通路の細長い区域の組織が細
長い移植片により支持されることを可能とし;そして脈
管系のような身体通路における曲がりくねった曲がり部
及び湾曲部を乗り越えるのに必要な柔軟性を与える;と
いう利点を有している。
の態様に限定することを意図するものではないことを理
解されたい。反対に、本発明は、特許請求の範囲に示さ
れた本発明の精神及び範囲内に包含されるすべての替り
の態様、修正及び均等手段を包含することを意図する。
又は身体通路のための伸張可能なプロテーゼ70が例示
されている。用語「伸張可能な管腔的脈管移植片」及び
「伸張可能なプロテーゼ」とは、本発明の方法、装置、
及び構造が血管又は身体通路の部分的に閉塞されたセグ
メントを伸張させるだめの伸張可能な管腔的脈管移植片
に関連してのみならず、他の多くの型の身体通路のため
の伸張可能なプロテーゼとして多くの他の目的にも使用
することができる限りにおいて、本発明を説明する際に
成程度交換可能に使用されることは理解されるべきであ
る。例えば伸張可能なプロテーゼ70は(1)トランス
ルミナル再疎通(transluminalu rec
analization)により開かれているが、内部
支持体の不存在下ではつぶれそうな閉塞された動脈内の
支持移植片配置; (2)手術不能のガンにより閉塞さ
れた縦隔静脈(mediastinal vein)及
び他の静脈を通るカテーテル通路に従う同様な使用;(
3)門脈高圧症(portal hypertensi
on)に罹患している患者の門脈と肝臓静脈間のカテー
テルで作られた肝内の連通を生じさせるカテーテルの強
化;(4)食道、腸、尿管、尿道の狭窄化の支持移植片
配置(supportive graft place
ment);及び(5)再開された又は以前に閉塞され
た胆管の支持移植片の強化;のような目的にも使用する
ことができる。従って、用語「プロテーゼ」の使用は種
々の形式の身体通路内の前述の使用法を包含し、そして
用語「管腔的脈管移植片」の使用は身体通路の内腔を伸
張させるための使用を包含する。更にこの点について、
用語「身体通路」は前記したような人体内の任意の管及
び人間の脈管系内の任意の静脈、動脈又は血管を包含す
る。
腔的脈管移植片又はプロテーゼ70は、第1及び第2の
端部72.73と該第1及び第2の端部72.73との
間に配置された壁表面74を有する管状部材71を一般
に具備することが示されている。管状部材71は、後に
詳細に説明するように、内腔81を有する身体通路80
内への管状部材71の管腔内送り込みを可能とする第1
の直径、dを有する(第3図)。第1B図を参照すると
、後に詳細に説明するように、半径方向外向きに伸び広
げる力が管状部材の内側から加えられると、管状部材は
第2の伸張した直径、d゛を有し、該第2の直径d″は
寸法が可変であり、管状部材を変形させるように加えら
れた力の量に依存する。
ゼが接触し得る体液(図示されていない)と適合性のあ
る任意の適当な材料であってもよい。
状から第1B図に示された形状に伸張し且つ変形するこ
とを許容すると共に、更に管状部材71が第1B図に示
された拡大された直径d゛を有するその伸張され且つ変
形した形状を保持し、半径方向の圧し潰しに抵抗するこ
とを許容するのに必要な強度及び及び弾性特性を有する
材料から作られなければならない。管状部材を製造する
のに適当な材料には、銀、タンタル、ステンレス鋼、金
、チタン又は前記した必要な特性を有する任意のプラス
チック材料が包含される。
薄肉のステンレス鋼の管であり、多数のスロット82が
管状部材71の壁表面74に形成されている。第1A図
に示されるように、管状部材71が第1の直径dを有す
るとき、スロット82は管状部材71の長手方向の軸線
に事実上平行に配置されている。第1A図に示されるよ
うに、スロット82は好適には接続部材77によって隣
接するスロット82から均一に且つ周方向に一定の間隔
を保っており、該接続部材77は第1A図に示されるよ
うに、スロット82の幅に等しい長さを有することが好
ましい。スロット82は管状部材71の長手方向の軸線
に沿って隣接するスロットと均一な間隔を保っており、
この間隔は接続部材77の幅と等しいことが好ましい。
に、少なくとも一つの細長い部材75が、隣接するスロ
ット82の間に形成され、細長い部材75は管状部材7
1の第1及び第2の端部、72.73の間に延びる結果
をもたらす。
の第1及び第2の端部に配置されている接続部材77と
共に第1及び第2の端部を有することになる。好適には
、各スロット82の第1及び第2の端部は、管状部材7
1の長手方向軸線に沿った隣接するスロット82の第1
及び第2の端部の中間に配置されている。従って、各ス
ロット82の第1及び第2の端部にあり、細長い部材7
5の間に配置されている接続部材77は、管状部材71
の長手方向軸線に沿って隣接するスロット82の第1及
び第2の端部の中間に配置されることになる。従って、
好適にはスロット82は隣接するスロット82から均一
に且つ周方向に一定の間隔を保たれており、且つ管状部
材71の長手方向軸線に沿って相互に隣接しているスロ
ット82は、互に互い違いの関係にある。管状部材71
の第1及び第2の端部72.73の両者において管状部
材71の円周の周りに配置された一つ置きのスロットは
、完全なスロット82の長さの約半分に等しいだけの長
さを有しており、該半分のスロット82は管状部材71
の第1及び第2の端部72.73の両端部において部材
78.79により接合している。第1A図及び第1B図
の移植片又はプロテーゼ、70は2つのスロット82の
長さにほぼ等しい長さを有しているように例示されてい
るが、移植片70の長さは必要に応じてより長く又は短
く作ることもできる。
テーゼ70が、後に詳細に記載されるように、管状部材
71の内部から適当な力を加えることにより、制御され
た方式で、均一に及び外向きに、第1B図に示されたよ
うな形状に、伸張せしめられることを可能とするもので
ある。更に、管状部材71の第1B図に示された形状へ
の伸張が管状部材71の長さ方向に沿って均一であるの
は、前述のようにスロット82の間の間隔が均一である
ばかりでなく、壁表面74、又は接続部材77、細長い
部材75、及び部材78.79の厚さが同じ均一な厚さ
であるからである。第2図に例示されるように、細長い
部材75の厚さが均一であることが示され、及び細長い
部材75、接続部材77及び部材78.79の好適な断
面形状が例示されており、その形状は長方形である。勿
論当業者には前記の移植片、又はプロテーゼ70の部品
の断面形状は、正方形、長方形又は他の断面形状であっ
てもよいことが理解されるべきである。
移植片又はプロテーゼ70(第4図)の外側表面74は
比較的平滑でなければならない。
張し第1B図に示されるような形状に変形した後、第1
B図に示すように、管状部材71が第2の伸張した直径
d′を有する時、スロット82は事実上六角形の形状を
呈するであろう。かような六角形の形状は、スロット8
2か最初に事実上長方形の形状を有し、管状部材71が
第1A図に示したような第1の直径dを有する時に結果
として生じるものである。スロット82の幅を事実上減
少させ、これによって接続部材77の長さが一点交差に
近似すれば、かような管状部材71の伸張の結果、スロ
ット82は事実上平行四辺形である形状(図示せず)を
呈することに留意すべきである。
第1B図に示された形状に達するばかりでなく、管状部
材71は更に“変形″′してその形状に達する。“変形
″という用語は、移植片又はプロテーゼ70が製造され
た材料が、管状部材71を製造するために使用された材
料の弾性限界よりも大きい力に暴露されることを意味す
る。従ってその力は、細長い部材75を永久的に曲げ、
それにより細長い部材75のセグメントが接続部材77
の周りにピボット回転(pivot) L 、それらが
ピボット回転する際に、管状部材71が第1直径dから
第1B図の伸張した直径d′まで増大することにより周
辺方向に移動するのに充分な力である。後で詳細に記載
されるように、管状部材71を伸張するために加えられ
る力は、管状部材71を伸張させるだけでなく、前記の
方式で細長い部材75をも変形させ、それにより接続部
材77の端部の周りにピボット回転する細長い部材75
の一部が「スプリングバック(spring back
)Jせず、第1A図に示されたような形状を呈すること
がなく、第1B図に図示した形状を保持するのに充分で
なければならない。移植片又はプロテーゼ70が一旦伸
張し、第1B図に示されたような形状に変形すると、移
植片又はプロテーゼ70は、後で詳細に記載されるよう
に、身体通路が潰れることを防止するのに役立つ。管状
部材71が第1A図に示された第1の直径dを有する時
、又は管状部材71が伸張して第1B図に示す第2の伸
張した直径d″に変形した後、管状部材71は外向きの
半径方向の力を及ぼす傾向のある、[ばね様(spr
ing−11ke)J又は「自己伸張性部材(self
−expanding +oember)、1ではない
ので、管状部材71は何等外向きの半径方向の力を及ぼ
すことがない。
に記載されている。この場合も、本発明の装置は静脈、
動脈又は人間の脈管系内の血管のような身体通路の内腔
を伸張させるためのみならず、前記した方法を行って前
記したような他の身体通路又は管を管腔内で強化する(
intraluminally reinforce)
のにも有用であることが理解されるべきである。更に第
3及び4図に関して、第1A図及び18図に関連して前
記した形式の伸張可能な管腔内脈管移植片又はプロテー
ゼ70は、カテーテル83上に配置又は取り付けられる
。カテーテル83はそれに関連した伸張可能で膨張可能
な部分84を有している。カテーテル83は、伸張可能
な管腔内脈管移植片又はプロテーゼ70をカテーテルの
伸張可能で膨張可能な部分84に取り付は及び保持する
ための手段85を含むことができる。取り付は及び保持
手段85は、カテーテル83の伸張可能な膨張可能な部
分84に隣接してカテーテル83上に配置された保持器
リング部材86を具備し;そして保持器リング部材86
は伸張可能な管腔内脈管移植片又はプロテーゼ70の各
端部72.73に隣接して配置されている。第3図に示
すように、保持器リング部材はカテーテル83と一体的
に形成され、後で詳細に説明するように、移植片又はプ
ロテーゼ70が身体通路70の内腔81に挿入される時
それを保護又は保持するために、カテーテル83の先導
チップ87に隣接した保持器リング部材86は、カテー
テルチップ87から遠ざかる方向に登り勾配をもってい
ることが好ましい。第3図に示すように、残りの保持器
リング部材86は、身体通路80からのカテーテル83
の容易な除去を確実にするために、カテーテル83のチ
ップ87から遠ざかる方向に下り勾配を持っている。伸
張可能な管腔内移植片又はプロテーゼ70が前記したよ
うにカテーテル83上に配置された後、移植片又はプロ
テーゼ70及びカテーテル83は、慣用の方法で身体通
路80のカテーテル挿入(catheter 1zat
1on)により身体通路80内に挿入され・る。
プロテーゼ70は身体通路内の所望の位置に送り込まれ
、そこで管腔内移植片70を経由して身体通路80の内
腔81を伸張させることが望まれ、又はそこでプロテー
ゼ70を移植することが望まれる。カテーテル83及び
移植片又はプロテーゼ70が身体通路内の所望の位置に
送り込まれることを確実にするために、X線透視検査(
F 1uoroscopy)及び/又は他の慣用の方法
を利用することができる。次いでプロテーゼ又は移植片
70は、カテーテル83の伸張可能な膨張可能な部分8
4を制御下に伸張させられ、変形せしめられ、それによ
りプロテーゼ又は移植片70は、第4図に示すように、
身体通路80と接触するように伸張され、半径方向外向
きに変形させられる。
な部分は慣用の血管形成術バルーン88であることがで
きる。プロテーゼ又は移植片70の所望の伸張が終了し
た後、血管形成術バルーン88はしぼまされ又は収縮さ
せられ、そしてカテーテル83は慣用の方法で身体通路
80から除去することができる。必要に応じ、第3図に
示されたように移植片及びプロテーゼ70が配置されて
いるカテーテル83は、最初慣用のテフロン■鞘89又
はその他の適切な材料から作られた鞘89に包まれてい
てもよく、鞘89はプロテーゼ又は移植片70の伸張の
前にプロテーゼ又は移植片70から引っ張り離される。
片70の管状部材71は、前記したように身体通路80
内に挿入されるのを可能とするために、最初は第1A図
に関連して記載されたような第1の所定のしぼまされた
直径dを有することに留意すべきである。前記した目的
でプロテーゼ70を身体通路80内に移植することが必
要な場合は、プロテーゼ70は制御可能な方法で伸張さ
れ且つ第2の直径d′に変形され、そして第2の直径d
′は可変であり、そして第4図に示されるように身体通
路80の内径により、及びカテーテル83の膨張可能な
部分84の伸張の量によってd′が決定される。従って
、伸張され且つ変形したプロテーゼ70は、血管形成術
バルーン88が収縮すると身体通路80内の所望の位置
から移動することができず、プロテーゼ70の伸張は多
分身体通路80の破断(「upture)を引き起こさ
ないであろう。更に、プロテーゼ又は移植片70が「ば
ね様」又は「自己伸張性部材」でない限りは、プロテー
ゼは身体通路80の半径方向の潰れに抵抗するのに必要
な力以上に、外向きの半径方向の力を常時身体通路80
の内部表面に対し及ぼすことはない。こうして動脈又は
身体通路の内部表面又は内膜の侵食(erosion)
が防止される。
るのに伸張可能な管腔内移植片70を使用することが必
要な場合には、血管形成術バルーン88による管腔内脈
管移植片の伸張は狭窄症区域の制御された拡張を可能と
し、同時に脈管移植片70の制御された伸張及び変形を
可能とし、それにより脈管移植片70は身体通路80が
しぼんだり、先に伸張させられた内腔81の寸法が減少
したりするのを防止する。この場合も、第4図に示され
たような、管腔内脈管移植片70の第2の伸張させられ
た直径d′は可変であり、そして身体通路80の所望の
伸張させられた内径により決定される。かくして、伸張
可能な管腔内移植片70は、血管形成術バルーン88が
収縮しても身体通路80内の所望の位置から離れるよう
に移動せず、管腔内移植片70の伸張は、前記のように
身体通路80の破断を引き起こさず、又何等の侵食をも
起こさないようである。更に内膜フラップ又は裂溝(f
issure)が身体通路80内で移植片70の位置に
形成されているならば、移植片70はこのような内膜フ
ラップが身体通路80へと内方に折り込まれ得ないこと
、及びゆるく引き裂けたり身体通路80を通って流れた
りしなことを確実にする。左主冠状動脈のような重要な
身体通路の部分の内腔を伸張させるために前記した方法
で移植片゛70を使用する状況においては、内膜フラン
ゾは心臓の左主冠状動脈を閉塞することはできず、そし
て患者の死を引き起こすことはないと信じられる。
を一回しか膨らます必要はないので、トランスルミナル
血管形成術(transluminal angiop
Iasty)期間中内皮の表皮剥落(endothel
ial denudation)の程度がバルーンの膨
らまし時間に比例する限りは、より多くの量の内皮、又
は内膜の内側層、又は身体通路の内側表面が保存される
と信じられる。更に、理論上は、移植片70の伸張させ
られた形状においては、可能性として内皮の80%が移
植片の開口又は伸張されたスロット82を通して露出さ
れるので、保存される内皮(preserv6d en
d□thelium)の量は大きい筈である。更に、移
植片70の伸張されたスロット82内の内皮の損なわれ
ていないバッチが実験的研究により示されたように、迅
速な多中心内皮化パターン(multicentric
endothelialization patte
rn)をもたらし得ると信じられる。
に関連して先に記載したプロテーゼ又は移植片70が示
されており、そして移植片又はプロテーゼ70の管状部
材71は管状の形状の部材71の壁表面74上に生物学
的に不活性な又は生物学的に適合性のある被覆90が配
置されている。
タン、テフロン■又は他の慣用的な生物学的に不活性な
プラスチック材料である。被W190は、プロテーゼ又
は移植片70の所望の伸張及び変形を妨害しないように
薄く且つ高度に弾性的でなければならない。被覆90は
更に管状部材71を身体通路80に固着させるための手
段91(第6図)を具備していてもよい。固着手段91
は被覆90上に形成された多数の外側半径方向に延びて
いる突起92から成っていてもよい。第6図に示すよう
に、外側半径方向に延びている突起92は多数のりッジ
(ridge)93 、又は他の形式の外側半径方向に
延びている突起を包含することができる。更に、第5図
に示されるように、被覆90内に多数の開口94を形成
させることが望ましく、そのことによって、身体゛通路
80内に含まれる体液が拡張された又は伸張された身体
通路区域と直接接触することができる。生物学的に適合
性のある被覆90の例は、吸収性の縫合糸を製造するた
めに使用されるような吸収性重合体から製造された被覆
を包含する。このような吸収性の重合体はポリグリコリ
ド、ポリラクチド、及びそれらの共重合体を含んでいる
。該吸収性重合体は又、被覆90が吸収され、又は溶解
されるにつれて、薬品が徐々に身体通路中に放出される
ような、各種の形式の薬品を含むことも可能である。
プロテーゼ70よりも長いプロテーゼ又は移植片70′
が必要とされる場合に、曲がった身体通路80内に移植
するため又は身体通路80の細長い区域に使用するため
の、伸張可能な管腔内脈管移植片又はプロテーゼ70′
が示されている。第1A図乃至第6図に関連して前記し
た要素とデザイン、構成及び操作が同じである要素につ
いては第7図及び第8図会体にわたり同じ参照番号を使
用し、第1A図乃至第6図に関連して前記した要素とデ
ザイン、構成及び操作が類似している要素については、
添字のついた参照番号を使用する。
0′は、一般に、複数の、第1A図、第1B図及び第2
図に示されたような移植片又はプロテーゼ70を含んで
成る。隣接管状部材71間に又は隣接移植片又はプロテ
ーゼ70間に配置されているのは、隣接管状部材71又
は移植片もしくはプロテーゼ70を柔軟に接続するため
の単一のコネクタ部材100である。コネクタ部材10
0は、好ましくは、前記したような、移植片70と同じ
材料から形成され、そしてコネクタ部材100は、第7
図に示すように、隣接移植片70又は管状部材71かん
で一体的に形成されてもよい。
ネクタ部材100の断面形状は、コネクタ部材100が
細長い部材75の同じ均一な厚さを有するという点で同
じであり、そして隣接する管状部材71と同一平面にあ
・る薄い壁の細長い棒状部材101を形成する。勿論、
それに替わるものとして、コネクタ部材100の厚さは
細長い部材75の厚さよりも薄くすることができること
は、当業者には容易に明らかであろう。しかしながら、
コネクタ部材lOOの外周表面101は、第7図に示す
ように、移植片又はプロテーゼ70の壁表面74により
形成された同じ面内にあることが好ましい。
ーゼ70′は、コネクタ部材100により柔軟に接続さ
れている3つの移植片又はプロテーゼ70を含むものと
して例示されているけれども、2つといったような少数
の移植片70を接続して移植片又はプロテーゼ70′を
形成することができることに留意されるべきである。更
に、所望に応じて多くの移植片70をコネクタ部材10
0により柔軟に接続して、移植片又はプロテーゼ70′
を形成することができる。好ましくは、各移植片又はプ
ロテーゼ70の長さは、近似的に2つのスロット82の
長さである;しかしながら、各移植片70の長さを2つ
又はそれ以上のスロット82の長さと概ね等しくするこ
ともできる。3つ又はそれ以上の移植片70がコネクタ
部材100によって柔軟に連結される場合、第1のコネ
クタ部材100は第1の管状部材70Aの第2の端部7
3と第2の管状部材70Bの第1の端部72との間に配
置されることが好ましい。第2のコネクタ部材100は
次に第2の管状部材70Bの第2の端部73と第3の管
状部材70Cの第1の端部72との間に配置される。第
7rM及び第8図に示すように、相互に連結された移植
片又はプロテーゼ70の間で必要な柔軟性を可能にする
ために、管状部材70の長手方向の軸線に対して第1及
び第2のコネクタ部材100を互いに角度的にずらすこ
とができる。
1A図、第1B図、及び第3図乃至第4図について前記
したのと同じである。カテーテル83の伸張可能で膨張
可能な部分84は、当業者には容易に明らかなように、
移植片又はプロテーゼ70′の長さと合致するような寸
法とされるであろう。伸張可能で膨張可能な部分84の
長さを除いては、カテーテル83、移植片又はプロテー
ゼ70′の送り方法及びその後の制御可能な伸張及び変
形は、前述と同じである。
0内の所望の位置に送られつつあり、あるいは移植片又
はプロテーゼ70′はカテーテル83上に配置されてお
りそして動脈の曲がり部のような身体通路80の曲がっ
た部分を通過しているときに、とるであろう形状として
示されている。
0間に柔軟なコネクタ部材100を配置したので、移植
片又はプロテーゼ70′は、移植片又はプロテーゼ70
’の長手方向軸線に対して柔軟に曲がるか又は関節式に
接合する(articulaie)ことができて、身体
通路80内に見出だされる湾曲部又は曲がり部を乗り越
えることができる。コネクタ部材100は、移植片又は
プロテーゼ70′の長芋方向軸線の回りのいかなる方向
においても隣接管状部材71の曲がり又は関節状になる
ことを可能とすることに留意すべきである。移植片又は
プロテーゼ70′が伸長しそして変形した形状状態にあ
るとき、移植片又はプロテーゼ70′の管状部材71は
第1B図に示す形状を呈するであろう。
本発明はこれまでに説明しそして示された構造の詳細、
材料又は態様に厳密に限定されるものではないことが理
解されるべきである。従って、本発明は特許請求の範囲
に記載の範囲により限定されるべきである。
び該第1の端部と第2の端部との間に配置されている壁
表面を有し、該壁表面は実質的に均一な厚さを有してお
りそして該壁表面には複数のスロットが形成されており
、該スロットは各管状部材の長手方向軸線に実質的に平
行に配置されており;及び、 隣接管状部材間に配置されていて隣接管状部材を柔軟に
接続する単一のコネクタ部材、ここで、該単一のコネク
タ部材は管状部材の長手方向軸線に対して実質的に平行
な関係にてそして各管状部材と同一平面に配置されてお
り; とを備えて成り; 各管状部材は、管腔を持った身体通路内への前記管状部
材の管腔内送り込みを可能とする第1の直径を有し; 前記管状部材は、該管状部材の内側から半径方向外向き
に伸張させる力を加えられるとき、伸張しそして変形し
た第2の直径を有し、該第2の直径は可変でありそして
該管状部材に及ぼされる力の量に依存しており、それに
より、該管状部材は身体通路の管腔を伸張させるように
伸張及び変形することができる; ことを特徴とする伸張可能な管腔内脈管移植片。
面の薄肉の細長い棒状部材である上記lに記載の伸張可
能な管腔内移植片。
部と第2の管状部材の第1の端部との間に配置され、第
2のコネクタ部材が第2の管状部材の第2の端部と第3
の管状部材の第1の端部との間に配置され、第1及び第
2のコネクタ部材は、管状部材の長手方向軸線に対して
互いに角度的にずれている上記lに記載の伸張可能な管
腔内移植片。
び該第1の端部と第2の端部との間に配置されている壁
表面を有し、該壁表面は実質的に均一な厚さを有してお
りそして該壁表面には複数のスロットが形成されており
、該スロットは各管状部材の長手方向軸線に実質・的に
平行に配置されており;及び、 隣接管状部材間に配置されていて隣接管状部材を柔軟に
接続する単一のコネクタ部材、ここで、該単一のコネク
タ部材は管状部材の長手方向軸線に対して実質的に平行
な関係にてそして各管状部材と同一平面に配置されてお
り: とを備えて成り; 各管状部材は、管腔を持った身体通路内への前記管状部
材の管腔内送り込みを可能とする第1の直径を有し: 前記管状部材は、該管状部材の内側から半径方向外向き
に伸張させる力を加えられるとき、伸張しそして変形し
た第2の直径を有し、該第2の直径は可変でありそして
該管状部材に及ぼされる力の量に依存しており、それに
より、該管状部材は身体通路の管腔を伸張させるように
伸張及び変形することができる; ことを特徴とする身体通路のための伸張可能なプロテー
ゼ。
面の薄肉の細長い棒状部材である上記4に記載の伸張可
能なプロテーゼ。
部と第2の管状部材の第1の端部との間に配置され、第
2のコネクタ部材が$2の管状部材の第2の端部と第3
の管状部材の第1の端部との間に配置され、第1及び第
2のコネクタ部材は、管状部材の長手方向軸線に対して
互いに角度的にずれている上記4に記載の伸張可能なプ
ロテーゼ。
ーゼを送り込むことを可能とする第1の直径を有する、
身体通路のための伸張可能な管腔内脈管移植片又はプロ
テーゼの斜視図である。 第1B図は、身体通路内に配置されているときに伸張し
た形状にある、第1A図の移植片又はプロテーゼの斜視
図である。 第2図は、第1B図の線2−2に沿って取ったプロテー
ゼの断面図であ、る。 第3図は、第1A図に示された形状にあるプロテーゼ又
は管腔内脈管移植片を例示している、身体通路を管腔内
で補強するため、又は身体通路の管腔を伸張させるため
の装置の断面図である。 第4図は、第1B図に示された形状にある管腔内脈管移
植片又はプロテーゼにより、身体通路を管腔内で補強す
るため、又は身体通路の管腔を伸張させるための装置の
断面図である。 第5図及び第6図は、前記移植片又はプロテーゼがコー
ティングを有している、身体通路のためのプロテーゼの
斜視図である。 第7図は、本発明に従う移植片又はプロテーゼの他の態
様の斜視図である。 第8図は、移植片が曲げられているか又は関節状になっ
ている、第7図の移植片の斜視図である。 図において、70・・・身体通路のための伸張可能な管
腔内脈管移植片又は伸張可能なプロテーゼ、71・・・
管状部材、72・・・第1の端部、73・・・第2の端
部、74・・・壁表面、75・・・細長い部材、77・
・・接続部材、80・・・身体通路、81・・・管腔、
82・・・スロット、83・・・カテーテル、84・・
・カテーテル83の伸張可能で膨張可能な部分、85・
・・取り付は及び保持するための手段、86・・・保持
リング部材、87・・・カテーテルチップ、88・・・
慣用の血管形成術バルーン、100・・・コネクタ部材
、104・・・湾曲部又は曲がり部、である。 !’5F−6
Claims (1)
- 【特許請求の範囲】 1、複数の薄肉管状部材、 ここで、該管状部材の各々は第1の端部、 第2の端部及び該第1の端部と第2の端部 との間に配置されている壁表面を有し、該 壁表面は実質的に均一な厚さを有しており そして該壁表面には複数のスロットが形成 されており、該スロットは各管状部材の長 手方向軸線に実質的に平行に配置されてお り;及び、 隣接管状部材間に配置されていて隣接管状部材を柔軟に
接続する単一のコネクタ部材、 ここで、該単一のコネクタ部材は管状部 材の長手方向軸線に対して実質的に平行な 関係にてそして各管状部材と同一平面に配 置されており; とを備えて成り; 各管状部材は、管腔を持った身体通路内への前記管状部
材の管腔内送り込みを可能とする第1の直径を有し; 前記管状部材は、該管状部材の内側から半径方向外向き
に伸張させる力を加えられるとき、伸張しそして変形し
た第2の直径を有し、該第2の直径は可変でありそして
該管状部材に及ぼされる力の量に依存しており、それに
より、該管状部材は身体通路の管腔を伸張させるように
伸張及び変形することができる; ことを特徴とする伸張可能な管腔内脈管移植片。 2、複数の薄肉管状部材、 ここで、該管状部材の各々は第1の端部、 第2の端部及び該第1の端部と第2の端部 との間に配置されている壁表面を有し、該 壁表面は実質的に均一な厚さを有しており そして該壁表面には複数のスロットが形成 されており、該スロットは各管状部材の長 手方向軸線に実質的に平行に配置されてお り;及び、 隣接管状部材間に配置されていて隣接管状部材を柔軟に
接続する単一のコネクタ部材、 ここで、該単一のコネクタ部材は管状部 材の長手方向軸線に対して実質的に平行な 関係にてそして各管状部材と同一平面に配 置されており; とを備えて成り; 各管状部材は、管腔を持った身体通路内への前記管状部
材の管腔内送り込みを可能とする第1の直径を有し; 前記管状部材は、該管状部材の内側から半径方向外向き
に伸張させる力を加えられるとき、伸張しそして変形し
た第2の直径を有し、該第2の直径は可変でありそして
該管状部材に及ぼされる力の量に依存しており、それに
より、該管状部材は身体通路の管腔を伸張させるように
伸張及び変形することができる; ことを特徴とする身体通路のための伸張可能なプロテー
ゼ。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US25311588A | 1988-10-04 | 1988-10-04 | |
US253115 | 1988-10-04 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH02174859A true JPH02174859A (ja) | 1990-07-06 |
JP2680901B2 JP2680901B2 (ja) | 1997-11-19 |
Family
ID=22958929
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP1257987A Expired - Lifetime JP2680901B2 (ja) | 1988-10-04 | 1989-10-04 | 伸張可能な管腔内移植片 |
Country Status (12)
Country | Link |
---|---|
US (5) | US5195984A (ja) |
EP (1) | EP0364787B1 (ja) |
JP (1) | JP2680901B2 (ja) |
KR (1) | KR0142674B1 (ja) |
AT (1) | ATE72955T1 (ja) |
AU (1) | AU623438B2 (ja) |
BR (1) | BR8905130A (ja) |
CA (1) | CA1322628C (ja) |
DE (2) | DE68900929D1 (ja) |
ES (1) | ES2016233T3 (ja) |
GR (2) | GR900300138T1 (ja) |
ZA (1) | ZA897357B (ja) |
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Also Published As
Publication number | Publication date |
---|---|
ES2016233T3 (es) | 1992-10-16 |
GR3003987T3 (ja) | 1993-03-16 |
GR900300138T1 (en) | 1991-09-27 |
CA1322628C (en) | 1993-10-05 |
ATE72955T1 (de) | 1992-03-15 |
AU4248589A (en) | 1990-04-12 |
DE364787T1 (de) | 1990-12-20 |
ES2016233A4 (es) | 1990-11-01 |
KR0142674B1 (ko) | 1998-07-01 |
US20060149353A1 (en) | 2006-07-06 |
EP0364787B1 (en) | 1992-03-04 |
JP2680901B2 (ja) | 1997-11-19 |
BR8905130A (pt) | 1990-05-15 |
DE68900929D1 (de) | 1992-04-09 |
EP0364787A1 (en) | 1990-04-25 |
US20030195617A1 (en) | 2003-10-16 |
US5902332A (en) | 1999-05-11 |
KR900005943A (ko) | 1990-05-07 |
US5195984A (en) | 1993-03-23 |
AU623438B2 (en) | 1992-05-14 |
ZA897357B (en) | 1990-10-31 |
US20020133221A1 (en) | 2002-09-19 |
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