JPH03198845A - 血管用補綴具 - Google Patents
血管用補綴具Info
- Publication number
- JPH03198845A JPH03198845A JP2017670A JP1767090A JPH03198845A JP H03198845 A JPH03198845 A JP H03198845A JP 2017670 A JP2017670 A JP 2017670A JP 1767090 A JP1767090 A JP 1767090A JP H03198845 A JPH03198845 A JP H03198845A
- Authority
- JP
- Japan
- Prior art keywords
- stent
- sheet
- diameter
- mesh
- vascular prosthesis
- 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
- 210000004204 blood vessel Anatomy 0.000 title claims abstract description 28
- 238000004804 winding Methods 0.000 claims abstract description 4
- 238000002399 angioplasty Methods 0.000 claims description 16
- 230000002792 vascular Effects 0.000 claims description 15
- 239000000463 material Substances 0.000 claims description 12
- 208000031481 Pathologic Constriction Diseases 0.000 claims description 3
- 230000036262 stenosis Effects 0.000 claims description 3
- 208000037804 stenosis Diseases 0.000 claims description 3
- 239000013013 elastic material Substances 0.000 claims 1
- 239000004615 ingredient Substances 0.000 claims 1
- 239000007779 soft material Substances 0.000 abstract 1
- 229910001220 stainless steel Inorganic materials 0.000 description 6
- 238000000034 method Methods 0.000 description 4
- 230000008602 contraction Effects 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 239000002184 metal Substances 0.000 description 3
- 229910052751 metal Inorganic materials 0.000 description 3
- 239000000853 adhesive Substances 0.000 description 2
- 230000001070 adhesive effect Effects 0.000 description 2
- 238000005516 engineering process Methods 0.000 description 2
- 239000007788 liquid Substances 0.000 description 2
- 239000010935 stainless steel Substances 0.000 description 2
- 239000012209 synthetic fiber Substances 0.000 description 2
- 229920002994 synthetic fiber Polymers 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 1
- 230000023555 blood coagulation Effects 0.000 description 1
- 230000004663 cell proliferation Effects 0.000 description 1
- 229910010293 ceramic material Inorganic materials 0.000 description 1
- 239000000701 coagulant Substances 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 150000002739 metals Chemical class 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 230000003716 rejuvenation Effects 0.000 description 1
- 230000007998 vessel formation 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
- A61F2/92—Stents in the form of a rolled-up sheet expanding after insertion into the vessel, e.g. with a spiral shape in cross-section
-
- 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
- A61F2230/0054—V-shaped
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
Abstract
め要約のデータは記録されません。
Description
確実かつ容易に挿入できるようにした血管用補綴具に関
する。
れたりする補綴手段としてはカテーテルの周囲にガイド
ワイヤを比較的きつく巻き付けたような手段が用いられ
てきている。この種の手段では上記の狭窄部や閉塞部に
送り込まれたり、挿入されている間は補綴具、すなわち
ステントを一時的にカテーテルに巻き付けられた状態に
保持しておくような種々の手段が提案されてきた。
。このステントの一般的な特徴は、円筒形状のそで状を
なしていることで、これらは患者の血管内やその他の体
腔内や管腔内等に適用されている。このステントの壁面
はステント全体が拡径したり縮径したりできるように変
形自在なメツシュにより一種の格子状に形成されている
。この種のステントの1つである米国特許第4,740
゜207号(クリーマ)に示されたようなステントはス
テンレスシートから形成されており、初期状態において
小径に巻回された状態に置かれている。
、上記巻回されたステントの内側に配置されているカテ
ーテルの端部に備えられた血管形成用バルーン6により
拡径させることができる。この血管形成用バルーン6は
液体により好みの直径に膨張でき、通常は血管形成用バ
ルーン6が膨張可能な最大径まで膨張させるようになっ
ている。
.956号や日本国特開昭57−89859号に記載さ
れているような温度膨張性材料によって作られたステン
トがある。このステントは血管内に挿入された後に熱に
より拡径できるようになっている。
性状を有するステンレスワイヤから作られており、この
ステンレスワイヤはメツシュの内部に織り込まれている
。上記のタイプのステントの直径は患部の血管の通常の
内径よりわずかに大きく設定されている。このため、こ
のステントは、挿入された後において残余の半径方向圧
力を動脈壁に作用させることが可能である。ステントを
患者の血管内に挿入する前と、患部の血管部分に導いて
いる間は上記ステントは長手方向に引き伸ばされて縮径
されるとともに、カテーテルの周囲に配置された引込み
スリーブによって押圧されている。−旦、ステントが挿
入されると、上記引込みスリーブが前進して上記ステン
トは血管内で展開することができる。
に示した温度膨張性材料によって作られたステントは血
管内に挿入するのが非常に難しいとともに、拡径量の制
御が難しく、確実でないという問題がある。この問題は
ステンレスワイヤ製のステントでは生じないが、このス
テンレスワイヤ製のステントではステントが所定の最大
径に拡径するのど引き替えに比例してステント長が短く
なってしまうという欠点がある。このステント長の縮小
は、円筒が横方向に拡径されるのに応じて長手方向の長
さが減じられることにより格子メツシュに幾何変形が生
じた結果によって起こるものである。
イヤが円筒の端部でほつれて動脈細胞を傷つけたり、そ
の内部で著しい変化が生じたり血管内につけた傷により
新しい別の狭窄を生じさせるおそれもある。
問題点を解消し、従来の装置に比べ、血管壁をほとんど
傷つけないようにしてステントを容易かつ正確に所定の
動脈位置に導けるような血管用補綴具を提供することに
ある。
のシートをカテーテルの周囲に小さな直径の渦巻状をな
すように巻回し、一時的な保持手段により小径に巻回し
た状態に保持する一方、上記の一時的な保持手段が除去
された場合は巻きが解かれることで直径が増すようにし
たことを特徴とするものである。
巻き解くという方法によれば、ステントはその全長を減
少させることなく大きな直径を形成することができる。
よりむしろ巻き解くことにより生じるものだからである
。この方法によって上記ステントを所定の位置に容易か
つ確実に挿入させることができるようになる。
ために金属ワイヤを編み込んだ構造を使用する必要はま
ったくなくなった。このことはステントは特殊な目的の
場合には平板状のシートを使用することもできることを
意味する。しかしながら、表面が露出した状態の網状構
造が必要な場合には上記ステントは通常の非変形性の網
目状の格子形状を示すように開口を配置したような平板
状のシートを用いることもできる。
た場合にもステントの壁面の表面は平滑でかつシートの
端部では金属の繊維部分が出入り自由になっている。こ
のため、ステントを挿入する隙も血管壁をほとんど傷つ
けることはない。また、ステントは内面が平滑なため液
体が内部をスムーズに流れることができる。
るという効果を奏する。
示すことができ、特にステンレス鋼に代わる血液凝固性
がなく、劣化しない材質についての使用可能性について
も明らかにされる。
第1図乃至第4図を参照して説明する。
を有する四角形の平坦なシートから構成されており、第
1図に示したような一時的に円筒形状を形成するように
巻回されている。
角形の窓状の変形を生じない網目2を有している。そし
て、この網目2は上述のように形成された円筒形の長手
方向に延在する2本の平行な辺3に沿って配置されてい
る。この網目構造の一部分を第4図に示した。
ラップ5が形成されており、このフラップ5は上記巻回
された円筒の長手方向の軸心から外方に向けて延出して
おり、格子の網目2に係止してシートが互いに重なるよ
うになっている。
2つずつ配置されており、上記網目と容易に係止できる
ようになっている。
の先端部の外周には萎んだ状態の血管形成用バルーン6
が装若されている。さらにこの血管形成用バルーン6の
外周に比較的小さな径(d)となるように渦巻状に巻回
されたシート1が嵌挿されている。上記血管形成用バル
ーン6とカテーテル7の両者はステントを血管に嵌挿す
る際、協動するようになっている。
段としてワイヤ8が用いられている。このワイヤ8は渦
巻状に巻回されたシート1の外側重なり端9の近くで最
外周から2層分の網目に織り込まれている。また、上記
ワイヤ8は外側から引き抜いて取り除くことができるよ
うになっている。
が示されており、その断面形状が第3図に示されている
。このステントは上記ワイヤ8が引き抜かれた後の血管
形成用バルーン6の膨張により拡径するようになってい
る。第1b図には明瞭にするために血管形成用バルーン
6とカテーテル7は図示されていない。
が巻き解かれるのと反対方向に傾斜させられ、網目と係
止しないように網目の表面をすべるようになっている。
トの周囲にある血管の収縮圧によりシート1は再び巻回
されようとする。しかしながら、上記シートが収縮しよ
うとすると上記フラップ5が再び巻回されようとする方
向を向き、第1b図及び第3図から明らかなように網目
の端部同士が引っ掛かるようにして最初に遭遇した格子
の網目に係止することができる。上記ステントはこのよ
うに堅固かつ確実に保持され、血管内で拡径した状態に
あっても血管を傷つけることもない。
とは上記血管形成用バルーン6が膨張できる最大直径の
関数となっており、また上記血管形成用バルーンが最も
膨張した時でもフラップ5の形成されたシートの端部4
は少なくとも対向するシートの外側重なり端9の網目の
最終列の辺と重なり合うように計算されているのは当然
のことである。
いることにより、格子形状を変形させることなく、血管
形成用バルーンの表面上で容易にステントを巻回したり
、巻き解いたりすることができる。
上記円筒形状は高い安定性を発揮することができ、直線
形状の血管の治療に好適である。
ない。
トを挿入するのに比較的高い柔軟性が必要であるような
場合には第5図に示された網目10のようなひし形状の
網目を用いることも可能である。この他の実施例ではひ
し形状の網目の短軸(a)は円筒形状の長手方向と一致
している。
先端を延ばした延長部11がフラップを形成しており、
このフラップ11は血管形成用バルーン6が萎んだ後に
、血管の収縮圧により再び巻回されようとするシート1
の性質に抵抗するようになっている。これらの延長部1
1は重なり合う網目の対向する内側のシートの網目の角
部に引っ掛かるようになっている。
成される開口部は格子状の外観に限定されることなく、
ステントの適用において特別な効果や態様が要求される
ような場合には、好みの幾何形状とすることができる。
よりステントが拡径するという原理によれば、ステント
長のいかなる減少も防ぐことができる。
を傷つけるようなワイヤを有しないという従来例に比べ
て好ましい効果を奏するが、このような効果は、図示さ
れたような四角形(2)やひし形(10)の格子形状に
何ら限定されるものではない。
としてフラップ5.11の自己係止機構がその効果を発
揮するようになっている。このとき、このステントは良
好な弾性的性質を有する材質のものである必要はないが
、柔軟性に富むとともに、血液凝固性がなく、難溶解性
材料を使用したほうがより効果的であり、望ましい。
を係止できるように必要に応じて打ち抜かれた孔を有し
て表面が平坦なシートを巻回したものにも適用すること
ができる。
所の端部が重ならないかわりに、上記長手方向の端部に
把持機構を備えるようにすることも可能である。この把
持機構は血管の収縮圧が作用すると、血管の壁面に埋め
込まれるようになっている。
る材質は生体適合性を満たすものであれば、金属、合成
繊維又はセラミックス材料のようにあらゆる種類のもの
を利用することができる。
で細胞が増殖しないような生体適合性の有る製品や材料
から構成された被覆材を広い範囲で選定することができ
る。
した場合には巻きを解くことによる拡径を自己の弾性性
状により果たすことができるような円筒状のシートを形
成することが可能である。
筒形状となる。
血管の収縮圧の両者が平衡する点までステントは押し広
げられる。この実施例によれば、フラップ5又は11の
ような手段は何ら必要ない・最後に、上記巻回されたス
テントをカテーテルの周囲に保持するための他の一時的
な手段としては、たとえば、劣化しない接着剤によって
ステントのそで部分や一部を接合する方法や、接着部と
ワイヤ8とを組み合わせてワイヤを引くことによりその
部分を引き剥がすような方法も可能である。
、7・・・カテーテル、8・・・ワイヤ、9・・・外周
端部。
Claims (8)
- 1.カテーテルの外周にステントを装着するとともに、
ガイドワイヤを覆うようにして進行させることで血管内
やその他の体腔内の狭窄部や閉塞部に配置することがで
き、また、この狭窄部や閉塞部に進行する際は、上記ス
テントを縮径された第1の状態に一時的に保持するよう
な手段と、上記狭窄部や閉塞部に達した際は、上記ステ
ントを拡径させるような手段とを有する円筒形状をなす
血管用補綴具において、 上記ステントは、その内面と外面とが長手方向に重なる
ようにカテーテル(7)の周囲で縮径された直径(d)
の渦巻状に巻回されるとともに、一時的な保持手段によ
り上記カテーテルの外周に巻回状態で固定される平面状
のシート(1)と、上記保持手段を解除する手段と、上
記保持手段を解除した後、上記シートの長手方向の端部
に重なりが生じるように巻きを解いて上記ステントを直
径(D)まで拡径され、その後上記シートの長手方向の
内側重なり部分に形成された半径方向に延出した爪を、
上記シートの長手方向の外側重なり部分に形成された開
口に差し込むように係止する手段により上記ステントの
拡径状態を保持するようにしたことを特徴とする血管用
補綴具。 - 2.上記ステントは弾性材料により形成され、上記ステ
ントの巻きを解くことによる拡径はステント自身の弾性
性状によることを特徴とする請求項1記載の血管用補綴
具。 - 3.上記ステントは柔軟性材料により製造され、上記ス
テントの巻きを解くことによる拡径は上記カテーテルの
周囲に装着された血管形成用バルーン(6)の膨張によ
り得られることを特徴とする請求項1記載の血管用補綴
具。 - 4.上記平板を巻回したシートは非変形性の等辺等角の
網目(2、10)を有する網状又は格子状を形成するよ
うな整列した開口が備えられたことを特徴とする請求項
1記載の血管用補綴具。 - 5.上記平板を巻回したシートは、上記円筒の覆われる
長手方向の端部(4)に沿って突設するように配置され
た所定個数の折り上げられたフラップ(5、11)が拡
径状態では網目に対して半径方向の外側に向くようにな
るとともに、上記血管形成用バルーンが萎んだ際には重
なり合っているシートのうち最初に遭遇した網目開口に
係止し、上記ステントの拡径状態を保持する手段を備え
たことを特徴とする請求項4記載の血管用補綴具。 - 6.上記巻回されたシートを形成する網目がひし形状を
なし、このひし形状の網目の短軸(a)はステントの長
手方向と一致していることを特徴とする請求項4記載の
血管用補綴具。 - 7.上記巻回されたシートを形成する網目が四角形状(
2)をなし、この網目を形成する2本の平行な辺(3)
はステントの長手方向と一致していることを特徴とする
請求項4記載の血管用補綴具。 - 8.上記一時的にカテーテルの周囲に上記ステントを巻
回状態に保持する手段は自ら渦巻状に形成されたシート
(1)の少なくとも外周から2層分の網目に縫い込まれ
たワイヤ(8)から構成され、このワイヤは外方から除
去できるように設定されていることを特徴とする請求項
1記載の血管用補綴具。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CH237/89A CH678393A5 (ja) | 1989-01-26 | 1989-01-26 | |
CH237/89-0 | 1989-01-26 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH03198845A true JPH03198845A (ja) | 1991-08-30 |
JP2931010B2 JP2931010B2 (ja) | 1999-08-09 |
Family
ID=4182412
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2017670A Expired - Lifetime JP2931010B2 (ja) | 1989-01-26 | 1990-01-26 | 血管用補綴具 |
Country Status (6)
Country | Link |
---|---|
US (1) | US5443500A (ja) |
EP (1) | EP0382014B1 (ja) |
JP (1) | JP2931010B2 (ja) |
CA (1) | CA2008312C (ja) |
CH (1) | CH678393A5 (ja) |
DE (1) | DE69014923T2 (ja) |
Families Citing this family (445)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5876419A (en) * | 1976-10-02 | 1999-03-02 | Navius Corporation | Stent and method for making a stent |
US5643314A (en) * | 1995-11-13 | 1997-07-01 | Navius Corporation | Self-expanding stent |
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-
1989
- 1989-01-26 CH CH237/89A patent/CH678393A5/fr not_active IP Right Cessation
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1990
- 1990-01-23 CA CA002008312A patent/CA2008312C/en not_active Expired - Lifetime
- 1990-01-25 DE DE69014923T patent/DE69014923T2/de not_active Expired - Lifetime
- 1990-01-25 EP EP90101509A patent/EP0382014B1/en not_active Expired - Lifetime
- 1990-01-26 JP JP2017670A patent/JP2931010B2/ja not_active Expired - Lifetime
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US5443500A (en) | 1995-08-22 |
JP2931010B2 (ja) | 1999-08-09 |
EP0382014B1 (en) | 1994-12-14 |
EP0382014A1 (en) | 1990-08-16 |
CH678393A5 (ja) | 1991-09-13 |
DE69014923T2 (de) | 1995-06-22 |
CA2008312C (en) | 2000-05-30 |
DE69014923D1 (de) | 1995-01-26 |
CA2008312A1 (en) | 1990-07-26 |
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