JPH0379023B2 - - Google Patents

Info

Publication number
JPH0379023B2
JPH0379023B2 JP2186958A JP18695890A JPH0379023B2 JP H0379023 B2 JPH0379023 B2 JP H0379023B2 JP 2186958 A JP2186958 A JP 2186958A JP 18695890 A JP18695890 A JP 18695890A JP H0379023 B2 JPH0379023 B2 JP H0379023B2
Authority
JP
Japan
Prior art keywords
core
obturator
sleeve
outer sleeve
distal end
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.)
Expired - Lifetime
Application number
JP2186958A
Other languages
English (en)
Other versions
JPH0357465A (ja
Inventor
Eichi Baaton Jon
Jii Suteiru Buratsudofuoodo
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
American Medical Systems LLC
Original Assignee
American Medical Systems LLC
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by American Medical Systems LLC filed Critical American Medical Systems LLC
Publication of JPH0357465A publication Critical patent/JPH0357465A/ja
Publication of JPH0379023B2 publication Critical patent/JPH0379023B2/ja
Granted legal-status Critical Current

Links

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
    • A61F2/95—Instruments specially adapted for placement or removal of 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
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • 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
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • 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
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Description

【発明の詳細な説明】 本発明は、体内導管内に栓塞子を設置するため
の器具に関わり、特に自己膨張形の栓塞子の展開
又は引き込みのための器具に係わる。
例えば血管のような体内導管内における、治療
又は拡延を目的とする内腔経由移植のための細管
プロテーゼが、当業では公知である。本明細書で
は栓塞子と呼ばれるこれらのプロテーゼは非伸張
性もしくは伸張性の（なすわち縦方向に伸張する
のに適合した）管状要素であつてもよく、又は横
断方向に自己膨張するものであつてもよい。
典型的な自己膨張形の栓塞子は、米国特許第
4665771号に開示され、この栓塞子は、予め決め
られた直径を持つ半径方向及び軸方向に曲げられ
る弾性管状本体を有し、前記直径が前記管状本体
の両端部の軸方向の相互移動に応じて変化可能で
あり、更に前記栓塞子が、半径方向に自己膨張す
る螺旋を形成する、個別的には剛性であるが全体
的には可撓性である複数の弾性糸要素で作られて
いる。この米国特許第4665771号における開示内
容は、本明細書内に参照事項として組み込まれ
る。
米国特許第4665771号による体内血管内への栓
塞子の配置は、１つの実施例では、ピストンを使
用する器具を用いて行われ、又は別の実施例で
は、栓塞子を前方に押すラツチ手段を使用するこ
とによつて行われる。
米国特許第4768507号は、その外側表面上に螺
旋状の溝が形成された内側コア部材を含む栓塞子
挿入器具を開示し、前記溝は外側シースと組み合
わされて、膨張可能なコイル栓塞子を内含するよ
うに適合された螺旋形の空洞を形成する。
栓塞子を体内導管内に配置する器具が以下で説
明されるような形状及び特徴を持つならば、米国
特許第4665771号に開示されるような自己膨張形
の栓塞子は、体内導管の中で展開されるばかりで
なく、単純で信頼性が高く且つ廉価である前記配
置用器具の外側スリーブ内に引き込み戻されるこ
とも可能であることが見出されている。
本発明に従つて、体内導管内で自己膨張形の栓
塞子を展開し又は引き込むための器具が提供さ
れ、この器具が、近位の端部及び遠位の端部を有
する細長い管状の外側スリーブと、前記スリーブ
内に配置され且つ前記スリーブに対し相対的に移
動可能な細長いコアとから成り、前記コアが前記
スリーブより長く、近位の端部及び遠位の端部を
有し、且つ前記コアの前記遠位端部において又は
その付近にグリツプ部材を含み、前記グリツプ部
材が前記コアの一体的な部分であるか、スリーブ
であるか、又は前記コアの外周の周りに取付けら
れた被覆であつて、更に前記グリツプ部材が、
（）前記外側スリーブ内に自己膨張形栓塞子を
解除可能な形で保持し、（）前記コアに対して
後ろ向きの方向に前記外側スリーブを移動する時
に、前記外側スリーブの遠位端部を越えた位置に
前記栓塞子を展開し、及び、（）前記外側スリ
ーブに対して後ろ向きの方向に前記コアが引つ張
られる時に、前記外側スリーブ内に前記栓塞子を
引き込むために適した形に作られている。
本発明は又、体内導管内で自己膨張形の栓塞子
を展開するための方法も提供し、前記方法では、
前記栓塞子が、上記のような器具の外側スリーブ
内で、前記コアのグリツプ部材の上に予め配置さ
れ、従つて前記栓塞子の内側表面が前記グリツプ
部材の外側接触表面によつて解除可能な形で保持
され、更に前記方法は、前記栓塞子の適正な配置
位置に達するまで本発明の器具を体内導管内を通
して移動させることと、前記コアに対し近い方向
に前記外側スリーブを移動させることによつて前
記栓塞子を前記位置で展開することと、更に体内
導管内の望ましい位置に前記栓塞子を適性に配置
した時に本発明の器具を引き抜くこととから成
る。
本発明による器具によつて展開され且つ引き込
まれる栓塞子のタイプは、米国特許第4665771号
に開示され且つ説明されるような自己膨張性の栓
塞子であることが好ましい。
以下では、本発明は特にこのタイプの栓塞子に
関して説明されることになろう。しかし本発明に
よる器具は、その器具のグリツプ部材と外側スリ
ーブとの間に解除可能な形で保持されることが可
能な形状及び寸法を持つあらゆる膨張形の栓塞子
の配置のために使用されることが可能であるとい
うことが理解されるべきである。
本発明の好ましい実施例の１つでは、前記コア
は中空であり、この特徴は体内導管内で本発明の
器具を正しく位置決めする上で役立つ。これによ
つて、案内ワイヤを体内導管内に導入し且つそれ
に沿つて動かし、及び本発明の器具が体内導管内
の適正な位置に位置決めされるまで、前記案内ワ
イヤ上を本発明の器具を移動させることが可能で
ある。この実施例では、本発明の器具は、前記コ
ア内に且つその軸に沿つて配置された、細長くて
可撓性であり且つ操作可能な案内ワイヤを含む。
前記器具が体内導管内に位置決めされる時には、
前記栓塞子が望ましい位置で展開されるまで前記
案内ワイヤが前記器具内に保持され、またその後
で前記器具と共に引き抜かれてもよい。又はこの
代わりに、前記案内ワイヤは、前記器具内に栓塞
がある間にその栓塞子を適正な位置決めが例えば
内視鏡もしくはＸ線透視装置手段によつて確認さ
れることが可能であるように、栓塞子の展開の前
に引き抜かれてもよい。
前記外側スリーブに対する前記コアの移動を容
易にするために、前記コアはその近位端部に取り
付けられたハンドルを有することが好ましく、ま
た外側スリーブの近位端部はフランジ又はハンド
ルの形で終端することが好ましい。
本明細書で使用される場合に、術語「近位の」
は、この器具の操作者にとつて最も近い端部又は
部分を意味し、また術語「遠位の」は前記操作者
から最も遠い端部又は部分を意味するということ
が理解されるべきである。従つて、体内導管に入
る前記器具の前の端部は、遠位の端部である。
本発明による器具の最も重要な特徴はそのグリ
ツプ部材であり、この特徴の重要性はこのグリツ
プ部材が栓塞子の展開及び引込みの両方を可能に
するということである。特にグリツプ部材はコア
と直接的に結合されるか又は一体化され、且つ外
側スリーブ内に自己膨張形の栓塞子を解除可能な
形で保持するのに適合される。例えばこのグリツ
プ部材は、コア外周に取り付けられたスリーブも
しくは被覆であつても、コアの一体的部分であつ
ても、又はコアの他の部分の外径よりも大きい外
径を持つコアの長さ部分であつてもよい。
好ましい実施例は、そのグリツプ部材が摩擦接
触表面を持つ材料のスリーブであるか、又は例え
ばシリコーンゴムもしくはポリウレタンのような
変形性の材料のスリーブである本発明の器具を含
む。これらの実施例の各々では、前記スリーブの
材料は、十分に円滑で且つ切れ目のない外側表面
か又は荒面のもしくは不規則的な外側表面を有し
てよい。この代わりに、コア自体が変形性の材料
から作られるならば、グリツプ部材はこのコアの
一体的な部分であつてもよい。この実施例の利点
は、グリツプ部材が、コアに取り付けられるか又
は接着されなければならない別個の要素である必
要がないということである。
本明細書で使用される場合に、材料又は材料表
面に対して用いられる術語「摩擦」又は「高摩
擦」は、高い摩擦係数を持つ材料を、即ち滑り運
動に対し高い抵抗を呈する表面を持つ材料を意味
するよう意図され、一方、術語「低摩擦」は、滑
り運動に対し少ししか抵抗を呈しない、相対的に
滑り易い表面を持つ材料を意味するよう意図され
る。
従つてグリツプ部材の重要な特徴の１つは、こ
のグリツプ部材が栓塞子をグリツプし又は保持す
ることが可能でなければならないということと、
コアが外側スリーブに対して前方又は後方に移動
させられる時に滑りが生じないように前記グリツ
プ部材による栓塞子のグリツプが、前記栓塞子が
本発明の器具内に保持されている間は有効でなけ
ればならないということとである。それ故に、グ
リツプ部材がスリーブである時には、そのスリー
ブの材料は滑り運動に対し高い抵抗を呈する表面
を持つことが必要である。そのスリーブ材料が既
に高い摩擦係数を持つている時には、栓塞子と接
触している表面は十分に滑らかで切れ目のないも
のであることが可能である。しかし摩擦を増大さ
せ又は固有摩擦を高めるためには、そのグリツプ
部材の外側表面が荒面であるか又は不規則的なも
のでなければならない。
本発明の別の実施例では、前記グリツプ部材が
解除可能な接着剤の被覆から成る時に、そのグリ
ツプ部材のグリツプ特性が得られる。この実施例
では、前記被覆の接着強さは、栓塞子が本発明の
器具に残つている間はその栓塞子を保持し又はグ
リツプするのに十分なものでなければならず、一
方、その栓塞子が外側スリーブの拘束から解放さ
れる時には、前記接着強さは、その栓塞子自体の
膨張によつてその栓塞子が解放されるのを可能に
するのに十分なだけ弱いものでなければならな
い。
本発明の更に別の実施例で、コア自体が例えば
ポリウレタンのような高摩擦材料から作られ、ま
たそのグリツプ部材が、前記コアの他の部分より
も大きな外径を持つ前記コアの遠位端部の又はそ
の付近のコア長さ部分から成る。実際にはこの直
径の拡大は比較的小さく、約0.01インチ台である
が、このコアの太い部分の上に栓塞子を取り付け
ることによつて、本発明の器具が望み通りに操作
されることを可能にするのに十分なグリツプが与
えられることが見出されている。
コア自体が変形性の材料から作られ、且つそう
した材料が高い固有摩擦を有する時には、グリツ
プ部材の形成のためには、直径の拡大は必要では
ないだろう。本明細書では、術語「変形性の材
料」とは、外側スリーブによつて栓塞子がコアに
対して押し付けられる時に、その栓塞子の圧迫に
よつてその本来の位置において局所的に変形さ
れ、且つその栓塞子がそれによつて効果的にグリ
ツプされるように前記変形を維持することになる
材料として定義される。
上記の実施例の各々では、そのグリツプ部材が
少なくとも栓塞子と同一の長さであることが好ま
しい。
本発明による器具によつて展開される膨張形の
栓塞子が、米国特許第4665771号に説明される編
組み作業のような編組み作業によつて、例えばプ
ラスチツク又は特に金属のフイラメントのよう
な、複数の十字形の織り糸で作られる時には、そ
の栓塞子の両端部は幾つかの露出されたフイラメ
ント末端を有するだろう。例えば外側スリーブの
中にこれらの露出末端を引つ掛けることを避ける
ために、また外側スリーブ又は栓塞子自体に重大
な損傷を与えることを避けるために、栓塞子の
各々の端部を収容するための円周ギヤツプをグリ
ツプ部材の遠位端部及び近位端部に隣接して備え
ることが有利である。この実施例では、栓塞子の
両端部が前記ギヤツプの中に収まり、それによつ
て栓塞子の両端部が保護され且つその露出フイラ
メントが引つ掛かることを防止する。
グリツプ部材の高摩擦特性とは対照的に、本発
明の器具内における栓塞子−保持グリツプ部材の
動きの滑動性及び容易さを与えるために、外側ス
リーブの内側壁が低い摩擦係数をもつことが望ま
しい。この特性を得るためには、外側スリーブ
が、例えばポリテトラフルオロエチレンのような
フルオロカーボンポリマーといつた低摩擦材料れ
から作られた中空カテーテルであることが好まし
い。
更に上記の引つ掛かりの問題を回避するため
に、外側スリーブの内側表面に硬化材料層を備え
ることが有利である。そうした材料も低摩擦材料
であるべきである。
これに加えて、外側スリーブが比較的軟質の材
料から作られる時には、そのスリーブの軟質の遠
位端部に、例えば金属で作られた保護用の硬質中
空カツプが取り付けられてもよい。
本発明の器具の適正な位置決めを容易にするた
めには、外側スリーブ又はコアの上の予め決めら
れた位置に各々が配置される１つ以上の標識要素
を含むことが有利である。好ましい実施例では、
前記標識要素の各々は、外側スリーブの外周に取
り付けられる金属又は放射線不透過性材料の帯で
あつてもよく、それによつて、栓塞子の展開の前
に、本発明の器具の正しい配置がＸ線透視法によ
つて検査されることが可能である。
滑らかな操作と、正しい設置と、栓塞子に対す
る引つ掛かり又は損傷の防止とをもたらすため
に、上記の諸特徴及びその何れかの組合せが本発
明の器具に含まれてよい。
体内導管内への挿入及び体内導管に沿つた移動
を容易にするために、前記コアの遠位端部に可撓
性の糸が取付けられることも有利である。この実
施例では案内ワイヤの使用が省略されてもよい。
以下では、本発明の好ましい実施例が添付の図
面を参照して説明される。
第１図に示される本発明の好ましい実施例は、
一体的なハンドル２をその近位端部に持つ外側ス
リーブ１から成る。前記外側スリーブの遠位端部
３は、体内導管４内に配置される。ハンドル６を
その近位端部に有するコア５が前記外側スリーブ
内に軸方向に配置される。前記コア遠位端部７が
前記外側スリーブ遠位端部と接触する個所では、
前記コア遠位端部７は拡大された直径を有し、従
つて、前記遠位端部７は前記外側スリーブ遠位端
部から体内導管内へと滑らかに移行することが可
能である。案内ワイヤ８は前記中空コア内を通つ
て軸方向に動く。自己膨張形の栓塞子１０を解除
可能な形で掴むグリツプ部材９が、前記コアの遠
位端部の外周の周囲に取付けられ、前記栓塞子は
この図では体内導管の中の適切な位置で幾分か展
開された形で示される。
第２図は、外側スリーブ１の遠位端部から幾分
か展開された、網状の自己膨張形栓塞子１０を示
す拡大側面図である。この図は、栓塞子を形成す
るワイヤフイラメント１１の露出された端部を示
す。
第３Ａ図及び第３Ｂ図は、中空コア５の外周の
周囲に取付けられる、高摩擦材料から作られたグ
リツプ部材９を示す。このグリツプ部材はその遠
位端部及び近位端部の付近に各々に外周ギヤツプ
１２，１３を有し、これらの外周ギヤツプは栓塞
子の端部１１を収容し、それによつて、外側スリ
ーブの内側壁内に栓塞子が引つ掛かることが防止
される。
第４図は、内側コア５の外周の周囲の解除可能
な接着剤の被覆から成るグリツプ部材９Ａを示
す。
第５図は、例えばポリウレタンのような高摩擦
材料から中空コア５が作られる実施例の断面図を
示す。グリツプ部材９Ｂは、段１４で概略的に示
されるように、前記コアの他の部分の直径よりも
大きな直径を持つ前記コアの長さ部分から成る。
前記高摩擦材料が変形性の材料である場合には、
グリツプ部材は直径拡大のない単純なコア部分で
あつてよい（図示されていない）。
第６図は、本発明の他の特徴を示す実施例の一
部分の側面断面図である。この実施例では、ポリ
テトラフルオロエチレンから作られることが好ま
しい外側スリーブ１は、栓塞子１０の端部が引つ
掛かるのを防止するため、その遠位端部に滑らか
な金属リム１５を有する。体内導管に沿つて動く
ことを容易にするために、この金属リムの遠位端
部１６には丸みが付けられることが好ましい。
更に、体内導管内のこの器具の位置決めをＸ線
透視装置で監視するための標識要素として、金属
キヤツプが備えられることが可能である。追加の
又は別の標識要素１７が、前記外側スリーブ上の
及び／又は前記コア上の予め決められた位置に備
えられることが可能である（図示されていない）。
公知の方法で体内導管に沿つて本発明の器具を
送り込むことを容易にするために、可撓性の糸１
８が前記コア５の遠位端部に取付けられてもよ
い。
本発明の方法による体内導管内の栓塞子の展開
は、添付の諸図面に示され及び前述された何れの
実施例を使用して行われてもよい。
前記方法を行うために、自己膨張形栓塞子が当
業では公知の方法で本発明の器具の中に導入さ
れ、前記グリツプ部材の上に前もつて配置され
る。栓塞子を掴むグリツプ部材が前記器具内に引
き込まれ、それによつて栓塞子全体が前記外側ス
リーブ内にその遠位端部の付近に配置され、前記
外側スリーブによつて圧迫される。その後で、案
内ワイヤの補助によつて又はその補助なしに、栓
塞子を包含する本発明の器具が体内導管内に導入
され、更にその栓塞子の適正な設置位置に到達す
るまで、体内導管内に送り込まれる。前述のよう
に前記コアの遠位端部に糸が取付けられる場合に
は、この器具の体内導管内への導入と及び送り込
みとが容易なものにされることが可能である。
体内導管内における前記器具の位置決めは、例
えば内視鏡の使用又はＸ線透視のような当業で公
知の何れかの手段によつて監視され及び確認され
ることが可能である。前述のように、Ｘ線透視検
査を補助するために、１つ以上の標識要素が外側
スリーブ又はコアの予め決められた位置に配置さ
れてもよい。
栓塞子の適正な配置のための正しい位置に到達
し及びそれが確認され終わると、外側スリーブを
コアに対して動かすことによつて、栓塞子が展開
される。この操作は、栓塞子を掴むグリツプ部材
と共に前記コアが静止状態のままであるように、
前記コアの近位端部のハンドルを保持し、前記外
側スリーブの近位端部のハンドルを掴み、更に、
前記外側スリーブが後ろ向きの方向に動くように
前記外側スリーブのハンドルを前記コアのハンド
ルの方向に引つ張り、こうして栓塞子を露出させ
ることによつて行われる。この結果、栓塞子は前
記外側スリーブの圧迫から解放されてその膨張状
態へと自己膨張する。この器具から栓塞子が完全
に展開され終わる前に、体内導管内の栓塞子の位
置決めが検査される。その位置が正しい時には、
更に栓塞子が前記器具から完全に外に出終わるま
で外側スリーブが引つ張り続けられ、その後で前
記器具は体内導管から引き出される。
しかし、こうした位置の監視によつて、その栓
塞子が正しい位置にないことが判明した時には、
コア上のハンドルと外側スリーブ上のハンドルと
を使用して、外側スリーブに対してコアを後方の
方向に動かすことだけによつて、栓塞子を外側ス
リーブ内に引き込み戻すことが可能である。その
後で引き込まれた栓塞子を収容する本発明の器具
が、必要に応じて再位置決めされ、その後で正し
い位置にある栓塞子に関して、前述の展開操作が
繰り返されることが可能である。
コアに対して外側スリーブを引き出すことによ
つて行われる栓塞子の展開は、栓塞子が後方から
体内導管内に押し込まれなければならない場合に
起こる可能性がある栓塞子の遠位端部が体内導管
の壁に対して食い込む又は引つ掛かるという問題
を、回避するという利点を有する。
栓塞子に損傷を与えずに又は体内導管を傷つけ
ずに前記器具を再位置決めできるように、栓塞子
を引込み戻すことが可能であるということは、本
発明の明白な利点である。
【図面の簡単な説明】
第１図は本発明による器具の一部分の縦断面
図、第２図は部分的に展開された栓塞子を示す本
発明の器具の遠位端部の拡大側面図、第３Ａ図は
グリツプ部材の１つの実施例の拡大断面図、第３
Ｂ図は第３Ａ図の線３Ａ−３Ａに沿つた横断面
図、第４図及び第５図は別のグリツプ部材の縦断
面図、第６図は他の特徴を示す本発明による器具
の一部分の縦断面図である。 １……外側スリーブ、２……外側スリーブハン
ドル、３……外側スリーブ遠位端部、４……体内
導管、５……中空コア、６……中空コアハンド
ル、７……中空コア遠位端部、８……案内ワイ
ヤ、９，９Ａ，９Ｂ……グリツプ部材、１０……
自己膨張形栓塞子、１２，１３……グリツプ部材
外周ギヤツプ、１５……金属リム、１７……標識
要素、１８……可撓性の糸。

Claims (1)

  1. 【特許請求の範囲】 １ 体内導管内で自己膨張形の栓塞子を展開し又
    は引き込むための器具であつて、前記器具が、近
    位の端部及び遠位の端部を有する細長い管状の外
    側スリーブと、前記スリーブ内に配置され且つ前
    記スリーブに対し相対的に移動可能な細長いコア
    とから成り、前記コアが前記スリーブより長く、
    近位の端部及び遠位の端部を有し、且つ前記コア
    の前記遠位端部においては又はその付近にグリツ
    プ部材を含み、前記グリツプ部材が前記コアの一
    体的な部分であるか、スリーブであるか、又は前
    記コアの外周の周りに取付けられた被覆であつ
    て、更に前記グリツプ部材が、（）前記外側ス
    リーブ内に自己膨張形栓塞子を解除可能な形で保
    持し、（）前記コアに対して後ろ向きの方向に
    前記外側スリーブを移動させる時に、前記外側ス
    リーブの遠位端部を越えた位置で前記栓塞子を展
    開し、また（）前記外側スリーブに対して後ろ
    向きの方向に前記外側コアが引つ張られる時に、
    前記外側スリーブ内に前記栓塞子を引き込むのに
    適した形に作られていることを特徴とする体内導
    管内で自己膨張形の栓塞子を展開し又は引き込む
    ための器具。 ２ 前記コアが中空であることを特徴とする請求
    項１に記載の器具。 ３ 前記コア内に及びその軸に沿つて配置される
    細長く可撓性で且つ操作可能な案内ワイヤが含ま
    れることを特徴とする請求項２に記載の器具。 ４ 前記外側スリーブに対する前記コアの移動を
    容易にするために、前記コアが、その近位端部に
    取り付けられたハンドルを有することを特徴とす
    る請求項１から３のいずれか一項に記載の器具。 ５ 前記コアに対する前記外側スリーブの移動を
    容易にするために、前記外側スリーブの近位端部
    がフランジ又はハンドルの形で終端することを特
    徴とする請求項１から４のいずれか一項に記載の
    器具。 ６ 前記グリツプ部材が摩擦接触表面を持つ材料
    のスリーブであることを特徴とする請求項１から
    ５のいずれか一項に記載の器具。 ７ 前記グリツプ部材が変形性の材料で作られ、
    且つ前記コアの一体的部分か又は前記コアの外周
    の周りに取り付けられるスリーブのどちらかであ
    ることを特徴とする請求項１から６のいずれか一
    項に記載の器具。 ８ 前記材料がシリコーンゴム又はポリウレタン
    であることを特徴とする請求項７に記載の器具。 ９ 前記グリツプ部材が、解除可能な接着剤の被
    覆であるか、十分に滑らかで且つ切れ目のない外
    側表面を持つ材料のスリーブであるか、又は荒面
    の又は不規則的な外側表面を持つ材料のスリーブ
    であることを特徴とする請求項１から６のいずれ
    か一項に記載の器具。 １０ 前記コアが高摩擦材料で作られ、前記グリ
    ツプ部材が、前記コアの他の部分の外径よりも大
    きな外径を持つ前記コアの長さ部分から成ること
    を特徴とする請求項１から６のいずれか一項に記
    載の器具。 １１ 前記高摩擦材料がポリウレタンであること
    を特徴とする請求項１０に記載の器具。 １２ 前記外側スリーブ又は前記コア上の予め決
    められた位置に各々配置された１つ以上の標識要
    素を含むことを特徴とする請求項１から１１のい
    ずれか一項に記載の器具。 １３ 前記標識要素の各々が、外側スリーブに取
    り付けられる金属又は放射線不透過性材料の帯で
    あることを特徴とする請求項１２に記載の器具。 １４ 前記外側スリーブが低摩擦材料から作られ
    ている中空カテーテルであることを特徴とする請
    求項１から１３のいずれか一項に記載の器具。 １５ 前記低摩擦材料が、ポリテトラフルオロエ
    チレンであることを特徴とする請求項１４に記載
    の器具。 １６ 前記カテーテルの内側表面が、前記栓塞子
    の端部による損傷を防ぐために、硬化された材料
    の層を有することを特徴とする請求項１４又は１
    ５に記載の器具。 １７ 前記カテーテルの軟質の遠位端部に、保護
    用の硬質中空リムが取り付けられていることを特
    徴とする請求項１４から１６のいずれか一項に記
    載の器具。 １８ 前記グリツプ部材に、その遠位端部及び近
    位端部の付近において、前記栓塞子の端部を収容
    するための円周ギヤツプが備えられていることを
    特徴とする請求項１から１７のいずれか一項に記
    載の器具。 １９ 可撓性の糸が前記コアの遠位端部に取り付
    けられていることを特徴とする請求項１から１８
    のいずれか一項に記載の器具。
JP2186958A 1989-07-13 1990-07-13 体内導管内で自己膨張形の栓塞子を展開し又は引き込むための器具 Granted JPH0357465A (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US37945889A 1989-07-13 1989-07-13
US379458 1989-07-13

Publications (2)

Publication Number Publication Date
JPH0357465A JPH0357465A (ja) 1991-03-12
JPH0379023B2 true JPH0379023B2 (ja) 1991-12-17

Family

ID=23497347

Family Applications (1)

Application Number Title Priority Date Filing Date
JP2186958A Granted JPH0357465A (ja) 1989-07-13 1990-07-13 体内導管内で自己膨張形の栓塞子を展開し又は引き込むための器具

Country Status (5)

Country Link
US (1) US5026377A (ja)
EP (1) EP0408245B1 (ja)
JP (1) JPH0357465A (ja)
CA (1) CA2020957C (ja)
DE (1) DE9010130U1 (ja)

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Publication number Publication date
US5026377A (en) 1991-06-25
EP0408245A1 (en) 1991-01-16
CA2020957C (en) 1996-05-21
JPH0357465A (ja) 1991-03-12
DE9010130U1 (ja) 1990-09-13
EP0408245B1 (en) 1994-03-02
CA2020957A1 (en) 1991-01-14

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