RU2019115837A - Устройство и система доставки для лечения аневризмы - Google Patents

Устройство и система доставки для лечения аневризмы Download PDF

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RU2019115837A
RU2019115837A RU2019115837A RU2019115837A RU2019115837A RU 2019115837 A RU2019115837 A RU 2019115837A RU 2019115837 A RU2019115837 A RU 2019115837A RU 2019115837 A RU2019115837 A RU 2019115837A RU 2019115837 A RU2019115837 A RU 2019115837A
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distal
aneurysm
proximal
braid
segment
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RU2019115837A
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Лейси ГОРОЧОВ
Ариэль СОТОДЕЛЬВАЛЛЕ
Хуан ЛОРЕНСО
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Депуи Синтез Продактс, Инк.
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12027—Type of occlusion
    • A61B17/12031—Type of occlusion complete occlusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12136—Balloons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/1214—Coils or wires
    • A61B17/12145—Coils or wires having a pre-set deployed three-dimensional shape
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00778—Operations on blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205—Introduction devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205—Introduction devices
    • A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device
    • 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
    • A61B2090/3966—Radiopaque markers visible in an X-ray image
    • 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
    • A61F2002/068—Modifying the blood flow model, e.g. by diffuser or deflector
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M2025/0004—Catheters; Hollow probes having two or more concentrically arranged tubes for forming a concentric catheter system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A61M2025/0042—Microcatheters, cannula or the like having outside diameters around 1 mm or less
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • A61M2025/0079—Separate user-activated means, e.g. guidewires, guide tubes, balloon catheters or sheaths, for sealing off an orifice, e.g. a lumen or side holes, of a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/12—Blood circulatory system

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Reproductive Health (AREA)
  • Neurosurgery (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Surgical Instruments (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Claims (47)

1. Плетеное изделие для окклюдирования аневризмы, причем плетеное изделие содержит:
проксимальный расширяемый участок, размещенный внутри аневризмы и уплотняющий шейку аневризмы; и
дистальный расширяемый участок, расположенный дистально относительно проксимального расширяемого участка, причем дистальный расширяемый участок заполняет аневризму и обеспечивает направленное наружу давление на проксимальный участок таким образом, чтобы он оставался на месте в аневризме.
2. Плетеное изделие по п. 1, отличающееся тем, что в развернутом состоянии проксимальный расширяемый участок образует кольцевой расширенный участок, герметизирующий шейку аневризмы, а дистальный расширяемый участок образует дистальный мешок, заполняющий аневризму.
3. Плетеное изделие по п. 2, отличающееся тем, что кольцевой расширенный сегмент образует, окружает нижний конец дистального мешка и переворачивается вокруг него.
4. Плетеное изделие по п. 2, отличающееся тем, что пористость проксимального расширяемого участка меньше пористости дистального расширяемого участка.
5. Плетеное изделие по п. 4, отличающееся тем, что соответствующие пористости определяются по меньшей мере одним из размеров зазоров, угла изгиба, термической обработки и покрытия.
6. Плетеное изделие по п. 2, отличающееся тем, что кольцевой расширенный сегмент накладывается снаружи дистального мешка, при этом внешние концы дистального мешка выполнены с возможностью прижимания к внутренней поверхности кольцевого расширенного сегмента по мере расширения плетеного изделия в развернутое состояние.
7. Плетеное изделие по п. 6, отличающееся тем, что между кольцевым расширенным сегментом и дистальным мешком образуется зазор или полость, когда кольцевой расширенный сегмент перевернут вокруг дистального мешка.
8. Плетеное изделие по п. 2, дополнительно содержащее сужающийся сегмент, расположенный между проксимальным и дистальным расширяемыми участками.
9. Плетеное изделие по п. 8, отличающееся тем, что проксимальный расширяемый участок имеет пористость ниже пористости сужающегося сегмента и дистального расширяемого участка.
10. Плетеное изделие по п. 8, дополнительно содержащее участок изгиба, образованный между сужающимся сегментом и проксимальным расширяемым участком или дистальным расширяемым участком.
11. Система для лечения аневризмы, причем система содержит:
микрокатетер;
доставочную трубку, выполненную с возможностью поступательного перемещения в микрокатетере; и
плетеное изделие по п. 2, причем плетеное изделие соединено с возможностью отсоединения с доставочной трубкой и расположено с возможностью скольжения внутри микрокатетера в сложенном состоянии и дистально поступательно перемещается из микрокатетера в развернутое состояние;
при этом плетеное изделие расширяется, включая по меньшей мере одно из дистального и проксимального расширяемого участков, в развернутое состояние по мере того, как дистальный конец плетеного изделия дистально выходит из микрокатетера.
12. Система по п. 11, отличающаяся тем, что кольцевой расширенный сегмент накладывается снаружи дистального мешка по мере дистального поступательного перемещения плетеного изделия из микрокатетера и проталкивания плетеного изделия вплотную к стенке аневризмы.
13. Способ доставки окклюзирующего устройства к аневризме, включающий:
прикрепление проксимального конца плетеного изделия к дистальному концу доставочной трубки;
размещение плетеного изделия в микрокатетере;
выборочное расположение плетеного изделия с доставочной трубкой в сосудистой системе;
перемещение плетеного изделия в дистальном направлении с возможностью скольжения от микрокатетера к аневризме с помощью доставочной трубки,
расширение дистальной расширяемой части внутри аневризмы с образованием дистального мешка; и
образование кольцевого расширенного сегмента на проксимальном конце плетеного изделия вокруг окклюзирующего мешка путем переворачивания;
высвобождение плетеного изделия.
14. Способ по п. 13, дополнительно включающий:
размещение плетеного изделия внутри микрокатетера;
прикрепление проксимального конца плетеного изделия к дистальному концу доставочной трубки; и
заполнение аневризмы путем образования дистального мешка.
15. Способ по п. 13, дополнительно включающий:
соединение участка фиксации с доставочной трубкой на проксимальном конце плетеного изделия и дистальном конце доставочной трубки; и
высвобождение с помощью участка фиксации доставочной трубки из плетеного изделия.
16. Способ по п. 13, дополнительно включающий:
расширение кольцевого расширенного сегмента таким образом, что кольцевой расширенный сегмент перекрывает наружную поверхность дистального мешка.
17. Способ по п. 16, дополнительно включающий:
прижимание одного или более внешних концов наружной поверхности дистального мешка к кольцевому расширенному сегменту по мере дистального поступательного перемещения плетеного изделия в аневризму.
18. Способ по п. 17, дополнительно включающий:
образование по меньшей мере одного из зазора или полости между кольцевым расширенным сегментом и дистальным мешком, когда кольцевой расширенный сегмент переворачивается вокруг наружной поверхности окклюзирующего мешка.
19. Способ по п. 13, дополнительно включающий:
обеспечение меньшей пористости проксимального расширяемого участка, чем пористость по меньшей мере одного из сужающихся сегментов между проксимальным и дистальным расширяемыми участками;
размещение проксимального расширяемого участка в соединении с шейкой аневризмы или смежно с ней; и
отклонение, отведение или замедление потока в аневризму.
20. Способ окклюдирования аневризмы, включающий:
дистальное перемещение плетеного изделия в аневризму;
расширение проксимального расширяемого участка плетеного изделия из свернутого состояния в расширенное состояние, таким образом фиксируя шейку аневризмы; и
расширение дистального расширяемого участка плетеного изделия внутри аневризмы с образованием дистального мешка, таким образом заполняя аневризму.
RU2019115837A 2018-05-25 2019-05-23 Устройство и система доставки для лечения аневризмы RU2019115837A (ru)

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US15/989,725 US11058430B2 (en) 2018-05-25 2018-05-25 Aneurysm device and delivery system
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US11284901B2 (en) 2014-04-30 2022-03-29 Cerus Endovascular Limited Occlusion device
US11406404B2 (en) 2020-02-20 2022-08-09 Cerus Endovascular Limited Clot removal distal protection methods
US11471162B2 (en) 2015-12-07 2022-10-18 Cerus Endovascular Limited Occlusion device
US11648013B2 (en) 2016-03-11 2023-05-16 Cerus Endovascular Limited Occlusion device
US11812971B2 (en) 2017-08-21 2023-11-14 Cerus Endovascular Limited Occlusion device

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US12004750B2 (en) 2008-05-01 2024-06-11 Aneuclose Llc Methods for creating an expandable two-part intrasacular aneurysm occlusion device from a tubular mesh
US11357511B2 (en) 2008-05-01 2022-06-14 Aneuclose Llc Intrasacular aneurysm occlusion device with globular first configuration and bowl-shaped second configuration
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EP3572010A1 (en) 2019-11-27
IL266819A (en) 2019-08-29
AU2019203647A1 (en) 2019-12-12
CN110522487A (zh) 2019-12-03
US20190357914A1 (en) 2019-11-28
JP2019202147A (ja) 2019-11-28
MX2019006078A (es) 2020-02-17
BR102019010729A2 (pt) 2019-12-10
JP7362296B2 (ja) 2023-10-17
CO2019005464A1 (es) 2020-11-30
KR20190134541A (ko) 2019-12-04
CA3044180A1 (en) 2019-11-25
TW202005621A (zh) 2020-02-01
TWI787511B (zh) 2022-12-21
US11058430B2 (en) 2021-07-13

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