JPS63246148A - 止血装置および止血方法 - Google Patents

止血装置および止血方法

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Publication number
JPS63246148A
JPS63246148A JP63024874A JP2487488A JPS63246148A JP S63246148 A JPS63246148 A JP S63246148A JP 63024874 A JP63024874 A JP 63024874A JP 2487488 A JP2487488 A JP 2487488A JP S63246148 A JPS63246148 A JP S63246148A
Authority
JP
Japan
Prior art keywords
blood vessel
hole
occluding
incision
adjacent
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
Application number
JP63024874A
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English (en)
Other versions
JPH0817777B2 (ja
Inventor
ケネス　ケンシー
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.)
INTORABASUKIYURAA SAAJIKARU IN
INTORABASUKIYURAA SAAJIKARU INSTR Inc
Original Assignee
INTORABASUKIYURAA SAAJIKARU IN
INTORABASUKIYURAA SAAJIKARU INSTR Inc
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Application filed by INTORABASUKIYURAA SAAJIKARU IN, INTORABASUKIYURAA SAAJIKARU INSTR Inc filed Critical INTORABASUKIYURAA SAAJIKARU IN
Publication of JPS63246148A publication Critical patent/JPS63246148A/ja
Publication of JPH0817777B2 publication Critical patent/JPH0817777B2/ja
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004—(bio)absorbable, (bio)resorbable or resorptive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00646—Type of implements
    • A61B2017/00659—Type of implements located only on one side of the opening
    • 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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30075—Properties of materials and coating materials swellable, e.g. when wetted
    • 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
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0061—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof swellable

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (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。

Description

【発明の詳細な説明】 （産業上の利用分野） 不発明は医療装置に係わり、さらに詳細にはＩＦ血装置
に係わる。
（従来の技術） 今日では、多くの外科処理が維管束内または管腔内で行
なわれている。例えば、アテローム性動脈硬化症のよう
な血管疾病の処理に際しては動脈にバルーンや他のカテ
ーテルのような装置を挿入させるのが通常である。この
ような方法には、導入シースが動脈に挿入され、その後
カテーテルのような装置がこのシニスを通して挿入され
て動脈内の治療位置に位置させるような動脈の経皮的な
穴あけも含まれている。このような処理が終わって装置
（およびその時使用した導入シース等）が除去されると
必ず出血が起こる。このような出血は穴または切開部を
医者または看護婦が上皿に到るまで４０〜５０分間位置
接指圧して止血させている。
このような処置は時間を浪費させ、その上、血管を通る
血行を実質的に低下させ血栓症を起こさせる危険性もあ
る。
血管の穴または心臓の隔壁欠陥を閉塞するための装置は
公知で１例えば米国特許第３．８７４．３８８号公報（
キング等）、米国特許第４，００７，７４３号公報（ブ
レーク）、米国特許第４，５８７．９ＥｉＱ号公報（ギ
リス）および米国特許第４．ＢＯＢ、３３７号公報（チ
ンマーマン等）がある。
（発明が解決しようとする問題点） 本発明の目的の一つは、血管の壁の穴又は切開部の血行
を実質的に低下させず、１合も指圧も必要なしに止血閉
塞させる簡単な方法を提供することにある。
本発明の一態様によれば、生物の血管壁の穴又は切開部
を止血閉塞する装置として、血管内に閉塞物を配置して
血管壁に穴又は切開部を押付け。
この穴又は切開部と接触した血管壁の接触を維持して、
血液が血管中を実質的に妨害されずに流動するようにな
っていることを特徴とする装置を提供することである。
（問題点を解決するための手段） 好ましくは、本装置け、血管内に配置された出口を有す
る管状手段と、この管状手段内に収納自在で血管の内面
に適合する部分を有する穴閉塞物と、この管状手段内か
ら血管内に前記閉塞物を押し出す押出し手段と、この閉
塞物が切開部に隣接した部分に維持されるようにこの閉
塞物を配置させる引戻し手段とを包含する。
（実施例） 本発明を十分に理解するために２以下の概略図を参照し
ながら説明することにする。
これらの図（第１図から第５図）は、本発明に基づく装
置（２０）が生物の血管の穴又は切開部を閉塞している
ところを示している。この装置（２０）は血管造影染料
の注射、バルーン血管形成、他種のアテローム性動脈硬
化症動脈の再疎通、即時弁膜切開や体内の他の導管や内
腔の穴又は他の切開部の止血閉塞のような維管束的処理
に使用すると効果がある。
このような処置では、（図示されていない）血管造影針
のような装置のカニューラを皮膚を介して動脈（２４）
中に挿入する。このカニューラの針をその位置に保持し
、（図示されていない）ガイド線の徴用で可撓性のある
末端を、このカニューラを介して動脈中の所望の深さま
で通し、カニュー　−ラを取り除いてこのガイド線をそ
の場所に留めておく０次いで、市販の導入シース（２６
）と（図示されていない）動脈拡張器をこのガイド線上
を経て穴（２８）を介して動脈（２６）中に通す。さら
に、ガイド線と動脈拡張器を取り除いてシース（２Ｂ）
をその゛　場所に残す０次に、（図示されていない）装
置を導入シース（２６）を介して挿入し１例えば、アテ
ロ−゛　　ム動脈硬化閉塞位置のような動脈の所望の維
管束内位置まで到達させる。（例えば血管形成のような
）維管束的処理が終わればカテーテルを取り除く。
第１図に示したように、本装置（２０）は、末端に出口
（３４）を持つ細長いチューブ（３２）でできている。
このチューブ（３２）は、好ましくは、ポリエチレンま
たはポリ塩化ビニルのような可撓性の材料でできており
、直径は導入シース（２Ｂ）を介して動脈（２４）にこ
のチューブ（３２）を挿入できる程の太さ［例えば８フ
レンチ（＝２．６７ｍｍ）　］である、このチューブ（
３２）は、本装置（２０）の使用者が指で握るようにし
たフランジ突出部（４６）を有する中茎部（４４）を包
含する。
このチューブ（３２）は、フィラメント（３６）で押込
み手段（３８）と係合した閉塞部材（３０）を有してい
る。
この閉塞部材（３０）は、圧縮または緊縮させて前記チ
ューブ（３２）内に収納できるが、圧縮を緩めると膨張
する膨張自在な部材でできている。前記閉塞部材（３０
）は弾力性のある止血材料でできており。
好ましくは生分解性で、取り付けた後除去する必要のな
いものが良い。特に好ましい一例としては。
ジョンソン・アンド・ジョンソン社　（Ｊｏｈｎｓｏｎ
　＆Ｊｏｈｎｓｏｎ、　Ｉｎｃ、　）から「ゲルフオー
ム（Ｇｅｌｆｏａｍ）　Ｊという商品名で市販されてい
る多孔質の止血性吸収性ゼラチンがある。
この閉塞部材（３０）は、円盤状の頭部（５２）と、ア
ンカー部分（５４）とを有し、前記頭部（５２）は直径
が６〜９　ｍｍ、厚さが１〜２■で、後部（中央）面（
４２）と前部（末端）面（５Ｂ）とを有している。萬た
、このアンカー部分（５４）は１例えば直径が２〜３ｍ
ｎ＋の小さなボス状の突起物で、前記頭部の中央面（４
２）の中心から突き出している。
細長い引込みフィラメント（３６）はチューブ（３２）
内を通り、その末端が前記閉塞部材（３０）のアンカー
部分（５４）に係合されている。このフィラメントは細
いので前記押込み手段の操作を妨げることはない、この
フィラメント（３６）は縫糸状の生分解性材料でできて
いることが好ましい。
前記押込み手段（３８）は細長い末端（４０）を有する
円筒状の棒で、例えばポリエチレンまたはポリ塩化ビニ
ル等の比較的可撓性のある材料でできている。この押込
み手段の一端にはキャップ（５０）があり、使用者の親
指で保持できるようになっている。
第３図に示すように、このチューブ（３２）はシース（
２６）を引き抜いた時に出口（３４）が動脈内に残るよ
うにシース（２６）内に挿入する６次に゛、押込み手段
（３８）で末端部分（４０）が前記閉塞部材（３０）を
出口（３４）から押し出して閉塞部材（３０）が円盤状
に膨張できるように、チューブ（３２）を押し込む、こ
の後。
チューブ（３２）を穴（２８）から引き出して、患者の
体から外し、閉塞部材（３０）を動脈中に残し、引込み
フィラメント（３６）の一端が前記穴（２８）を介して
伸びるようにする０次に、このフィラメントを引張って
衝合面（４２）を穴（２８）に近接させ、動脈（２４）
の円弧状また湾曲した内面（５８）と衝合させ、アンカ
ー部分（５４）が穴に接近してこの穴を止血シールする
ようにする。前記閉塞部材（３０）の頭部（５２）は細
くて動脈の内面に適合できるので、動脈を通る血行が妨
害されることはない、この閉塞部材（３０）をその位置
に保持するため前記フィラメント（３６）を緊張させて
患者の皮膚で位置固定させる。市販のテープ（６０）の
−片でこのフィラメントを固定するか、（図示されてい
ない）グリップ手段で皮膚と接触するフィラメントの摺
動を防ぐために固定しても良い。
前記閉塞部材（３０）および引込みフィラメントは、生
分解性材料でできているので、止血完了後もその位置に
残しておいても良い。
止血促進のために、閉塞部材（３０）を構成する材料は
１例えばティッシュ状のトロンボプラスチンのような市
販の凝血剤を包含していても良い、さらに、動脈中での
血栓症の危険性を最小にするため、この閉塞部材（３０
）の前部端面（５６）を、ココナツツ油のようなワック
ス塗膜による非凝塊形成性材料で塗布処理しておいても
良い。
本発明は、以上に提示した実施例に制約されるものでは
ない、従って、前記閉塞部材（３０）は種々の形状をな
していても良く、例えば他の体液を含む肉体の導管また
は内腔ないの穴を塞ぐような肉体の２つの部分間の開口
部をシールするという別の用途にも使用できる。
【図面の簡単な説明】
第１図は１本発明に基づく装置の一部が動脈の経皮的な
穴を介して通じるシース中に挿入しようとするところを
示した部分断面側面図である。 第２図から第４図は５種々の使用段階にある本装置の側
面図である。 第５図は１本装置の縮小平面図である。 各図の参照番号は下記のものを示している。 ２０・・・止血装置、　２４・・・血管、２６・・・導
入シース。 ２８・・・穴又は切開部、　３０・・・閉塞部材、　３
２・・・チューブ、３４・・・出口、　３６・・・引込
みフィメント、３８・・・押込み手段、４２・・・後部
衝合面、４６・・・フランジ突出部、５２・・・頭部、
５４・・・アンカー部分。 ５６・・・前部端面。

Claims (7)

    【特許請求の範囲】
  1. （１）生物の血管壁（２４）の穴又は切開部（２８）を
    止血的に閉塞する装置において、閉塞部材（３０）が血
    管内に位置するように配置され、前記血管壁（２４）の
    穴又は切開部と隣接する血管壁とを架橋して、前記穴又
    は切開部と隣接する血管壁との接合を維持し、これによ
    って血管を介する血行が実質的に妨害されないようにな
    っていることを特徴とする止血装置。
  2. （２）特許請求の範囲第１項に記載の装置において、 （ａ）血管内に位置する出口（３４）を有するチューブ
    手段（３２）と、 （ｂ）前記チューブ手段内に収納自在で、血管の内面（
    ２４）に適合する部分（５２）を有する閉塞部材（３０
    ）と、 （ｃ）前記チューブ手段内から血管中に、前記閉塞部材
    （３０）を突き出す押込み手段（３８）と、（ｄ）前記
    閉塞部材（３０）を位置するように配置し、これによっ
    てこの閉塞部材（３０）を穴（２８）に隣接する部分（
    ５２）に維持するようにする引込み手段（３６）と、 を包含することを特徴とする止血装置。
  3. （３）特許請求の範囲第１項または第２項のいずれかに
    記載の装置において、前記閉塞部材（３０）が弾力性の
    ある材料で構成され、円盤状の頭部（５２）とアンカー
    部分（５４）とを包含することを特徴とする止血装置。
  4. （４）特許請求の範囲第２項に記載の装置において、前
    記引込み手段（３６）がその一端に前記閉塞部材（３０
    ）のアンカー部分（５４）と係合した細長いフィラメン
    ト（３６）を包含することを特徴とする止血装置。
  5. （５）特許請求の範囲第１項から第４項のいずれかに記
    載の装置において、前記閉塞部材（３０）と引込み手段
    （３８）とが、生分解性材料で構成されていることを特
    徴とする止血装置。
  6. （６）生物の血管、導管または他の体内腔壁（２４）の
    穴、切開部または他の開口部（２８）を閉塞する装置に
    おいて、閉塞部材（３０）が血管（２４）、導管または
    内腔内に位置するように配置され、それらの内壁の開口
    部を架橋して、前記開口部と隣接する血管、導管または
    内腔壁との接合を維持し、これによって前記開口部を介
    する体液の流通が妨害されないようになっていることを
    特徴とする止血装置。
  7. （７）生物の血管壁（２４）の穴を止血的に閉塞する方
    法において、 （ａ）血管の内面（２４）に適合する形状部分（５４）
    を有する閉塞部材（３０）を血管中に導入する工程と、 （ｂ）前記穴と隣接する前記閉塞部材（３０）を架橋し
    、維持して血管を介する血行が実質的に妨害されないよ
    うになっている工程と、 よりなることを特徴とする止血方法。
JP63024874A 1987-02-17 1988-02-04 止血装置および止血方法 Expired - Lifetime JPH0817777B2 (ja)

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US15267 1987-02-17
US07/015,267 US4744364A (en) 1987-02-17 1987-02-17 Device for sealing percutaneous puncture in a vessel

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JPS63246148A true JPS63246148A (ja) 1988-10-13
JPH0817777B2 JPH0817777B2 (ja) 1996-02-28

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