RU2019116175A - Устройство и система доставки для лечения аневризмы - Google Patents

Устройство и система доставки для лечения аневризмы Download PDF

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RU2019116175A
RU2019116175A RU2019116175A RU2019116175A RU2019116175A RU 2019116175 A RU2019116175 A RU 2019116175A RU 2019116175 A RU2019116175 A RU 2019116175A RU 2019116175 A RU2019116175 A RU 2019116175A RU 2019116175 A RU2019116175 A RU 2019116175A
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distal
segment
aneurysm
proximal
inflection
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Лейси ГОРОЧОУ
Ариэль СОТОДЕЛЬВАЛЛЕ
Хуан ЛОРЕНСО
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Депуи Синтез Продактс, Инк.
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12027Type of occlusion
    • A61B17/12031Type of occlusion complete occlusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12136Balloons
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172Occluding 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements 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
    • A61B2017/00575Implements 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 for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00623Introducing or retrieving devices therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205Introduction devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205Introduction devices
    • A61B2017/12054Details concerning the detachment of the occluding device from the introduction device
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0021Catheters; Hollow probes characterised by the form of the tubing
    • A61M2025/0042Microcatheters, cannula or the like having outside diameters around 1 mm or less
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • A61M2025/0079Separate 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

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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)
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  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Surgical Instruments (AREA)

Claims (45)

1. Плетеное изделие для лечения аневризмы, содержащее проксимальный конец и дистальный конец, причем плетеное изделие содержит:
дистальный сегмент, расположенный вокруг дистального конца, причем дистальный сегмент выполнен с возможностью перехода из сложенного состояния внутри микрокатетера в развернутое состояние дистальнее микрокатетера, за счет чего дистальный сегмент расширяется в радиальном направлении, образуя дистальный мешок;
центральный сегмент в соединении с дистальным сегментом, причем центральный сегмент выполнен с возможностью заворачивания в дистальный мешок; и
проксимальный сегмент в соединении с центральным сегментом и расположенный вокруг проксимального конца, причем проксимальный сегмент выполнен с возможностью заправления в центральный сегмент в развернутом состоянии;
причем каждый из проксимального, дистального и центрального сегментов имеет разную пористость или разную гибкость.
2. Плетеное изделие по п. 1, дополнительно содержащее точку перегиба, расположенную между центральным сегментом и дистальным сегментом, причем проксимальный конец выполнен с возможностью заправления внутрь дистального мешка в развернутом состоянии до тех пор, пока центральный сегмент не будет завернут так, чтобы положение точки перегиба было смежно с шейкой аневризмы для вызывания эффекта отклонения потока.
3. Плетеное изделие для лечения аневризмы, содержащее проксимальный конец и дистальный конец, причем плетеное изделие содержит:
дистальный сегмент, расположенный вокруг дистального конца, причем дистальный сегмент выполнен с возможностью перехода из сложенного состояния внутри микрокатетера в развернутое состояние дистальнее микрокатетера, за счет чего дистальный сегмент расширяется в радиальном направлении, образуя дистальный мешок; и
проксимальный сегмент, расположенный вокруг проксимального конца, причем проксимальный сегмент выполнен с возможностью заворачивания и заправления в дистальный мешок.
4. Плетеное изделие по п. 3, в котором проксимальный сегмент имеет большую пористость, чем дистальный сегмент.
5. Плетеное изделие по п. 4, в котором проксимальный конец выполнен с возможностью заправления внутрь дистального мешка в развернутом состоянии до тех пор, пока положение проксимального конца дистального сегмента не будет смежно с шейкой аневризмы для вызывания эффекта отклонения потока.
6. Плетеное изделие по п. 3, дополнительно содержащее точку перегиба, расположенную между проксимальным и дистальным сегментами.
7. Плетеное изделие по п. 6, в котором проксимальный сегмент выполнен с возможностью заворачивания, когда точка перегиба находится дистальнее микрокатетера, или выполнен с возможностью заворачивания в точке перегиба после поступательного перемещения плетеного изделия в дистальном направлении на предварительно определенное расстояние.
8. Плетеное изделие по п. 3, в котором дистальный мешок имеет диаметр, по меньшей мере в два раза превышающий диаметр микрокатетера.
9. Плетеное изделие по п. 3, дополнительно содержащее центральный сегмент, расположенный между проксимальным и дистальным сегментами.
10. Плетеное изделие по п. 9, в котором каждый из проксимального, дистального и центрального сегментов имеет разную пористость.
11. Плетеное изделие по п. 10, в котором центральный сегмент имеет большую пористость, чем пористость проксимального и дистального сегментов; и
при этом пористость дистального сегмента больше, чем пористость проксимального сегмента.
12. Плетеное изделие по п. 10, дополнительно содержащее:
первую точку перегиба, расположенную между дистальным сегментом и центральным сегментом; и
вторую точку перегиба, расположенную между центральным сегментом и проксимальным сегментом.
13. Плетеное изделие по п. 12, в котором в развернутом состоянии первая точка перегиба выполнена таким образом, чтобы проксимальный конец дистального сегмента изгибался при поступательном перемещении плетеного изделия в дистальном направлении на первое расстояние; и
при этом в развернутом состоянии вторая точка перегиба выполнена таким образом, чтобы центральный сегмент заворачивался в дистальный сегмент при поступательном перемещении плетеного изделия в дистальном направлении на второе расстояние.
14. Плетеное изделие по п. 12, в котором в развернутом состоянии первая точка перегиба выполнена таким образом, чтобы проксимальный конец дистального сегмента огибал шейку аневризмы; и
при этом в развернутом состоянии вторая точка перегиба выполнена таким образом, чтобы центральный сегмент заворачивался в дистальный сегмент.
15. Плетеное изделие по п. 12, в котором, если первая точка перегиба находится дистальнее микрокатетера, первая точка перегиба выполнена таким образом, чтобы проксимальный конец дистального сегмента огибал шейку аневризмы;
если вторая точка перегиба находится дистальнее микрокатетера, вторая точка перегиба выполнена таким образом, чтобы центральный сегмент заворачивался в дистальный сегмент, а проксимальный сегмент заправлялся в центральный сегмент.
16. Плетеное изделие по п. 12, в котором проксимальный и/или центральный сегмент выполнен (–ы) с возможностью заправления внутрь дистального мешка в развернутом состоянии до тех пор, пока первая точка перегиба не будет расположена смежно с шейкой аневризмы для вызывания эффекта отклонения потока.
17. Способ окклюдирования аневризмы, включающий:
выборочное расположение плетеного изделия на уровне шейки аневризмы или смежно с ней;
перемещение плетеного изделия с возможностью скольжения в дистальном направлении в аневризму;
радиальное расширение дистального сегмента плетеного изделия с образованием дистального мешка внутри аневризмы с возможностью окклюдирования аневризмы;
дальнейшее перемещение плетеного изделия с возможностью скольжения в дистальном направлении в аневризму, таким образом огибая часть дистального сегмента вокруг шейки аневризмы;
дальнейшее перемещение плетеного изделия с возможностью скольжения в дистальном направлении в аневризму, таким образом заворачивая центральный сегмент плетеного изделия в дистальный сегмент;
заправление проксимального сегмента плетеного изделия в центральный сегмент; и
высвобождение плетеного изделия внутри аневризмы.
18. Способ по п. 17, дополнительно включающий:
заправление проксимального сегмента в центральный сегмент, пока точка перегиба между дистальным сегментом и центральным сегментом не будет расположена смежно с шейкой аневризмы или в соединении с ней; и
вызывание эффекта отклонения потока на уровне шейки аневризмы.
19. Способ по п. 17, дополнительно включающий:
расположение первой точки перегиба между дистальным сегментом и центральным сегментом;
расположение второй точки перегиба между центральным сегментом и проксимальным сегментом;
огибание дистального сегмента вокруг шейки аневризмы в первой точке перегиба при поступательном перемещении проксимального конца плетеного изделия в дистальном направлении на первое расстояние относительно шейки аневризмы; и
заворачивание центрального сегмента в дистальный сегмент во второй точке перегиба путем поступательного перемещения проксимального конца плетеного изделия в дистальном направлении на второе расстояние относительно шейки аневризмы.
20. Способ по п. 19, в котором заворачивание центрального сегмента в дистальный сегмент во второй точке перегиба приводит к заправлению центрального сегмента в дистальный сегмент.
RU2019116175A 2018-05-31 2019-05-27 Устройство и система доставки для лечения аневризмы RU2019116175A (ru)

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US15/993,903 US10939915B2 (en) 2018-05-31 2018-05-31 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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CN106974691A (zh) 2008-05-02 2017-07-25 斯昆特医疗公司 用于治疗血管缺损的丝状装置
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US10939915B2 (en) 2018-05-31 2021-03-09 DePuy Synthes Products, Inc. Aneurysm device and delivery system
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JP2019209145A (ja) 2019-12-12
EP3574851A1 (en) 2019-12-04
US10939915B2 (en) 2021-03-09
AU2019203715A1 (en) 2019-12-19
MX2019006377A (es) 2019-12-02
CN110547841A (zh) 2019-12-10
BR102019011023A2 (pt) 2019-12-03
US20190365385A1 (en) 2019-12-05
TW202011898A (zh) 2020-04-01
KR20190137007A (ko) 2019-12-10
CA3044197A1 (en) 2019-11-30

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