JPS62231657A - 伸張性のある管腔内脈管移植片又はプロテーゼ - Google Patents
伸張性のある管腔内脈管移植片又はプロテーゼInfo
- Publication number
- JPS62231657A JPS62231657A JP61265419A JP26541986A JPS62231657A JP S62231657 A JPS62231657 A JP S62231657A JP 61265419 A JP61265419 A JP 61265419A JP 26541986 A JP26541986 A JP 26541986A JP S62231657 A JPS62231657 A JP S62231657A
- Authority
- JP
- Japan
- Prior art keywords
- body passageway
- catheter
- prosthesis
- extensible
- tubular member
- 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
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- 239000007943 implant Substances 0.000 title claims description 16
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- 230000001419 dependent effect Effects 0.000 claims description 4
- 230000003014 reinforcing effect Effects 0.000 claims description 4
- 230000000916 dilatatory effect Effects 0.000 claims description 2
- 238000003780 insertion Methods 0.000 claims description 2
- 230000037431 insertion Effects 0.000 claims description 2
- 238000002399 angioplasty Methods 0.000 abstract description 15
- 210000004204 blood vessel Anatomy 0.000 abstract description 12
- 210000001367 artery Anatomy 0.000 description 9
- 229910001220 stainless steel Inorganic materials 0.000 description 9
- 239000000463 material Substances 0.000 description 8
- 210000003462 vein Anatomy 0.000 description 7
- 208000031481 Pathologic Constriction Diseases 0.000 description 6
- 208000037804 stenosis Diseases 0.000 description 6
- 230000036262 stenosis Effects 0.000 description 6
- 210000004351 coronary vessel Anatomy 0.000 description 5
- 230000010339 dilation Effects 0.000 description 5
- 239000010935 stainless steel Substances 0.000 description 5
- 210000003038 endothelium Anatomy 0.000 description 4
- 238000002513 implantation Methods 0.000 description 4
- 206010057469 Vascular stenosis Diseases 0.000 description 3
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- 238000000576 coating method Methods 0.000 description 3
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- 238000007631 vascular surgery Methods 0.000 description 3
- 206010051268 Anastomotic stenosis Diseases 0.000 description 2
- 206010020772 Hypertension Diseases 0.000 description 2
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- 229920006362 Teflon® Polymers 0.000 description 2
- 238000007796 conventional method Methods 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 210000003240 portal vein Anatomy 0.000 description 2
- 208000037803 restenosis Diseases 0.000 description 2
- 229910052709 silver Inorganic materials 0.000 description 2
- 239000004332 silver Substances 0.000 description 2
- 238000005476 soldering Methods 0.000 description 2
- 230000002966 stenotic effect Effects 0.000 description 2
- 230000003319 supportive effect Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 238000003466 welding Methods 0.000 description 2
- 206010060965 Arterial stenosis Diseases 0.000 description 1
- 201000001320 Atherosclerosis Diseases 0.000 description 1
- 206010016654 Fibrosis Diseases 0.000 description 1
- 229910000831 Steel Inorganic materials 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
- 238000004026 adhesive bonding Methods 0.000 description 1
- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 229910052782 aluminium Inorganic materials 0.000 description 1
- XAGFODPZIPBFFR-UHFFFAOYSA-N aluminium Chemical compound [Al] XAGFODPZIPBFFR-UHFFFAOYSA-N 0.000 description 1
- 206010003230 arteritis Diseases 0.000 description 1
- 210000000013 bile duct Anatomy 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
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- 238000005219 brazing Methods 0.000 description 1
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- 238000004891 communication Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
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- 238000011161 development Methods 0.000 description 1
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- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
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- 238000002594 fluoroscopy Methods 0.000 description 1
- 210000002989 hepatic vein Anatomy 0.000 description 1
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- 210000005036 nerve Anatomy 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
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- 210000002254 renal artery Anatomy 0.000 description 1
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- 208000024891 symptom Diseases 0.000 description 1
- 229910052715 tantalum Inorganic materials 0.000 description 1
- GUVRBAGPIYLISA-UHFFFAOYSA-N tantalum atom Chemical compound [Ta] GUVRBAGPIYLISA-UHFFFAOYSA-N 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 229910052719 titanium Inorganic materials 0.000 description 1
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- 230000009278 visceral effect Effects 0.000 description 1
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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
- A61F2/82—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
-
- 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
- A61F2/82—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
- A61F2230/0028—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)
- Life Sciences & Earth Sciences (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Veterinary Medicine (AREA)
- Vascular Medicine (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Optics & Photonics (AREA)
- Physics & Mathematics (AREA)
- Prostheses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Surgical Instruments (AREA)
- Materials For Medical Uses (AREA)
Abstract
(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。
め要約のデータは記録されません。
Description
【発明の詳細な説明】
本発明は身体通路(body passageway)
又は管(duct)内で使用するための伸張性のある管
腔内移植片(expandable inLrulum
inal 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開基した血管をイ1復
するための特に有用な伸張性のある管腔内脈管移植片(
expunduble vuscular graf’
t)移植片及び伸張性のある管腔内移植片を移植するた
めの装置に関する。管腔的脈管内移植(intralu
minal endovascular grafti
B)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た。管腔的脈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。慣用の脈管手術に対するこの方法の利点は欠
陥のあ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(することを含
む。
又は管(duct)内で使用するための伸張性のある管
腔内移植片(expandable inLrulum
inal 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開基した血管をイ1復
するための特に有用な伸張性のある管腔内脈管移植片(
expunduble vuscular graf’
t)移植片及び伸張性のある管腔内移植片を移植するた
めの装置に関する。管腔的脈管内移植(intralu
minal endovascular grafti
B)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た。管腔的脈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。慣用の脈管手術に対するこの方法の利点は欠
陥のあ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(することを含
む。
従米管腔内脈管移植片として使用されて外な構造物には
、ステンレス鋼コイルバネ;伸張性のある感熱性材料か
ら製造されたら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) (stents)が包含されて
いた。一般に、上記の構造は共通した1つの欠点を有し
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(col 1apsed)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限り、各
構造物の最終の伸張した形状にたい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’
& ハ:l イルバネ構造物を製造するのに使用された
特定ノ材料のバネ定数及び弾性率によりにより予め決定
される。これらの同じ7ア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。
、ステンレス鋼コイルバネ;伸張性のある感熱性材料か
ら製造されたら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) (stents)が包含されて
いた。一般に、上記の構造は共通した1つの欠点を有し
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(col 1apsed)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限り、各
構造物の最終の伸張した形状にたい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’
& ハ:l イルバネ構造物を製造するのに使用された
特定ノ材料のバネ定数及び弾性率によりにより予め決定
される。これらの同じ7ア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。
故に、前記した型の管腔内移植片が身体通路内の、例え
ば動脈又は静脈内の所望の位置で伸張させられると、移
植片の伸張したり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。
ば動脈又は静脈内の所望の位置で伸張させられると、移
植片の伸張したり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。
慣用の血管手術に替わる池の方法としては、カテーテル
に取り付けられた血管形成術バルーンの弾性脈管狭窄症
(elastic vascular 5tenose
s)又は連断障害(blockages)の経皮バルー
ン拡大(percutaneous balloon
dilation)であった、この方法においては、血
管の壁成分に剪断力をかけてそれを砕いて(disru
pt)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(adventitial)
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(dissecLio
r+)又は裂け(splitting)及び引き裂!!
(tearing)を生じ、動脈又は身体通路の脈管
内膜(intima)又は内側表面はき裂(rissu
rinビ)を生じる。この切り裂きは下にあるAl1織
の′フラップ”(flap)を形成し、これは内腔を通
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(distending
)管腔内圧力が砕かれたM又はフラップを所定の位置に
保持することができる。バルーン拡大過程により生じた
脈管内膜フラップが伸張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。
に取り付けられた血管形成術バルーンの弾性脈管狭窄症
(elastic vascular 5tenose
s)又は連断障害(blockages)の経皮バルー
ン拡大(percutaneous balloon
dilation)であった、この方法においては、血
管の壁成分に剪断力をかけてそれを砕いて(disru
pt)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(adventitial)
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(dissecLio
r+)又は裂け(splitting)及び引き裂!!
(tearing)を生じ、動脈又は身体通路の脈管
内膜(intima)又は内側表面はき裂(rissu
rinビ)を生じる。この切り裂きは下にあるAl1織
の′フラップ”(flap)を形成し、これは内腔を通
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(distending
)管腔内圧力が砕かれたM又はフラップを所定の位置に
保持することができる。バルーン拡大過程により生じた
脈管内膜フラップが伸張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。
バルーン拡大法は典型的には病院のカテーテル挿入室(
caLbeterizaLion tub)で行なわれ
るけれども、前記の問題のため、脈管内膜フラップが血
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
管から引き裂けな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曲に死亡す
ることがある。
caLbeterizaLion tub)で行なわれ
るけれども、前記の問題のため、脈管内膜フラップが血
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
管から引き裂けな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曲に死亡す
ることがある。
弾性脈管狭窄症のバルーン拡大に関連した追加の火照は
狭窄性病変(stenoLic 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11「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(
restenosis)が起こることがある。例えば、
入り口(ostium)における腎臓動脈の狭窄症は、
前記拡大力が!臓動脈自体にががるよりはむしろ大動脈
壁にかがるため、バルーン拡大にたいして治療抵抗性で
あることが知られている。
狭窄性病変(stenoLic 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11「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(
restenosis)が起こることがある。例えば、
入り口(ostium)における腎臓動脈の狭窄症は、
前記拡大力が!臓動脈自体にががるよりはむしろ大動脈
壁にかがるため、バルーン拡大にたいして治療抵抗性で
あることが知られている。
新生内aia症(neointimul fibros
is)により引き起こされる脈管狭窄症、例えば、透析
路フイステル(dialysis−acces9fi!
Itulas)においCみられる如きこれらは、商い拡
大圧力及びより大きいバルーン直径を必要とするので拡
大するのが困難であ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−artery an
astomotic 5trictures)及び動脈
内膜切除後の再発狭窄症(postendartere
Ctomy recurrent 5tenoses)
の血管形成術において観′c!−された。高安動脈炎(
’rakayasu arteritis)及び神経#
!維腫症動脈狭窄症(neurof 1broa+at
osisarterial 5Lenoses)の経皮
血管形成術は不十分な初期応答及びこれらの症状のMA
維症の性質(ribrotic nature)による
と考えられる再発を示すことがある。
is)により引き起こされる脈管狭窄症、例えば、透析
路フイステル(dialysis−acces9fi!
Itulas)においCみられる如きこれらは、商い拡
大圧力及びより大きいバルーン直径を必要とするので拡
大するのが困難であ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−artery an
astomotic 5trictures)及び動脈
内膜切除後の再発狭窄症(postendartere
Ctomy recurrent 5tenoses)
の血管形成術において観′c!−された。高安動脈炎(
’rakayasu arteritis)及び神経#
!維腫症動脈狭窄症(neurof 1broa+at
osisarterial 5Lenoses)の経皮
血管形成術は不十分な初期応答及びこれらの症状のMA
維症の性質(ribrotic nature)による
と考えられる再発を示すことがある。
従って、本発明の開発以MLには、身体通路における狭
窄症の再発を防止し;患者の心臓の左主冠状動脈の如き
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を防止することを可能
とする、伸張性のある管腔的脈管移植片及び身体通路内
の内腔を伸張させるための方法及V装置はなかった。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如き極めて重要な身体通路に
使用することがで慇ると考えられ;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を防止
することができる、伸張性のある管腔的脈管移植片及び
身体通路の内腔を伸張させるための方法及び装置が探し
求められてきた。
窄症の再発を防止し;患者の心臓の左主冠状動脈の如き
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を防止することを可能
とする、伸張性のある管腔的脈管移植片及び身体通路内
の内腔を伸張させるための方法及V装置はなかった。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如き極めて重要な身体通路に
使用することがで慇ると考えられ;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を防止
することができる、伸張性のある管腔的脈管移植片及び
身体通路の内腔を伸張させるための方法及び装置が探し
求められてきた。
本発明に従えば、前記利点は本発明の伸張性のある管腔
的脈管移植片により達成される1本発明は、f51端部
及び第2端部と該第1端部と該第2端部との間に配置さ
れている壁表面とを有する管状部材を含み、該!!!表
面は複数の交差する縮尺い部材によって形成されており
、該縮尺い部材の少なくと?3幾つかは該管状部材の第
1端部と第2端部との中間で相互に交差しており、 該
管状部材は内腔を有する身体通路内への該管状部材の管
腔内送り込みを可能とする第1の直径を有しでおり、そ
して 該管状部材は該管状部材の内側から半径方向外方
に伸び広げる力をかけられるとi&第2の伸張した直径
を有し、該第2の直径は可変であり且つ該管状部材に加
えられた力の量に依存しており、それにより、該管状部
材は該身体通路の内腔を伸張させるように伸張させるこ
とができるようになっている。
的脈管移植片により達成される1本発明は、f51端部
及び第2端部と該第1端部と該第2端部との間に配置さ
れている壁表面とを有する管状部材を含み、該!!!表
面は複数の交差する縮尺い部材によって形成されており
、該縮尺い部材の少なくと?3幾つかは該管状部材の第
1端部と第2端部との中間で相互に交差しており、 該
管状部材は内腔を有する身体通路内への該管状部材の管
腔内送り込みを可能とする第1の直径を有しでおり、そ
して 該管状部材は該管状部材の内側から半径方向外方
に伸び広げる力をかけられるとi&第2の伸張した直径
を有し、該第2の直径は可変であり且つ該管状部材に加
えられた力の量に依存しており、それにより、該管状部
材は該身体通路の内腔を伸張させるように伸張させるこ
とができるようになっている。
本発明の更なる特徴は複数のJll艮い部材が複数のワ
イヤであることができ、そして該ワイヤは該ワイヤが相
互に交差するところで相互に固定される(fixedl
y 5ecurecl)ことがでさるということである
0本発明の追加の特徴は複数の縮尺い部材が複数の薄い
バーであることができ、該複数の#Il長いバーは該バ
ーが相互に交差しているところで相互に固定されている
ことである。本発明の更なる特徴は管状部材がその壁表
面に生物学的に不活性なコーティングを有することがで
き、このコーティングは管状部材を身体通路に固着させ
るための手段を含むことができることである。
イヤであることができ、そして該ワイヤは該ワイヤが相
互に交差するところで相互に固定される(fixedl
y 5ecurecl)ことがでさるということである
0本発明の追加の特徴は複数の縮尺い部材が複数の薄い
バーであることができ、該複数の#Il長いバーは該バ
ーが相互に交差しているところで相互に固定されている
ことである。本発明の更なる特徴は管状部材がその壁表
面に生物学的に不活性なコーティングを有することがで
き、このコーティングは管状部材を身体通路に固着させ
るための手段を含むことができることである。
本発明に従えば、前記利点は身体通路の内腔を伸張させ
るための本発明の方法によっても達成される1本発明の
方法は、カテーテル上に配置された管腔内移植片を、そ
れが該身体通路内の所望の位置に隣接して配置されるま
で、該身体通路内に挿入することと、該身体通路の所望
の位置における該身体通路の内腔が伸張させられるまで
、該カテーテルの部分を伸張させて該管腔内移植片を半
径方向外方に伸張させて該身体通路と接触させ、それに
より、該管腔内移植片は該身体通路がしぼんだり該伸張
した内腔の寸法が減少するのを防止することを含む。
るための本発明の方法によっても達成される1本発明の
方法は、カテーテル上に配置された管腔内移植片を、そ
れが該身体通路内の所望の位置に隣接して配置されるま
で、該身体通路内に挿入することと、該身体通路の所望
の位置における該身体通路の内腔が伸張させられるまで
、該カテーテルの部分を伸張させて該管腔内移植片を半
径方向外方に伸張させて該身体通路と接触させ、それに
より、該管腔内移植片は該身体通路がしぼんだり該伸張
した内腔の寸法が減少するのを防止することを含む。
本発明の更なる特徴は管腔内移植片と接触している該カ
テーテルの部分をしぼませそして該カテーテルを該身体
通路から除去することがで島ることである。本発明の更
なる特徴はそれと関連した伸張性のある膨張可能な部分
を有するカテーテルを使用することができ、そして該管
腔内移植片及び該カテーテルの部分の伸張は該カテーテ
ルの伸張性のある膨張可能な部分を膨らますことにより
達成されることである。
テーテルの部分をしぼませそして該カテーテルを該身体
通路から除去することがで島ることである。本発明の更
なる特徴はそれと関連した伸張性のある膨張可能な部分
を有するカテーテルを使用することができ、そして該管
腔内移植片及び該カテーテルの部分の伸張は該カテーテ
ルの伸張性のある膨張可能な部分を膨らますことにより
達成されることである。
本発明の更なる特徴は管腔内移植片として金網W(wi
re mesh tube)を使用することができ、こ
の金網管は、肢管が所望の位置で身体通路内に挿入され
そして所望の位置に送り込まれることを可能とする第1
の所定のしぼんだ直径を有することである。本発明の他
の特徴は、金網管を該身体通路内で12の直径に伸張さ
せることができ;該第2の伸張した直径は可変でありそ
して、該身体通路の所望の伸張された内径により決定さ
れ、それにより、該伸張した金網管は該身体通路内で所
望の位置から移動せず且肢管腔内移植片の伸張は該身体
通路の破壊を引き起こさないことである。
re mesh tube)を使用することができ、こ
の金網管は、肢管が所望の位置で身体通路内に挿入され
そして所望の位置に送り込まれることを可能とする第1
の所定のしぼんだ直径を有することである。本発明の他
の特徴は、金網管を該身体通路内で12の直径に伸張さ
せることができ;該第2の伸張した直径は可変でありそ
して、該身体通路の所望の伸張された内径により決定さ
れ、それにより、該伸張した金網管は該身体通路内で所
望の位置から移動せず且肢管腔内移植片の伸張は該身体
通路の破壊を引き起こさないことである。
本発明に従えば、前記利点は身体通路を管腔内で強化す
るための本発明の装置によっても達成される。本発明は
、第i1部及び第2端部と該第1端部と該第2端部との
間に配置されている壁表面とを有する伸張性のある管状
プロテーゼとカテーテルをi4:備し、該に!11表面
は複数の交差する縮尺い部材によって形成されており;
該カテーテルはプロテーゼに関連した伸張性のある膨張
可能な部分を有しそして該伸張性のある膨張可能な部分
に前記伸張性のある管状プロテーゼを我り付け且つ保持
するための手段を含み、 それにより該カテーテルの
伸張性のある膨張可能な部分が膨ら曳されると、該プロ
テーゼは半径方向外方に強制されて該身体通路と接触す
るようになっている。本発明の更なる特徴は上記取り付
け及び保持手段が該伸張性のある膨張可能な部分に隣接
して且つ該伸張性のある管状プロテーゼの各端部に隣接
して該カテーテル上に配Wtされている保持器リング部
材を具備することができることである。
るための本発明の装置によっても達成される。本発明は
、第i1部及び第2端部と該第1端部と該第2端部との
間に配置されている壁表面とを有する伸張性のある管状
プロテーゼとカテーテルをi4:備し、該に!11表面
は複数の交差する縮尺い部材によって形成されており;
該カテーテルはプロテーゼに関連した伸張性のある膨張
可能な部分を有しそして該伸張性のある膨張可能な部分
に前記伸張性のある管状プロテーゼを我り付け且つ保持
するための手段を含み、 それにより該カテーテルの
伸張性のある膨張可能な部分が膨ら曳されると、該プロ
テーゼは半径方向外方に強制されて該身体通路と接触す
るようになっている。本発明の更なる特徴は上記取り付
け及び保持手段が該伸張性のある膨張可能な部分に隣接
して且つ該伸張性のある管状プロテーゼの各端部に隣接
して該カテーテル上に配Wtされている保持器リング部
材を具備することができることである。
本発明の、伸張性のある管腔的脈管移植片、身体通路の
内腔を伸張させる方法及び身体通路を管腔内で強化する
装置を、これまでl:提唱された先行技術の管腔内移植
片、それらを移植する方法及びバルーン拡大法と比較し
たとき、狭窄症の再発を防止する;心臓の左主冠状動脈
における如き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る;身体通路の跳ね返りを防
止する;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する:という利点を有
している。
内腔を伸張させる方法及び身体通路を管腔内で強化する
装置を、これまでl:提唱された先行技術の管腔内移植
片、それらを移植する方法及びバルーン拡大法と比較し
たとき、狭窄症の再発を防止する;心臓の左主冠状動脈
における如き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る;身体通路の跳ね返りを防
止する;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する:という利点を有
している。
本発明を好ましい態様に関して説明するが、これは本発
明をそ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、特許請求の範囲に記載され
た本発明の精神及び範囲内に包含されうるようなすべて
の代替、修正及び均等物及び均等手段を包含することを
意図する。
明をそ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、特許請求の範囲に記載され
た本発明の精神及び範囲内に包含されうるようなすべて
の代替、修正及び均等物及び均等手段を包含することを
意図する。
pAIA図及び第2A図において、伸張性のある管腔的
脈管移植片又は身体通路のための伸張性のあるプロテー
ゼ70が例示されている。用語“伸張性のある管腔的脈
管移植片”及び伸張性のあるプロテーゼとは、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ための伸張性のある管腔
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性のあるプロテーゼとして多くの他
の目的にも使用することが出来る限りにおいて、本発明
を説明する際に成る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、伸張性のあるプロテーゼ
70は(1)トランスルミナル再疎通(translu
minal recanalization)により開
かれているがしかし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〃ンにより閉塞された縦隔静脈(mediasti
nal 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)門脈尚圧症(portal
hypertension)にかかつてbする患者の門
脈と肝臓静脈間のカテーテルで作られた針内の連通の強
化;(4)食道、腸、尿管、尿道の狭窄化の支持移植片
配(77(supportive graft pla
cemenL);及び(5)再開された及び以前に閉塞
された胆管の支持移植片強化;の如き目的にも使用する
ことが出来る。従って、用語“プロテーゼの使用は種々
のタイプの身体通路内の使用法を包含しそして用語′管
腔内脈管移植片”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”は前記した如き人間の身体内の管及び人間の
脈管系(vascufar system)内の静脈、
動脈又は血管を包含する。
脈管移植片又は身体通路のための伸張性のあるプロテー
ゼ70が例示されている。用語“伸張性のある管腔的脈
管移植片”及び伸張性のあるプロテーゼとは、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ための伸張性のある管腔
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性のあるプロテーゼとして多くの他
の目的にも使用することが出来る限りにおいて、本発明
を説明する際に成る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、伸張性のあるプロテーゼ
70は(1)トランスルミナル再疎通(translu
minal recanalization)により開
かれているがしかし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〃ンにより閉塞された縦隔静脈(mediasti
nal 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)門脈尚圧症(portal
hypertension)にかかつてbする患者の門
脈と肝臓静脈間のカテーテルで作られた針内の連通の強
化;(4)食道、腸、尿管、尿道の狭窄化の支持移植片
配(77(supportive graft pla
cemenL);及び(5)再開された及び以前に閉塞
された胆管の支持移植片強化;の如き目的にも使用する
ことが出来る。従って、用語“プロテーゼの使用は種々
のタイプの身体通路内の使用法を包含しそして用語′管
腔内脈管移植片”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”は前記した如き人間の身体内の管及び人間の
脈管系(vascufar system)内の静脈、
動脈又は血管を包含する。
更にPISIA図を参照すると、伸張性のある管腔的脈
管移植片又はプロテーゼ70は、第1端部72及び第2
ra部73と該第i4部72と該第21部73の間に配
置された壁表面74を有する管状部材71をJ′4備す
る。好ましくは、壁表面74は複数の交差する細長い部
材75.76により形成され、細長い部材75.76の
少なくとも幾つかは交差、α77で示された如き管状部
材71の第1及び第2RIs72.73の中間で相互に
交差している。管状部材71は、後に詳細に説明する如
く、内腔81を有する身体通路80への管状部材71の
管腔内送り込みを可能とする@i直径dを有する。第1
B図を参照すると、後に更に詳細に説明する如く、半径
方向外方に伸び広げる力が管状部材71の内側から加え
られると管状部材71は第2の伸張した直径d′を有し
、該第2直径d′は寸法が可変でありそして管状部材7
1に加えられた力の量に依存する。
管移植片又はプロテーゼ70は、第1端部72及び第2
ra部73と該第i4部72と該第21部73の間に配
置された壁表面74を有する管状部材71をJ′4備す
る。好ましくは、壁表面74は複数の交差する細長い部
材75.76により形成され、細長い部材75.76の
少なくとも幾つかは交差、α77で示された如き管状部
材71の第1及び第2RIs72.73の中間で相互に
交差している。管状部材71は、後に詳細に説明する如
く、内腔81を有する身体通路80への管状部材71の
管腔内送り込みを可能とする@i直径dを有する。第1
B図を参照すると、後に更に詳細に説明する如く、半径
方向外方に伸び広げる力が管状部材71の内側から加え
られると管状部材71は第2の伸張した直径d′を有し
、該第2直径d′は寸法が可変でありそして管状部材7
1に加えられた力の量に依存する。
第1A図及び第1B図を参照すると、管状部材71の壁
表面74を形成する細撓い部材75.76は人間の身体
及び脈管移植片又はプロテーゼ70が接触しうる体液(
示されていない)と適合性であるいかなる適当な材料で
あってもよい。細長い部材75.76は又、管状部材7
1が第1A図−に示された形状からPJIJIB図に示
された形状に伸張させられることを許容するとともに更
に管状部材71をwSIB図に示された拡大された直径
d′を有するその伸張された形状を保持することを許容
するのに必要な強度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71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、会、チタン又
は前記した必要な特性を有する適当なプラスチック材料
が包含される6好ましくは、細長い部材75.76はス
テンレス鋼から作られる。好ましくは、第1A図及び第
1B図に示された細長い部材’i5.’16はシリング
状断面を有する小さな直径のステンレス鋼ワイヤである
。各細長い部材75.76は三角形、四角形、怪力形、
六角形等の如外他の断面形状を有することもでさること
はもちろん理解されるべきである。
表面74を形成する細撓い部材75.76は人間の身体
及び脈管移植片又はプロテーゼ70が接触しうる体液(
示されていない)と適合性であるいかなる適当な材料で
あってもよい。細長い部材75.76は又、管状部材7
1が第1A図−に示された形状からPJIJIB図に示
された形状に伸張させられることを許容するとともに更
に管状部材71をwSIB図に示された拡大された直径
d′を有するその伸張された形状を保持することを許容
するのに必要な強度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71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、会、チタン又
は前記した必要な特性を有する適当なプラスチック材料
が包含される6好ましくは、細長い部材75.76はス
テンレス鋼から作られる。好ましくは、第1A図及び第
1B図に示された細長い部材’i5.’16はシリング
状断面を有する小さな直径のステンレス鋼ワイヤである
。各細長い部材75.76は三角形、四角形、怪力形、
六角形等の如外他の断面形状を有することもでさること
はもちろん理解されるべきである。
更に、複数の細長い部材75.76は、該細長い部材7
5,76が例えば交差点77における如き、相互に交差
するところで相互に固定して取り付けられる(fixe
dly 5ecured)ことが好ましい、細長い部材
75,76は慣用の方法で、例えば、溶接、はんだ付け
又は接着(gluing)、例えば適当なエポキシ接着
材(epoxyビ1ue)による接着によって相互に固
定的に取り付けることができる。しかしながら、交差点
77は銀ではんだ付けされていることが好ましい。細長
い部材75.76を相互に固定的に取り付けることによ
って、管状部材71は半径方向押しつぶしに対する比較
的高い抵抗を与えられ、そして管状部材71は第1B図
に示された如きその拡大された直径d′を保持する能力
を有する。好ましくは、管状部材71は、一般に金網管
(四ire mesh tube)として示すことがで
きるらのを形成するように、十字形管状パターンで織ら
れた連続的なステンレス鋼ワイヤが作られる。
5,76が例えば交差点77における如き、相互に交差
するところで相互に固定して取り付けられる(fixe
dly 5ecured)ことが好ましい、細長い部材
75,76は慣用の方法で、例えば、溶接、はんだ付け
又は接着(gluing)、例えば適当なエポキシ接着
材(epoxyビ1ue)による接着によって相互に固
定的に取り付けることができる。しかしながら、交差点
77は銀ではんだ付けされていることが好ましい。細長
い部材75.76を相互に固定的に取り付けることによ
って、管状部材71は半径方向押しつぶしに対する比較
的高い抵抗を与えられ、そして管状部材71は第1B図
に示された如きその拡大された直径d′を保持する能力
を有する。好ましくは、管状部材71は、一般に金網管
(四ire mesh tube)として示すことがで
きるらのを形成するように、十字形管状パターンで織ら
れた連続的なステンレス鋼ワイヤが作られる。
管状部材又は金網管71を製造する場合に、それは第1
A図に示された直径dを有する形状に最初作ることがで
きる。あるいは、それは最初の直径dより大きい直径に
作り、作った後第1A図に示された直径dを有するよう
に注意深くしぼませることができる。管状部材又は金網
管71をしばませる期間中隣接したla艮い部材75,
7(3の重なりが回避されるように注意しなければなら
ない。
A図に示された直径dを有する形状に最初作ることがで
きる。あるいは、それは最初の直径dより大きい直径に
作り、作った後第1A図に示された直径dを有するよう
に注意深くしぼませることができる。管状部材又は金網
管71をしばませる期間中隣接したla艮い部材75,
7(3の重なりが回避されるように注意しなければなら
ない。
管状部材又は金網!71が第1B図に示された形状に伸
張されると第1及び第2端部72及び73間の距離はも
ちろん減少することは理解されるべきである。
張されると第1及び第2端部72及び73間の距離はも
ちろん減少することは理解されるべきである。
第2A図及び第2B図を参照すると、伸張性のある管腔
的脈管移植片又はプロテーゼ70の他の態様が示される
。同じ参照番号が使用されそして第IA図及び第1B図
に前記した要素に適用可能である。第2A図及びftr
J2B図の管腔内脈管移植片又はプロテーゼ70は、複
数のm艮い部材75゜76が複数の薄いバー78.79
であり、これらのバーはバー78.79が相互に交差す
るところで好ましくは相互に固定的に取り付けられてい
るという点で、lIA図及び第2A図に関連して前記し
たそれとは異なる。バー78.79は好ましくは薄い長
方形断面形状を有しており、そして例えば、溶接、ろう
付け、はんだ付けの如き慣用の方法によって相互に接合
されていてもよく、又は相互に一体的に形成されていて
もよい、好ましくは、管状部材71は最初肉薄の(th
in−i*alled)ステンレスw4管であり、そし
て交差するバー78と79間の開口82は慣用のエツチ
ングプロセス、例えば電気機械的又はレーザーエツチン
グにより形成され、その際得られる構造は複数の交差す
る#A便い部材78.79を有する管状部材71である
。第2八図の移植片又はプロテーゼ70の態も)は半径
方向外方に伸び広げる力が管状部材71の内側から加え
られると、PjS2 B図に示されそして第1B図に関
連して前記した如き伸張された形状を同様にとることが
できろ。更に第2A図及び第2B図の脈管移植片又はプ
ロテーゼ70の態様は一般に金網管として示すこともで
きることは理解されるべきである。
的脈管移植片又はプロテーゼ70の他の態様が示される
。同じ参照番号が使用されそして第IA図及び第1B図
に前記した要素に適用可能である。第2A図及びftr
J2B図の管腔内脈管移植片又はプロテーゼ70は、複
数のm艮い部材75゜76が複数の薄いバー78.79
であり、これらのバーはバー78.79が相互に交差す
るところで好ましくは相互に固定的に取り付けられてい
るという点で、lIA図及び第2A図に関連して前記し
たそれとは異なる。バー78.79は好ましくは薄い長
方形断面形状を有しており、そして例えば、溶接、ろう
付け、はんだ付けの如き慣用の方法によって相互に接合
されていてもよく、又は相互に一体的に形成されていて
もよい、好ましくは、管状部材71は最初肉薄の(th
in−i*alled)ステンレスw4管であり、そし
て交差するバー78と79間の開口82は慣用のエツチ
ングプロセス、例えば電気機械的又はレーザーエツチン
グにより形成され、その際得られる構造は複数の交差す
る#A便い部材78.79を有する管状部材71である
。第2八図の移植片又はプロテーゼ70の態も)は半径
方向外方に伸び広げる力が管状部材71の内側から加え
られると、PjS2 B図に示されそして第1B図に関
連して前記した如き伸張された形状を同様にとることが
できろ。更に第2A図及び第2B図の脈管移植片又はプ
ロテーゼ70の態様は一般に金網管として示すこともで
きることは理解されるべきである。
本発明の方法及び装置を更に詳細に説明する。
再び、本発明の方法及び装置は人間の脈管系の動脈、静
脈又は血管の如き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i「記した如き他の身体
通路又は管を管腔内で強化する(intrnlumin
ally reinforce)のにも有用であること
が理解されるべきである。第1A図又は第2A図に関し
て前記した型のものであってもよい伸張性のある管腔的
脈管移植片又はプロテーゼ70はカテーテル83上に配
置され又は取り付けられる。
脈又は血管の如き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i「記した如き他の身体
通路又は管を管腔内で強化する(intrnlumin
ally reinforce)のにも有用であること
が理解されるべきである。第1A図又は第2A図に関し
て前記した型のものであってもよい伸張性のある管腔的
脈管移植片又はプロテーゼ70はカテーテル83上に配
置され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性のある膨張可能
な部分84を有している。カテーテル8;(は伸張性の
ある管腔的脈管移植片又はプロテーゼをカテーテル83
の伸張性のある膨張可能な部分84に取り付け及び保持
するための手段85を含む、好ましくは、取り付け及び
保持手段85はカテーテル83の伸張性のある膨張可能
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は伸張性のある管腔的脈管移植片又はプロテーゼ7
0の各端部72,73に隣接して配置されている。保持
器リング部材はカテーテル83と一体的に形成されるが
、後に詳細に説明する如く、移植片又はプロテーゼ70
が身体通路80の内腔81に挿入されるときそれを保護
及び保持すめために、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8
7から遠ざかる方向に登りこう配を持っていることが好
ましい、残りの保持器リング部材86は身体通路8()
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がら遠ざかる方向に下りこ
う配を持っている。伸張性のある管腔的脈管移植片又は
プロテーゼ70が前記した如くカテーテル8:(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(c
atl+eterization)により身体通路80
内に挿入される。
な部分84を有している。カテーテル8;(は伸張性の
ある管腔的脈管移植片又はプロテーゼをカテーテル83
の伸張性のある膨張可能な部分84に取り付け及び保持
するための手段85を含む、好ましくは、取り付け及び
保持手段85はカテーテル83の伸張性のある膨張可能
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は伸張性のある管腔的脈管移植片又はプロテーゼ7
0の各端部72,73に隣接して配置されている。保持
器リング部材はカテーテル83と一体的に形成されるが
、後に詳細に説明する如く、移植片又はプロテーゼ70
が身体通路80の内腔81に挿入されるときそれを保護
及び保持すめために、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8
7から遠ざかる方向に登りこう配を持っていることが好
ましい、残りの保持器リング部材86は身体通路8()
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がら遠ざかる方向に下りこ
う配を持っている。伸張性のある管腔的脈管移植片又は
プロテーゼ70が前記した如くカテーテル8:(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(c
atl+eterization)により身体通路80
内に挿入される。
慣用の方法においては、カテーテル83及び移植片又は
プロテーゼ70は身体通路80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を移植する二とが望まれろ。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#I透祝検
査(rIuoroscopy)及び/又は他の慣用1の
方法を使用することが出来る。次いでプロテーゼ又は移
植片70はカテーテル83の伸張性のある膨張可能な部
分84を伸張させることにより伸張せしめられ、それに
よりプロテーゼ又は移植片70は身体通路80と接触す
るように半径方向外方1こ強制される。
プロテーゼ70は身体通路80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を移植する二とが望まれろ。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#I透祝検
査(rIuoroscopy)及び/又は他の慣用1の
方法を使用することが出来る。次いでプロテーゼ又は移
植片70はカテーテル83の伸張性のある膨張可能な部
分84を伸張させることにより伸張せしめられ、それに
よりプロテーゼ又は移植片70は身体通路80と接触す
るように半径方向外方1こ強制される。
この点について、カテーテル83の伸張性のある膨張可
能な部分は慣用の血管形成術バルーン88であることが
出来る。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IIP180から除去することができる。所望により
、それに移植片又はプロテーゼ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さや89に包まれて
いてもよく、さや8っ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fil
!される。
能な部分は慣用の血管形成術バルーン88であることが
出来る。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IIP180から除去することができる。所望により
、それに移植片又はプロテーゼ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さや89に包まれて
いてもよく、さや8っ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fil
!される。
プロテーゼ又は移植片70の管状部材71は、金網管又
は管状部材71が前記した如く身体通路80内に挿入さ
れるのを可能とするために、最初は、第1A図及び第2
A図に関連して記載された如きPjtJlの所定のしは
虫された直径dを有することに留意するべきである。前
記した目的でプロテーゼ70を身体通路80内に移植す
ることを望む場合には、金網管又はプロテーゼ70は第
2直径d′に伸張させられ、そして第2直径d′は可変
でありそして身体通路80の内径により決定される。従
って、伸張させられたプロテーゼ70は血管形成術バル
ーン88が収縮させられると身体通路80内の所望の位
置から移動することが出来ず、プロテーゼ70の伸張は
多分身体通路80の破断(rupture>を引き起こ
さないであろう。
は管状部材71が前記した如く身体通路80内に挿入さ
れるのを可能とするために、最初は、第1A図及び第2
A図に関連して記載された如きPjtJlの所定のしは
虫された直径dを有することに留意するべきである。前
記した目的でプロテーゼ70を身体通路80内に移植す
ることを望む場合には、金網管又はプロテーゼ70は第
2直径d′に伸張させられ、そして第2直径d′は可変
でありそして身体通路80の内径により決定される。従
って、伸張させられたプロテーゼ70は血管形成術バル
ーン88が収縮させられると身体通路80内の所望の位
置から移動することが出来ず、プロテーゼ70の伸張は
多分身体通路80の破断(rupture>を引き起こ
さないであろう。
狭窄症の区域を有する身体通路80の内腔81を伸張す
るのに伸張性のある管腔内移植片70を使用することが
所望される場合には、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大を
可能とし、同時に、脈管移植片70の制御11された伸
張を可能とし、それにより脈管移植片70は身体通路8
0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、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、伸張性のある管腔内移植片
70は血管形成術バルーン88が収縮しても身体通路8
0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の伸張は身体通路80の4?jtPfrを引き
起こさないようである。内膜7ラツプ又は裂溝(ris
qure)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
いことを確実にする。左主動脈の部分の内腔な伸張させ
るために前記した方法で移植片70を使用する情況にお
いては、内膜フラップは心臓にはいることができずそし
て患者の死を引き起こすことはできないと考えられる。
るのに伸張性のある管腔内移植片70を使用することが
所望される場合には、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大を
可能とし、同時に、脈管移植片70の制御11された伸
張を可能とし、それにより脈管移植片70は身体通路8
0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、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、伸張性のある管腔内移植片
70は血管形成術バルーン88が収縮しても身体通路8
0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の伸張は身体通路80の4?jtPfrを引き
起こさないようである。内膜7ラツプ又は裂溝(ris
qure)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
いことを確実にする。左主動脈の部分の内腔な伸張させ
るために前記した方法で移植片70を使用する情況にお
いては、内膜フラップは心臓にはいることができずそし
て患者の死を引き起こすことはできないと考えられる。
移植片70を伸張させるために血管形成術バルーン88
を1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(translu係1nal angiop
luSty )期間中内皮の表皮はく落(endotb
el ial denudaLion)の程度がバルー
ン膨らまし時間に比例している限りは、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
されると考えられる。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8()
%が移植片70の開口82をとおして露出されるので、
保存される内皮(preservCd endoLhe
lium)の量は大きいであろう。更に、移植片70の
細長いflb材75.7 G、78.79間の内皮の損
なわれていないパッチが実験的研究により示された如く
迅速な多中心内皮化パターン(mulLicentri
c end。
を1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(translu係1nal angiop
luSty )期間中内皮の表皮はく落(endotb
el ial denudaLion)の程度がバルー
ン膨らまし時間に比例している限りは、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
されると考えられる。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8()
%が移植片70の開口82をとおして露出されるので、
保存される内皮(preservCd endoLhe
lium)の量は大きいであろう。更に、移植片70の
細長いflb材75.7 G、78.79間の内皮の損
なわれていないパッチが実験的研究により示された如く
迅速な多中心内皮化パターン(mulLicentri
c end。
thelialization pattern)をも
たらしうると考えられる。
たらしうると考えられる。
本発明は例示されそして説明されたvI造、操作の詳細
そのもの、材料そのもの又は態様に限定されるものでは
なく、修正及び均等物又は均等手段が当業者には明らか
であることは理解されるべきである。例えば、プロテー
ゼ又は移植片を伸張させるための手段はカテーテル上に
配置された複数の流体圧作動式硬質部材であることがで
き、又は複数の血管形成術バルーンはがプロテーゼ又は
移植片を伸張させるのに使用されうる。従って、本発明
は特許請求の範囲のみによって限定されるべきである。
そのもの、材料そのもの又は態様に限定されるものでは
なく、修正及び均等物又は均等手段が当業者には明らか
であることは理解されるべきである。例えば、プロテー
ゼ又は移植片を伸張させるための手段はカテーテル上に
配置された複数の流体圧作動式硬質部材であることがで
き、又は複数の血管形成術バルーンはがプロテーゼ又は
移植片を伸張させるのに使用されうる。従って、本発明
は特許請求の範囲のみによって限定されるべきである。
fjSIA図は身体通路内への移植片又はプロテーゼの
送り込みを可能とする第1の直径を有する身体通路のた
めの伸張性のある管腔内脈管移植片又はプロテーゼの斜
視図である。 PI′IJIB図は身体通路内に配置されたときその伸
張された形状にある第1A図の移植片又はプロテーゼの
斜視図である。 第2A図は身体通路内への移植片又はプロテーゼの管腔
内送り込みを可能とする第1の直径を有する、身体通路
のための伸張性のある管腔内脈管移植片又はプロテーゼ
の他の態様の斜視図である。 PjS2B図は身体通路内に配置されたときその伸張さ
れた形状において示された第2Δ図の移植片又はプロテ
ーゼの斜視図である。 第3図は第1A図及び第2八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示している、身体通路
を管腔内で強化するための装置又は身体通路の内腔を伸
張させるための装置の断面図である。 第4図は移植片又はブが第1B図及1/!R2B図に示
された形状にある状態で、身体通路を管腔内で強化する
ための装置又は身体通路の内腔を伸張させるための装(
6の断面図である。 第5図及び第6図は移植片又はプロテーゼがその上にコ
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。 図において、70・・・伸張性のある管腔内脈管移植片
又はプロテーゼ、71・・・管状部材、72・・・第1
jsI部、73・・・第2端部、74・・・壁表面、7
5゜76・・・交差している細扱い部材、77・・・交
差点、78.79・・・バー、80・・・身体通路、8
1・・・内腔、82・・・開口、83・・・カテーテル
、84・・・伸張性のある膨張可能な部分、85・・・
取り付け及び保持手段、86・・・保持器リング部材、
87・・・先導チップ、88・・・慣用の血管形成術バ
ルーン、89・・・慣用のテフロンさや、である。 kP2B 手続補:iE書(龍) 昭和62年1月24日 特許庁長官 黒 1)明 雄 殿 1、事件の表示 昭和61年特許顧第265419号 2、発明の名称 3.1111正をする者 事件との関係 特許出願人 氏 名 ジュリオ・シー・パルマズ 4、代理人 〒107 5、補正命令の日付 な し 6、補正の対象 国籍証明書及びその訳文並びに図面(凰頂ぺ〜諏■7、
補正の内容 別紙のとおり
送り込みを可能とする第1の直径を有する身体通路のた
めの伸張性のある管腔内脈管移植片又はプロテーゼの斜
視図である。 PI′IJIB図は身体通路内に配置されたときその伸
張された形状にある第1A図の移植片又はプロテーゼの
斜視図である。 第2A図は身体通路内への移植片又はプロテーゼの管腔
内送り込みを可能とする第1の直径を有する、身体通路
のための伸張性のある管腔内脈管移植片又はプロテーゼ
の他の態様の斜視図である。 PjS2B図は身体通路内に配置されたときその伸張さ
れた形状において示された第2Δ図の移植片又はプロテ
ーゼの斜視図である。 第3図は第1A図及び第2八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示している、身体通路
を管腔内で強化するための装置又は身体通路の内腔を伸
張させるための装置の断面図である。 第4図は移植片又はブが第1B図及1/!R2B図に示
された形状にある状態で、身体通路を管腔内で強化する
ための装置又は身体通路の内腔を伸張させるための装(
6の断面図である。 第5図及び第6図は移植片又はプロテーゼがその上にコ
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。 図において、70・・・伸張性のある管腔内脈管移植片
又はプロテーゼ、71・・・管状部材、72・・・第1
jsI部、73・・・第2端部、74・・・壁表面、7
5゜76・・・交差している細扱い部材、77・・・交
差点、78.79・・・バー、80・・・身体通路、8
1・・・内腔、82・・・開口、83・・・カテーテル
、84・・・伸張性のある膨張可能な部分、85・・・
取り付け及び保持手段、86・・・保持器リング部材、
87・・・先導チップ、88・・・慣用の血管形成術バ
ルーン、89・・・慣用のテフロンさや、である。 kP2B 手続補:iE書(龍) 昭和62年1月24日 特許庁長官 黒 1)明 雄 殿 1、事件の表示 昭和61年特許顧第265419号 2、発明の名称 3.1111正をする者 事件との関係 特許出願人 氏 名 ジュリオ・シー・パルマズ 4、代理人 〒107 5、補正命令の日付 な し 6、補正の対象 国籍証明書及びその訳文並びに図面(凰頂ぺ〜諏■7、
補正の内容 別紙のとおり
Claims (1)
- 【特許請求の範囲】 1、複数の交差する細長い部材を形成するように開口が
形成されている肉薄の管状部材をプロテーゼとして使用
する工程と、 該プロテーゼをカテーテル上に配置する工程と、身体通
路のカテーテル挿入によって身体通路内にプロテーゼ及
びカテーテルを挿入する工程と、該プロテーゼに関連し
たカテーテルの部分を伸張させて該プロテーゼの前記交
差する細長い部材を半径方向外方に強制して該身体通路
と接触させることにより、該身体通路内の所望の位置で
該プロテーゼを伸張させる工程とを含むことを特徴とす
る身体通路内にプロテーゼを移植する方法。 2、該プロテーゼに関連したカテーテルの部分をしぼま
せる工程と、該カテーテルを該身体通路から除去する工
程を更に含む特許請求の範囲第1項記載の方法。 3、プロテーゼに関連した伸張性のある膨張可能な部分
を有するカテーテルを使用する工程を含み、該プロテー
ゼ及び該カテーテルの部分の伸張は該カテーテルの伸張
性のある膨張可能な部分を膨らますことにより達成され
る特許請求の範囲第1項記載の方法。 4、該交差する細長い部材は複数の薄いバーであり、各
バーは均一な薄い長方形の断面形状を有する特許請求の
範囲第1項記載の方法。 5、該プロテーゼの管状部材を該身体通路内で第2の直
径に伸張させ;該第2の伸張した直径は可変でありそし
て、該身体通路の内径により決定され、それにより、該
伸張した管状部材は該身体通路内で所望の位置から移動
せず且該プロテーゼの伸張は該身体通路の破壊を引き起
こさないようになっている特許請求の範囲第4項記載の
方法。 6、該交差する細長い部材は、該細長い部材が互いに交
差する点で相互に固定されている特許請求の範囲第1項
記載の方法。 7、身体通路の内腔を伸張させる方法であって、複数の
交差する細長い部材を形成するように肉薄の管状部材内
に複数の開口を設けることにより形成されている、カテ
ーテル上に配置された管腔内移植片を、それが該身体通
路内の所望の位置に隣接して配置されるまで、該身体通
路内に挿入する工程と、 該身体通路の所望の位置における該身体通路の内腔が伸
張させられるまで、該カテーテルの部分を伸張させて該
管腔内移植片の該交差する細長い部材を半径方向外方に
伸張させて該身体通路と接触させる工程を含み、 それにより、該管腔内移植片は該身体通路がしぼんだり
該伸張した内腔の寸法が減少するのを防止するようにな
っていることを特徴とする方法。 8、該管腔内移植片と接触している該カテーテルの部分
をしぼませそして該カテーテルを該身体通路から除去す
ることを更に含む特許請求の範囲第7項記載の方法。 9、移植片に関連した伸張性のある膨張可能な部分を有
するカテーテルを使用する工程を含み、該管腔内移植片
及び該カテーテルの部分の伸張は該カテーテルの伸張性
のある膨張可能な部分を膨らますことにより達成される
特許請求の範囲第7項記載の方法 10、該交差する細長い部材は複数の薄いバーであり、
各バーは均一な薄い長方形の断面形状を有する特許請求
の範囲第7項記載の方法。 11、該管状部材を該身体通路内で第2の直径に伸張さ
せ;該第2の伸張した直径は可変でありそして、該身体
通路の所望の伸張した内径により決定され、それにより
、該伸張した管状部材は該身体通路内で所望の位置から
移動せず且該管腔内移植片の伸張は該身体通路の破壊を
引き起こさないようになっている特許請求の範囲第10
項記載の方法。 12、該交差する細長い部材を該細長い部材が互いに交
差する点で相互に固定する工程を含む特許請求の範囲第
7項記載の方法。 13、第1端部及び第2端部と該第1端部と該第2端部
との間に配置されている壁表面とを有する管状部材を具
備し、該壁表面は複数の交差する細長い部材によって形
成されており、該細長い部材の少なくとも幾つかは該管
状部材の第1端部と第2端部との中間で相互に交差して
いることと、該交差している細長い部材は複数の薄いバ
ーであり、各バーは均一な薄い長方形の断面形状を有す
ることと、 該管状部材は内腔を有する身体通路内への該管状部材の
管腔内送り込みを可能とする第1の直径有していること
と、 該管状部材は該管状部材の内側から半径方向外方に伸び
広げる力をかけられるとき第2の伸張した直径を有し、
該第2の直径は可変であり且つ該管状部材に加えられた
力の量に依存しており、それにより、該管状部材は該身
体通路の内腔を伸張させるように伸張させることができ
るようになっていることを特徴とする伸張性のある管腔
内脈管移植片。 14、該複数の薄いバーは、該バーが相互に交差してい
るところで相互に固定されている特許請求の範囲第13
項記載の伸張性のある管腔内脈管移植片。 15、第1端部及び第2端部と該第1端部と該第2端部
との間に配置されている壁表面とを有する管状部材を具
備し、該壁表面は複数の交差する細長い部材によって形
成されており、該細長い部材の少なくとも幾つかは該管
状部材の第1端部と第2端部との中間で相互に交差して
いることと、該交差している細長い部材は複数の薄いバ
ーであり、各バーは均一な薄い長方形の断面形状を有す
ることと、 該管状部材は内腔を有する身体通路内への該管状部材の
管腔内送り込みを可能とする第1の直径有していること
と、 該管状部材は該管状部材の内側から半径方向外方に伸び
広げる力をかけられるとき第2の伸張した直径を有し、
該第2の直径は可変であり且つ該管状部材に加えられた
力の量に依存しており、それにより、該管状部材は該身
体通路の内腔を伸張させるように伸張させることができ
るようになっていることを特徴とする、身体通路のため
の伸張性のあるプロテーゼ。 16、該複数の薄いバーは、該バーが相互に交差してい
るところで相互に固定されている特許請求の範囲第15
項記載の身体通路のための伸張性のあるプロテーゼ。 17、第1端部及び第2端部と該第1端部と該第2端部
との間に配置されている壁表面とを有する伸張性のある
管状プロテーゼとカテーテルを具備し、 該壁表面は複数の交差する細長い部材によって形成され
ており、該交差している細長い部材は複数の薄いバーで
あり、各バーは均一な薄い長方形の断面形状を有してお
り; 該カテーテルはプロテーゼに関連した伸張性のある膨張
可能な部分を有しそして該伸張性のある膨張可能な部分
に前記伸張性のある管状プロテーゼを取り付け且つ保持
するための手段を含み、それにより該カテーテルの伸張
性のある膨張可能な部分が膨らまされると、該プロテー
ゼは半径方向外方に強制されて該身体通路と接触するよ
うになっていることを特徴とする、身体通路を管腔内で
強化するための装置。 18、該取り付け及び保持手段が該伸張性のある膨張可
能な部分に隣接して且つ該伸張性のある管状プロテーゼ
の各端部に隣接して該カテーテル上に配置されている保
持器リング部材を具備する特許請求の範囲第17項記載
の装置。 19、第1端部及び第2端部と該第1端部と該第2端部
との間に配置されている壁表面とを有する伸張性のある
管腔内脈管移植片とカテーテルを具備し、 該壁表面は複数の交差する細長い部材によって形成され
ており、該交差している細長い部材は複数の薄いバーで
あり、各バーは均一な薄い長方形の断面形状を有してお
り; 該カテーテルは該移植片に関連した伸張性のある膨張可
能な部分を有しそして該伸張性のある膨張可能な部分に
前記伸張性のある管腔内脈管移植片を取り付け且つ保持
するための手段を含み、それにより該カテーテルの伸張
性のある膨張可能な部分が膨らまされると、該管腔内脈
管移植片は半径方向外方に強制されて該身体通路と接触
するようになっていることを特徴とする、身体通路の内
腔を伸張させるための装置。 20、該取り付け及び保持手段が該伸張性のある膨張可
能な部分に隣接して且つ該伸張性のある管腔内脈管移植
片の各端部に隣接して該カテーテル上に配置されている
保持器リング部材を具備する特許請求の範囲第19項記
載の装置。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US796009 | 1985-11-07 | ||
US90/002493 US4733665C2 (en) | 1985-11-07 | 1985-11-07 | Expandable intraluminal graft and method and apparatus for implanting an expandable intraluminal graft |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP3225376A Division JP2731642B2 (ja) | 1985-11-07 | 1991-08-12 | 伸張性のある管腔内脈管移植片又はプロテーゼ |
Publications (2)
Publication Number | Publication Date |
---|---|
JPS62231657A true JPS62231657A (ja) | 1987-10-12 |
JPH046377B2 JPH046377B2 (ja) | 1992-02-05 |
Family
ID=25167022
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP61265419A Granted JPS62231657A (ja) | 1985-11-07 | 1986-11-07 | 伸張性のある管腔内脈管移植片又はプロテーゼ |
JP3225376A Expired - Lifetime JP2731642B2 (ja) | 1985-11-07 | 1991-08-12 | 伸張性のある管腔内脈管移植片又はプロテーゼ |
JP34646396A Expired - Lifetime JP2999731B2 (ja) | 1985-11-07 | 1996-12-11 | 移植片又はプロテーゼとカテーテルとを具備する装置 |
Family Applications After (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP3225376A Expired - Lifetime JP2731642B2 (ja) | 1985-11-07 | 1991-08-12 | 伸張性のある管腔内脈管移植片又はプロテーゼ |
JP34646396A Expired - Lifetime JP2999731B2 (ja) | 1985-11-07 | 1996-12-11 | 移植片又はプロテーゼとカテーテルとを具備する装置 |
Country Status (10)
Country | Link |
---|---|
US (3) | US4733665C2 (ja) |
EP (1) | EP0221570B2 (ja) |
JP (3) | JPS62231657A (ja) |
AT (1) | ATE60500T1 (ja) |
BR (1) | BR8605658A (ja) |
CA (2) | CA1281504C (ja) |
DE (2) | DE221570T1 (ja) |
ES (1) | ES2020502T5 (ja) |
GR (2) | GR3001410T3 (ja) |
ZA (1) | ZA868414B (ja) |
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- 1986-11-03 US US06923798 patent/US4739762B1/en not_active Expired - Lifetime
- 1986-11-04 ZA ZA868414A patent/ZA868414B/xx unknown
- 1986-11-06 CA CA000522324A patent/CA1281504C/en not_active Expired - Lifetime
- 1986-11-06 CA CA0616986A patent/CA1338303E/en not_active Expired - Lifetime
- 1986-11-07 ES ES86115473T patent/ES2020502T5/es not_active Expired - Lifetime
- 1986-11-07 JP JP61265419A patent/JPS62231657A/ja active Granted
- 1986-11-07 AT AT86115473T patent/ATE60500T1/de not_active IP Right Cessation
- 1986-11-07 DE DE198686115473T patent/DE221570T1/de active Pending
- 1986-11-07 DE DE8686115473T patent/DE3677321D1/de not_active Expired - Lifetime
- 1986-11-07 EP EP86115473A patent/EP0221570B2/en not_active Expired - Lifetime
- 1986-11-07 BR BR8605658A patent/BR8605658A/pt not_active IP Right Cessation
-
1991
- 1991-01-31 GR GR91400070T patent/GR3001410T3/el unknown
- 1991-08-12 JP JP3225376A patent/JP2731642B2/ja not_active Expired - Lifetime
-
1996
- 1996-12-11 JP JP34646396A patent/JP2999731B2/ja not_active Expired - Lifetime
-
2000
- 2000-12-27 GR GR20000402831T patent/GR3035143T3/el not_active IP Right Cessation
Cited By (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH04357949A (ja) * | 1985-11-07 | 1992-12-10 | Expandable Grafts Partnership | 伸張性のある管腔内脈管移植片又はプロテーゼ |
JP2558482B2 (ja) * | 1986-12-09 | 1996-11-27 | ボストン・サイエンティフィック・コーポレイション | 前立腺肥大治療のための方法および装置 |
JPS63214264A (ja) * | 1986-12-09 | 1988-09-06 | ボストン・サイエンティフィック・コーポレイション | 前立腺肥大治療のための方法および装置 |
US6596022B2 (en) * | 1991-10-28 | 2003-07-22 | Advanced Cardiovascular Systems, Inc. | Expandable stents and method for making same |
US6245100B1 (en) | 2000-02-01 | 2001-06-12 | Cordis Corporation | Method for making a self-expanding stent-graft |
US6296661B1 (en) | 2000-02-01 | 2001-10-02 | Luis A. Davila | Self-expanding stent-graft |
WO2003018101A1 (en) | 2001-08-27 | 2003-03-06 | Nipro Corporation | Stent |
US7648526B2 (en) | 2003-04-30 | 2010-01-19 | Nipro Corporation | Extendable soft stent with excellent follow-up capability to blood vessel |
EP1743603A2 (en) | 2005-07-11 | 2007-01-17 | Nipro Corporation | Flexible stent with excellent expandability and trackability |
US9108028B2 (en) | 2007-05-31 | 2015-08-18 | Abbott Cardivascular Systems Inc. | Method and apparatus for delivering an agent to a kidney |
US9144509B2 (en) | 2007-05-31 | 2015-09-29 | Abbott Cardiovascular Systems Inc. | Method and apparatus for delivering an agent to a kidney |
US9149610B2 (en) | 2007-05-31 | 2015-10-06 | Abbott Cardiovascular Systems Inc. | Method and apparatus for improving delivery of an agent to a kidney |
US9364586B2 (en) | 2007-05-31 | 2016-06-14 | Abbott Cardiovascular Systems Inc. | Method and apparatus for improving delivery of an agent to a kidney |
US11839560B2 (en) | 2019-02-28 | 2023-12-12 | Renata Medical, Inc. | Growth stent and valve for congenital narrowings |
US12004939B1 (en) | 2023-12-07 | 2024-06-11 | Renata Medical, Inc. | Transcatheter growth devices and methods for Norwood, Glenn and Fontan therapy |
Also Published As
Publication number | Publication date |
---|---|
US4733665B1 (en) | 1994-01-11 |
ZA868414B (en) | 1987-09-30 |
US4733665A (en) | 1988-03-29 |
US4739762A (en) | 1988-04-26 |
AU591942B2 (en) | 1989-12-21 |
EP0221570A2 (en) | 1987-05-13 |
EP0221570B1 (en) | 1991-01-30 |
CA1338303E (en) | 1996-05-07 |
JP2999731B2 (ja) | 2000-01-17 |
JPH046377B2 (ja) | 1992-02-05 |
ES2020502B3 (es) | 1991-08-16 |
EP0221570B2 (en) | 2000-10-04 |
CA1281504C (en) | 1991-03-19 |
JPH09276302A (ja) | 1997-10-28 |
ATE60500T1 (de) | 1991-02-15 |
US4739762B1 (en) | 1998-10-27 |
AU6488286A (en) | 1987-05-14 |
GR3001410T3 (en) | 1992-09-25 |
JP2731642B2 (ja) | 1998-03-25 |
US4733665C2 (en) | 2002-01-29 |
US4776337B1 (en) | 2000-12-05 |
EP0221570A3 (en) | 1987-12-23 |
BR8605658A (pt) | 1987-12-15 |
DE221570T1 (de) | 1987-12-17 |
DE3677321D1 (de) | 1991-03-07 |
GR3035143T3 (en) | 2001-04-30 |
ES2020502T5 (es) | 2001-03-16 |
JPH04357949A (ja) | 1992-12-10 |
US4776337A (en) | 1988-10-11 |
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