KR20020016775A - 스텐트 장치와 녹내장 치료방법 - Google Patents
스텐트 장치와 녹내장 치료방법 Download PDFInfo
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Abstract
본 발명의 스텐트장치 및 녹내장 치료방법은 실렘 도관을 통해 방수의 유동을 지속적으로 촉진시키켜 정주형 스텐트장치에서 외과수술후 개존이 유지된다. 상기 스텐트장치는 실렘 도관내에서 또한 실렘 도관을 통해 양방향 또는 단일방향 유동을 제공한다.
Description
녹내장은 실명(失明)을 유발하기 때문에 심각한 공공질병이다. 녹내장에 의해 유발되는 실명에는 중앙 시력과 주변 시력이 포함되며, 독립적인 생활을 영위하기 위한 개인의 능력에 심각한 충격을 가한다.
녹내장은 일반적으로 상승한 안압의 설정시 발생되는 광학적 신경장애(시신경 장애)이다. 눈(eye) 내부에서의 압력은 상승하며, 이것은 외형[커핑(cuppig)] 및 기능(시야에서의 "맹점")의 변화와 연관이 있다. 만일 압력이 장기간 높은 상태로 유지된다면, 전체적인 영상 손실(vision loss)이 발생된다. 내부 액체 불균형으로 인해 눈에는 높은 압력이 전개된다.
눈은 방수로 불리우는 맑은 액체를 포함한 중공구조체 이다. 상기 방수는 모양체(毛樣體)에 의해 눈의 후방 챔버에 분당 2.5㎕의 비율로 형성된다. 매우 안정된 비율로 이루어진 상기 액체는 수정체 주위를 통과한 후, 홍채의 동공 개구를 통해 눈의 전방 챔버로 유입된다. 전방챔버에서, 상기 액체는 2개의 다른 경로를 따라 배출된다. 포도막공막(uveoscleral route)에서, 상기 액체는 모양체 몸체의 근육섬유 사이에서 여과된다. 이러한 루트는 인체에서 방수 흐름의 약 10%를 점유한다. 방수 배출의 주요한 통로는 소주상 그물(trabecular meshwork)과 실렘 도관을 포함하는 소관(canalicular) 루트를 통해서 이루어진다.
상기 소주상 그물과 실렘 도관은 홍채와 공막 사이의 연결부에 위치된다. 이러한 연결부 또는 코너는 "앵글(angle)"로 불리워진다. 상기 소주상 그물은 눈의 외주 주위에서 작동되는 쐐기형 구조체이다. 이것은 3차원 체형 구조로 배치된 교원질 비임으로 구성되어 있다. 상기 비임은 소주상 세포 라 불리우는 단층세포와 정렬한다. 교원질 비임 사이의 공간은 소주상 세포에 의해 생성되는 세포외 기질로 충진된다. 이러한 세포들은 세포외 물질을 악화시키는 효소를 생성한다. 실렘의 도관은 소주상 그물에 인접하고 있다. 상기 소주상 그물의 외벽은 실렘 도관의 내벽과 일치하고 있다. 실렘 도관은 각막의 외주 주위에서 작용하는 관형 구조체이다. 성인에 있어서, 실렘 도관은 격막에 의해 일련의 자율적인 폐색 도관으로 분기된다.
방수는 실렘 도관으로부터 상공막 정맥시스템(episcleral venous system)으로 배출되는 25개의 수집채널을 통해, 실렘 도관의 내벽을 횡단하여 소주상 비임 사이의 공간을 이동한다. 일반적인 경우에 있어서, 방수 생산은 채액 배출과 동일하며, 안압은 15 내지 21mmHg 범위로 매우 일정하게 유지된다. 녹내장에 있어서,소관 배출시스템을 통한 저항은 비정상적으로 높다.
가장 일반적인 형태의 녹내장인 주요한 개방형 앵글 녹내장에 있어서, 비정상적인 저항은 소주상 그물과 실렘 도관의 내벽의 외관을 따라 이루어지는 것으로 여겨진다. 소주상 세포의 비정상적인 신진대사는 세포외 물질의 과도한 축적을 초래하거나, 이러한 영역에서 비정상적으로 "딱딱한" 물질의 축적을 유발한다. 녹내장 이 걸린 눈은 조직생리학적으로 실렘 도관의 붕괴를 나타내고 있다. 주요한 개방형 앵글 녹내장은 모든 녹내장의 85%를 점유한다. 다른 형태의 녹내장(앵글 폐쇄 녹내장 및 2차 녹내장)은 소관 통로를 통해 감소된 배출을 포함하지만, 기계적 봉쇄, 염증성 파편, 세포 봉쇄 등으로부터 저항이 증가된다.
저항의 증가에 따라, 방수는 신속히 배출되지 않아 축적이 된다. 방수가 축적됨에 따라, 안압(intraocular pressure: IOP)이 증가한다. 증가된 안압은 시신경의 축색돌기를 압박하고, 시신경으로의 혈액공급부를 포함한다. 시신경은 눈으로부터 뇌로 영상을 이송한다. 일부 시신경은 다른 눈 보다 안압(IOP)에 대한 영향을 받기가 쉽다. 리서치(research)라 함은 상승한 압력으로부터 신경을 보호하는 방법으로서, 녹내장에 있어 현재 가능한 치료적 접근은 안압을 감소시키는 것이다.
녹내장의 임상치료는 단계적으로 접근하고 있다. 간헐적 약물치료가 그 첫번째 치료법이다. 시사적으로나 구두적으로 인정된 바와 같이, 이러한 약물치료는 방수 생산을 감소시키거나 또는 배출을 증가시키도록 작용한다. 현재 가능한 약물치료는 울혈성 심장마비, 호흡곤란, 고혈압, 우울증, 신장결석, 재생불량성 빈혈,성기능장애 및 사망 등을 포함하여 심각한 부작용을 유발한다. 약물치료에 대한 순응은 주요한 문제로서, 녹내장 환자의 절반 이상이 그 정확한 복용 일정에 따르지 못하고 있다.
약물치료가 안압 감소에 실패하였을 때, 간헐적으로 레이저 트라베큘로플래스티(laser trabeculoplasty)가 실행된다. 레이저 트라베큘로플래스티에 있어서, 레이저로부터의 열에너지는 소주상 그물에서 다수의 연속한 점(spot)에 인가된다. 이러한 레이저 에너지는 어떠한 방식으로든 소주상 세포의 신진대사를 자극하여, 소주상 그물에서 세포외 물질을 변화시킨다. 환자의 약 85%에서 방수 배출이 강화되고, 안압(IOP)이 감소된다. 그러나, 간혹 그 효과는 지속적이지 않으며, 약 50%의 환자가 5년내에 압력이 상승하였다. 일반적으로, 레이저 수술은 되풀이 할 수 없다. 또한, 레이저 트라베큘로플래스티는 50세 이하의 환자에 있어서 주요한 개방형 앵글 녹내장에 대해서는 그다지 효과적인 처치가 아닐 뿐만 아니라, 폐쇄형 앵글 녹내장 및 수많은 2차 녹내장에 효과적이지도 않다.
만일 레이저 트라베큘로플래스티가 압력을 충분히 감소시키지 않는다면, 여과 수술(filtering surgery)이 실행된다. 이러한 여과 수술에 의해, 공막과 각 영역에는 구멍이 형성된다. 이러한 구멍에 의해 액체는 다른 길을 통해 눈을 떠나게 된다.
가장 일반적으로 사용되는 여과 처리는 트라베큘렉토미(trabeculectomy) 이다. 트라베큘렉토미에 있어서, 공막을 덮고 있는 투명한 조직인 결막에서는 후방 절개가 이루어진다. 결막은 전방으로 롤링되어 연접부지역에서 공막을 노출시킨다. 부분적인 두께의 공막 플랩이 형성되어 절반두께의 각막으로 절단된다. 전방 챔버는 공막 플랩 아래로 인입되며, 깊은 공막과 소주상 그물의 일부가 절개된다. 상기 공막 플랩은 후방에 느슨하게 봉합된다. 결막 절개는 단단히 폐쇄된다. 외과수술후, 방수는 공막 플랩 하부의 구멍을 통과하여, 결막 아래의 상승되어 있는 공간에 수집된다. 그후, 방수는 결막의 혈관을 통해 흡수되거나, 결막을 횡단하여 눈물막(tear film)으로 이동한다.
트라베큘렉토미는 여러가지 문제점과 연관되어 있다. 상공막에 존재하는 섬유아세포는 증식하여 이동하며, 공막 플랩 하부에 상처를 남긴다. 특히, 어린아이나 젊은이에게는 상처가 제거될수도 있다. 초기에 성공적인 트라베큘렉토미을 갖는 눈에 있어서, 80%는 수술후 3년 내지 5년 내에 상처가 제거된다. 섬유증을 최소화하기 위하여, 외과의사는 수술시 미토마이신C(MMC) 및 5플루로오우라실과 같은 반섬유제를 공막 플랩에 가한다. 이러한 약제를 사용하면 트라베큘렉토미의 성공률을 증가시키지만, 하이포토니(hypotony)의 만연을 증가시킨다. 하이포토니는 방수가 눈으로부터 너무 빨리 흐를 때 전개되는 문제점이다. 안압은 너무 낮게(일반적으로 6.0mmHg 이하) 강하되며, 눈의 구조는 붕괴되어, 영상이 감소된다.
트라베큘렉토미는 눈의 표면으로 탈출하는 방수를 위한 통로를 형성한다. 이와 동시에, 눈의 표면과 눈으로 접근하기 위해 눈꺼풀에 정주하는 박테리아를 위한 통로도 생성한다. 이렇게 되었을 경우, 내안구염으로 불리워지는 내부의 눈 감염이 발생된다. 때때로, 상기 내안구염은 영구적이고 심각한 시력손실을 유발한다. 내안구염은 트라베큘렉토미후에 언제라도 발생될 수 있다. 이러한 위험은MMC 및 5FU 처치후 전개되는 얇은 물집을 증가시킨다. 감염을 지속시키는 또 다른 요소는 물집의 위치 이다. 조악한 트라베큘렉토미 처리가 실행된 눈은 양호한 물집을 갖는 눈 보다 눈의 감염위험이 5배 정도나 높다. 따라서, 초기의 트라베큘렉토미는 코 또는 관자놀이의 1/4 부분에서 눈꺼풀 아래에서 양호하게 실행되어야 한다.
상처, 하이포토니 및 감염과 함께, 다른 트라베큘렉토미의 합병증도 있다. 물집이 터지면 심각한 하이포토니를 유발한다. 물집은 염증을 유발시키며, 정상적인 눈물막을 붕괴시켜, 영상을 흐리게 한다. 물집을 갖게 된 환자는 일반적으로 콘텍트렌즈를 착용할 수 없다. 트라베큘렉토미로부터의 이러한 모든 합병증은 액체는 눈의 내측으로부터 외측면으로 분기된다는 사실로부터 유래된다.
트라베큘렉토미가 안압을 성공적으로 낮추지 못했을 때, 차후의 수술단계는 방수 우회장치(shunt device)를 제공하는 것이다. 종래기술의 방수 우회장치는 플라스틱(폴리프로필렌 또는 기타 다른 합성수지) 판의 한쪽 단부에 부착된 실리콘 튜브 이다. 방수 우회장치에 의해, 결막이 절개되어 공막을 노출시킨다. 상기 플라스틱 판은 눈의 후방면에 봉합된다. 눈의 가장자리에는 일반적으로 바늘에 의해 완전한 두께의 구멍이 형성된다. 튜브는 상기 구멍을 통해 눈에 삽입된다. 튜브의 외측부는 기증자 공막 또는 심막으로 덮인다. 결막이 대체되고, 절개부는 단단히 폐쇄된다. 현존의 방수 우회장치의 기법에는 상처, 수술실패, 하이포토니 및 감염 등과 같은 많은 문제점이 있다.
녹내장 처치에 관한 종래의 일부 기법들은 실렘 도관에 촛점을 맞추고 있지만, 이들은 장기간의 유치(留置) 스텐트를 대체할 수는 없다. 예를 들어, 미국특허 제5.360.399호에는 소주상 그물을 유압식으로 절단하기 위해 튜브를 통해 점착성 물질을 삽입하므로써 실렘 도관에 플라스틱 튜브 또는 스틸 튜브의 일부를 대체하는 기법이 개시되어 있다. 상기 튜브는 주사후 도관으로부터 제거된다. 또한, 실렘 도관 내부에서의 일부에 대해, 상기 미국특허 제5.360.399호에서는 주사 및 관주를 위한 어댑터로서 작용하는 대직경의 주사 커프소자(cuff element)가 제공되고 있다. 따라서, 이러한 장치는 실렘 도관내에서 영구적인 대체품으로서는 적용되지 못한다.
실렘 도관을 통해 방수의 배출을 강화할 수 있는 보다 생리학적인 시스템이 요망되고 있다. 방수의 실렘 도관으로의 직접 흐름을 강화시키면 상처를 최소화시킬 수 있는데, 그 이유는 앵글 영역이 비증식 소주상 세포의 단선에 정주하기 때문이다. 방수의 실렘 도관으로의 직접 흐름을 강화시키면 하이포토니를 최소화시킬 수 있는데, 그 이유는 도관이 정상적인 배출시스템의 일부이어서 방수의 정상 체적에 대한 취급을 생물학적으로 처리하기 때문이다.
방수의 실렘 도관으로의 직접 흐름을 강화시키면 내안구염 및 누설과 같은 후유증을 제거할 수 있다.
본 발명은 녹내장의 외과치료에 관한 것으로서, 특히 도관의 적어도 일부를 횡단하며 이를 통과하는 방수(房水)의 배출을 촉진시키기 위해 외과수술로 위치된 홈형의 정주형 스텐트를 포함하는 실렘 도관의 개존(開存: patency)을 지속적으로 유지시키는 방법 및 장치에 관한 것이다.
도1은 본 발명의 실시예에 따라, 실렘 도관의 외주를 횡단하는 관형소자로 구성된 스텐트를 도시한 측면도.
도2는 본 발명의 다른 실시예에 따라, 발광형 그물 관형소자로 구성된 스텐트를 도시한 도면.
도3은 본 발명의 또 다른 실시예에 따라, 부분적으로 관형이며 부분적으로 개방된 소자로 구성된 스텐트를 도시한 도면.
도4는 인체의 눈을 해부학적으로 도시한 도면.
도5는 본 발명의 예시적인 실시예의 수술위치를 해부학적으로 도시한 도면.
본 발명은 신규의 스텐트와, 상기 스텐트가 실렘 도관에 위치되어 도관의 칫수를 확장시키고 그 개존을 유지시키는 녹내장의 수술형 보정을 위한 수술방법에 관한 것이다. 따라서, 본 발명은 도관을 통한 방수배출을 위한 정상적인 생리학적경로를 촉진시킨다. 또한 본 발명은 녹내장 처치를 위한 실렘 도관내에 영구적으로 정주하는 스텐트 제공에 관한 것이다.
본 발명은 도관을 확장시키고 도관의 개존을 유지시키는 정주형 임플란트로서 눈의 실렘 도관의 일부내에 위치되는 방수 스텐트장치를 제공하며, 상기 스텐트장치는 눈의 수집채널로 방수의 자연배출을 촉진시키기 위해 실렘 도관내에 완전히 수용되는 형태의 몸체부를 포함한다.
또한, 본 발명은 실렘 도관의 내부에 완전히 수용되고 실렘 도관의 외주 일부 내에서 확장되는 형상과 길이를 갖는 얇은 생물학적 물질을 포함하며, 실렘 도관 및 수집채널로의 방수 통과를 촉진시키는 채널이 내부에 구비된 스텐트를 제공한다. 본 발명은 루멘(lumen), 홈통(trough), 거즈, 또는 모세관현상에 의해 방수를 실렘 도관을 통해 전달할 수 있는, 다양한 형태의 스텐트 장치를 포함한다. 본 발명의 일부 실시예에서, 스텐트의 몸체는 필요로 하는 도관 위치에서 제1삽입위치와 제2팽창 스텐팅위치 사이에서 이동할 수 있다.
본 발명은 상기 스텐트장치를 사용하는 방법도 제공한다. 본 발명의 일실시예에 따르면, 본 발명의 스텐트를 실렘 도관의 외주 일부에 이식하는 수술방법이 제공된다. 실렘 도관내로 연장되는 장치는 동일한 반경부와, 곡률반경과 실렘 도관 직경을 갖는 가요성의 다공성, 또는 비다공성의 생물학적으로 불활성인 재료로 제조된다. 장치 전체 또는 일부는 관형이거나 비관형 일수도 있으며, 창문이 제공되거나 제공되지 않을 수도 있다. 또한, 상기 장치는 실렘 도관의 외주 전체 또는 일부에 위치될 수 있는 크기를 갖는다.
전통적인 녹내장 처리에 따르면, 성인에 있어 실렘 도관은 격막에 의해 분리된 도관으로 분기되며, 봉합사의 완전한 통과를 불가능하게 한다. 성인 안구은행의 눈에 대한 예비보고서에 따르면, 실렘 도관은 특허품이다. 봉합사는 도관의 전체 외주를 통과할 수 있다. 상기 실렘 도관은 격막에 의해 다수의 폐색 도관으로 분기되는 것과는 달리, 각각의 정상품의 원주에 대해서 특허품인지는 결정되지 않았다. 본 발명은 본 발명의 스텐트장치에 의해 실렘 도관내에 개존을 생성 및 유지시키기 위해 이러한 기법을 이용한다.
도1에는 본 발명의 일실시예에 따른 스텐트장치(100)가 도시되어 있다. 상기 스텐트장치(100)는 단단한 관형벽을 가지거나 또는 루멘(5)과 외부 사이를 연결하는 다수의 창문(15)이 구비된 루멘(5)을 형성하는 관형 몸체부(10)로 구성되어있다. 상기 몸체부는 성인 눈의 6mm 반경의 실렘 도관의 반경(r)을 갖는 예비성형된 곡률부를 포함한다. 몸체부(10)의 단면직경은 실렘 도관내에 완전히 수용될 수 있는 크기로 형성된다. 상기 몸체부(10)는 그 길이전체를 따라 여러 위치에서 단면이 상이할 때, 포위된 관형부 또는 다층형 구조체로 형성될 수 있으며, 또는 평탄하거나 뾰쪽하거나, 또는 굴곡된 개방형 구조체, 또는 이들이 조합된 조합체로 형성될 수도 있다. 창문(15)은 액체의 통과를 촉진시키기 위해 스텐트장치(100)의 그 어떠한 부분에라도 위치될 수 있다.
도2 및 도3에는 본 발명의 다른 실시예가 도시되어 있다. 도2에 도시된 본 발명의 스텐트장치(100)는 6mm 반경의 실렘 도관의 반경(r)과 상기 실렘 도관에 완전히 수용될 수 있도록 형성된 몸체부(10)의 단면직경을 구비한 예비성형된 곡률부로서, 발광형 관형 그물(luminal tubular mesh)를 포함한다.
도3에 도시된 바와 같이, 6mm 반경의 실렘 도관의 반경(r)과 상기 실렘 도관에 완전히 수용될 수 있도록 형성된 몸체부(10)의 단면직경을 구비한 예비성형된 곡률부로서, 상기 몸체부(10)는 개방되고 있고 그 길이를 따라 홈통형 채널 형상으로 굴곡되어 있다.
본 발명은 장기간 사용될 수 있는 임플란트 이므로, 조직과 이러한 조직과 접촉하는 액체에 대해 무독성인 재질로 제조될 수 있다. 상기 장치는 흡수되거나 부식되지 않는 것이 바람직하며, 그렇지 않을 경우 그 본래의 위치에서 구조적으로 손상되어 버린다. 또한, 눈 조직과 방수는 이식된 장치에 의해 손상되지 않는 것이 바람직하다. 스텐트로서의 의학적 칫수와 그 제어에 부응하기 위해 여러가지재질로 제조될 수 있다. 본 발명의 예시적인 실시예에서, 스텐트장치(100)는 실리콘이나 이와 유사한 폴리머와 같은 생물학적으로 불활성이며 가요성인 재료로 구성된다. 다른 재질도 포함될 수 있지만, 얇은 벽의 폴리테트라플루오로에틸렌, 폴리프로필렌 또는 기타 다른 폴리머로 한정된다. 스텐레스 스틸, 티타늄, 또는 니티놀 처럼, 스텐팅에 대해 불활성인 것으로 알려진 다른 금속 및 합금도 사용될 수 있다. 상기 스텐트는 시간이 경과함에 따라 장치로부터 제공되는 치료성 약제로 제조될 수도 있다.
도1 내지 도5에 도시된 실시예에서, 몸체부(10)는 인체 눈에서 약 6.0mm 반경의 실렘 도관으로 예비성형된 굴곡부를 포함한다. 상기 몸체부(10)는 인체의 눈에서 6mm 반경의 실렘 도관에 대응하는 예비성형부를 갖는다. 상기 몸체부(10)는 실렘 도관의 전체 외주를 통해 연장될 수 있는 길이를 가지며, 몸체부(10)에 대한 전체 길이는 약 1.0mm 내지 40mm, 약 2mm 내지 20mm, 또는 실렘 도관을 통해 원주방향 배치를 허용할 수 있는 5mm 이다. 몸체부(10)의 직경과 폭은 관형 또는 굴곡형 스텐트에 대해 0.1mm 내지 0.5mm, 양호하기로는 0.2mm의 내경과 0.1mm 내지 0.5mm, 또는 0.3mm의 외경을 제공하며, 다각형 형상을 갖는 스텐트에 대해 필적할 수 있는 최대 폭을 제공할 수 있는 크기로 형성되어야 한다. 상기 몸체부(10)는 특히 수집채널의 방향으로 실렘 도관의 인접한 벽에 의한 폐색을 방지하기 위해 배치되며 액체의 배출을 허용하는 다수의 창을 포함한다.
본 발명에 대한 외과적 해부가 도4에 도시되어 있다. 도4에는 전방 챔버(35)와, 실렘 도관(30)과, 홍채(40)와, 각막(45)과, 소주상 그물(50)과, 수집채널(55)과, 상공막 정맥(60)과, 동공(70)이 도시되어 있다. 도5는 본 발명의 예시적 실시예의 수술 위치와 이에 관련된 해부학적 관계를 도시하고 있다. 본 발명의 장치는 실렘 도관(30)내에서의 다수의 스텐트가 실렘 도관(30)의 거의 원주방향으로의 횡단을 유발할 수 있도록 설계되었다는 점을 인식해야 한다. 실렘 도관(30)으로의 외과적 절개는 스텐트장치(100)와의 직접적인 외부접촉 없이 폐쇄된다.
장치를 삽입하는데 필요한 수술절차는 다음과 같은 단계의 일부 또는 전부를 포함한다. 먼저, 결막 절개가 이루어진다. 그후, 부분적인 두께의 공막 플랩이 형성되어, 절반두께의 각막으로 절단된다. 실렘 도관의 후방부가 확인되며, 도관이 후방으로 인입된다. 후방 챔버는 점탄성 또는 동공수축제의 주사에 의해 깊어진다. 2000면 4월 26일자로 출원된 미국 특허출원에 개시된 바와 같은 풍선 카테테르가 실렘 도관에 유도되어 팽창되므로써, 실렘 도관의 일부를 팽창시키고, 이어서 풍선의 선택적 팽창과 실렘 도관내에 하나이상의 스텐트장치가 배치된다. 선택적으로, 상기 스텐트장치는 풍선 카테테르장치에 직접 유도될 수 있다. 따라서, 다수의 스텐트 세그먼트가 실렘 도관의 원주를 따라 선택적인 위치에 배치될 수 있다. 잔존의 스텐트 물질은 절단되며, 공막 플랩과 결막 상처는 종래의 방식에 따라 폐쇄된다.
상술한 바와 같은 실시예는 예시적이며, 본 발명은 전방 챔버와 실렘 도관과 수집채널 사이에 액체연결을 제공하기 위해 다양한 형상의 스텐트를 포함한다. 따라서, 상기 실시예는 본 발명과 그 등가물의 범주에 한정되지 않는다.
Claims (23)
- 눈에서 실렘 도관을 팽창시켜 그 위치를 유지시키며, 실렘 도관의 일부내에 완전히 수용되는 형상의 몸체부를 포함하는 스텐트장치에 있어서,상기 스텐트장치는 전방 챔버와 실렘 도관 사이의 액체연결을 개선하는 것을 특징으로 하는 스텐트장치.
- 제1항에 있어서, 상기 스텐트의 몸체부는 인체 눈의 실렘 도관 반경에 가까운 반경을 갖는 굴곡부를 포함하는 것을 특징으로 하는 스텐트장치.
- 제2항에 있어서, 상기 굴곡부는 3mm 내지 10mm의 반경을 갖는 것을 특징으로 하는 스텐트장치.
- 제2항에 있어서, 상기 굴곡부는 6mm의 직경을 갖는 것을 특징으로 하는 스텐트장치.
- 제1항에 있어서, 상기 몸체부는 0.1mm 내지 0.5mm의 외경을 갖는 적어도 부분적으로 발광체인 것을 특징으로 하는 스텐트장치.
- 제1항에 있어서, 상기 몸체부는 0.3mm의 외경을 갖는 적어도 부분적으로 발광체인 것을 특징으로 하는 스텐트장치.
- 제1항에 있어서, 상기 몸체부는 1mm 내지 40mm의 길이를 갖는 것을 특징으로 하는 스텐트장치.
- 제1항에 있어서, 상기 몸체부는 20mm의 길이를 갖는 것을 특징으로 하는 스텐트장치.
- 제1항에 있어서, 스텐트의 몸체부에는 실렘 도관으로의 액체 통과를 허용하기 위해 다수의 창이 형성되는 것을 특징으로 하는 스텐트장치.
- 제1항에 있어서, 상기 몸체는 눈의 수집채널을 향해 개방된 몸체의 적어도 일부 길이를 따라 부분적으로 개방된 홈통형 채널을 형성하도록 굴곡되는 것을 특징으로 하는 스텐트장치.
- 실렘 도관을 통한 배출을 촉진시켜 과도한 안압을 낮추기 위해, 눈에 사용되는 스텐트장치에 있어서,실렘 도관의 일부에 완전히 유지되는 길이와 형상을 가지며 생물학적으로 사용할 수 있는 재료로 제조된 얇은 몸체를 포함하는 것을 특징으로 하는 스텐트장치.
- 제11항에 있어서, 몸체부는 실렘 도관을 따라 양방향으로 배출부를 제공하는 것을 특징으로 하는 스텐트장치.
- 제11항에 있어서, 스텐트의 몸체부는 인체 눈의 실렘 도관의 반경에 가까운 반경을 갖는 굴곡부를 포함하는 것을 특징으로 하는 스텐트장치.
- 제13항에 있어서, 상기 굴곡부는 약 3mm 내지 10mm의 반경을 갖는 것을 특징으로 하는 스텐트장치.
- 제14항에 있어서, 상기 굴곡부는 6mm의 직경을 갖는 것을 특징으로 하는 스텐트장치.
- 제11항에 있어서, 상기 몸체부는 0.1mm 내지 0.5mm의 외경을 갖는 것을 특징으로 하는 스텐트장치.
- 제11항에 있어서, 상기 몸체부는 0.3mm의 외경을 갖는 것을 특징으로 하는 스텐트장치.
- 제11항에 있어서, 상기 몸체부는 1mm 내지 40mm의 길이를 갖는 것을 특징으로 하는 스텐트장치.
- 제11항에 있어서, 상기 몸체부는 20mm의 길이를 갖는 것을 특징으로 하는 스텐트장치.
- 제11항에 있어서, 스텐트의 몸체부에는 실렘 도관으로의 액체 통과를 허용하기 위해 다수의 창이 형성되는 것을 특징으로 하는 스텐트장치.
- 제11항에 있어서, 상기 몸체는 수집채널을 향해 개방된 몸체의 적어도 일부 길이를 따라 부분적으로 개방된 홈통형 채널을 형성하도록 굴곡되는 것을 특징으로 하는 스텐트장치.
- 녹내장을 수술치료하기 위한 방법에 있어서,연접부에서 결막 플랩을 통해 트라베큘렉토미를 실행하는 단계와,부분적인 두께의 공막 플랩을 전개시키는 단계와,실렘 도관이 후방으로 인입될 때까지 외과수술로 팽창되는 앵글 조직과 공막 사이의 연결부를 방사방향으로 절개하는 단계와,제1항에 청구된 하나이상의 스텐트장치를 실렘 도관내에 위치시키는 단계를 포함하는 것을 특징으로 하는 녹내장 치료방법.
- 녹내장을 수술치료하기 위한 방법에 있어서,연접부에서 결막 플랩을 통해 트라베큘렉토미를 실행하는 단계와,부분적인 두께의 공막 플랩을 전개시키는 단계와,실렘 도관이 후방으로 인입될 때까지 외과수술로 팽창되는 앵글 조직과 공막 사이의 연결부를 방사방향으로 절개하는 단계와,제11항에 청구된 하나이상의 스텐트장치를 실렘 도관내에 위치시키는 단계를 포함하는 것을 특징으로 하는 녹내장 치료방법.
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US60/131,030 | 1999-04-26 | ||
PCT/US2000/011215 WO2000064391A1 (en) | 1999-04-26 | 2000-04-26 | Stent device and method for treating glaucoma |
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KR10-2001-7013735A KR100456090B1 (ko) | 1999-04-26 | 2000-04-26 | 스텐트 장치와 녹내장 치료방법 |
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