WO2002000288A1 - Dispositif de transport pour instrument de transplantation - Google Patents

Dispositif de transport pour instrument de transplantation Download PDF

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Publication number
WO2002000288A1
WO2002000288A1 PCT/JP2000/004194 JP0004194W WO0200288A1 WO 2002000288 A1 WO2002000288 A1 WO 2002000288A1 JP 0004194 W JP0004194 W JP 0004194W WO 0200288 A1 WO0200288 A1 WO 0200288A1
Authority
WO
WIPO (PCT)
Prior art keywords
operating rod
tube
rod
blood vessel
transporting
Prior art date
Application number
PCT/JP2000/004194
Other languages
English (en)
Japanese (ja)
Inventor
Kanji Inoue
Original Assignee
Kanji Inoue
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Kanji Inoue filed Critical Kanji Inoue
Priority to PCT/JP2000/004194 priority Critical patent/WO2002000288A1/fr
Priority to JP2002505066A priority patent/JP4594583B2/ja
Publication of WO2002000288A1 publication Critical patent/WO2002000288A1/fr

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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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • 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
    • 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
    • A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
    • A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires

Definitions

  • the present invention relates to an implanting device belonging to the medical device field (in the present specification and claims, a device to be inserted into a foldable human organ having an elastic restoring force is abbreviated as "implanting device”.)
  • the present invention relates to a transport device.
  • a tubular artificial blood vessel with elasticity that can be restored is inserted in a folded state, transported to a predetermined position near the affected area using a lotus or traction device, and released from the catheter at that position In this way, the artificial blood vessel can be positioned at the blood vessel part causing an aneurysm or the like.
  • a relatively thin tube having a deformable shape and a coil spring connected to a distal end thereof, and a side window provided near a front end of the tube.
  • a transport device is used which comprises a pair of cords having both ends fixed to the vicinity of the side window and a loop formed in the middle, and a wire movably inserted into the tube.
  • the present invention relates to a device for transporting an implanting device comprising an operating rod which can be integrally transported together with the implanting device and can be separated from the implanting device. It is characterized in that the operating rod is further provided with an auxiliary operating rod capable of transmitting an operating force applied to the base end side to the distal end portion of the operating rod directly.
  • the auxiliary operation rod and the operation rod are connected together via a hook mechanism provided on the base end side. It is preferable that it be physically transportable and separable from the operating rod.
  • a pipe member disposed at a position that covers the vicinity of the distal end of the operation rod, and an operating force that is constructed on the pipe member and applied to the base end side, is used as the pipe.
  • a tube for transmitting the vicinity of the tip of the operating rod via a member is used as the pipe.
  • the pipe member includes a large-diameter distal end portion and a small-diameter proximal end portion connected to the proximal end portion and housed in the tube.
  • the lock mechanism includes an inner lock element for selectively locking the base end of the pipe member and the operating rod, and an outer lock element for selectively locking the base end of the pipe member and the tube. Is effective.
  • the pipe member be made of metal and the tube be made of resin.
  • An operating rod is a pair of tube elements that are separated from each other, a tube connecting element that connects the two tube elements in a state where an opening is formed between the two tube elements, and a tube connecting element that extends between the two tube elements.
  • a wire that can pass through the tube element move the wire relative to the tube element, expose the wire from the opening, engage the implanting device with the tip, and then reinsert the tip into the opening. Therefore, if the implanting device is anchored so that it can be transported integrally between the wire and the tube element, a cup-shaped space that opens forward is formed at the tip of the auxiliary operating rod.
  • the distal end portion is fitted to the connecting portion between the tube element on the proximal end side and the tube connecting element.
  • a cup-shaped space that opens rearward is formed in a connecting portion between the tube element on the proximal end side and the tube connecting element.
  • the distal end of the auxiliary operating rod may be inserted into the part, and the distal end of the auxiliary operating rod may be approximately the same diameter as the rear end of the connecting part between the proximal tube element and the tube connecting element.
  • the front end of the auxiliary operating rod may be close to or in contact with the rear end.
  • the transport device is provided with an operating rod that can be transported integrally with the transplant device and that can be separated from the implant device.
  • the operating rod and the auxiliary operating rod are made of a material having elasticity that can be bent, and at least one of the distal ends of the operating rod and the assisting operating rod has a predetermined shape in a state where no external force is applied.
  • an auxiliary operation rod is covered on the outside of the operation rod so that the tip side can be put in and out.
  • the distal end of the operating rod has a curved shape in a state where no external force is applied
  • the distal end of the assisting operating rod has a substantially linear shape in a state where no external force is applied.
  • Each of the rods and the auxiliary operation rod may have a curved shape in a state in which both end sides of the rod and the auxiliary operation rod are applied with no external force.
  • the implanting device has a curved shape when restored at a predetermined position, and that the operating rod has a curved shape substantially matching the curved shape.
  • the transplanting device is transported in a folded state, and an elastic body that promotes contraction of the device main body is provided at a portion located on the small bay side when restored. Things can be mentioned.
  • the transplanting device may have a branch at a site located on the side of the great bay when restored.
  • the distal end of the auxiliary operating rod has a substantially linear shape in a state where no external force is applied, and the distal end of the auxiliary operating rod has a curved shape in a state where no external force is applied.
  • the above transport device is extremely useful especially when applied to an artificial blood vessel which is one of the devices for transplantation.
  • the device for transporting a transplantation device includes an auxiliary operating rod for assisting the operating rod, so that even if the operating rod is fragile because it is flexible, it can be transported to the target position. Until the operating rod can transmit the operating force directly to the tip of the operating rod without relying on the strength of the operating rod itself, it is possible to effectively prevent the inconvenience of the operating rod being bent during transportation. Can be.
  • the auxiliary operation rod can be transported integrally with the operation rod and can be separated from the operation rod via a lock mechanism provided on the base end side, the connection state between the auxiliary operation rod and the operation rod can be improved.
  • the connection can be released at any time through the operation on the base end side, and the auxiliary operation rod can be retracted.
  • the auxiliary operating rod is provided with a pipe member disposed at a position where the distal end of the operating rod is externally provided, and an operating force applied to the proximal end side by connecting the pipe member to the proximal end side through the operating member. If it is composed of a tube that transmits to the distal end of the operating rod, the operating force can be transmitted with the pipe member exteriorly reinforced near the distal end of the operating rod. Build and operate In order to transmit the power to the pipe member, a flexible pipe member is adopted at the part where the operating force is being transmitted, as compared with the case where the strong pipe member is pulled out to the proximal end as it is, so that it can be pulled inside the body. It can be suitably performed.
  • the pipe member is composed of a large-diameter distal end portion and a small-diameter proximal end portion which is constructed on the proximal end side and is accommodated in the tube, it is simple. With this configuration, the reinforcement near the tip of the operating rod can be more securely prevented from being bent, and the pipe member, and eventually the auxiliary operating rod, can be flexibly bent inside the body. Close.
  • the lock mechanism includes an inner lock element for selectively locking the base end of the pipe member and the operating rod, and an outer lock element for selectively locking the base end of the pipe member and the tube.
  • the pipe member is made of metal and the tube is made of resin, the strength of the connecting portion between the operating rod and the catching operating rod can be maintained, and further, the base end side of the auxiliary operating rod It is possible to more suitably transmit the operating force applied to the operating rod to the distal end of the operating rod while securing flexible bending characteristics.
  • the operating rod moves between the two tube elements. Cup that opens forward to the distal end of the auxiliary operating rod when the implanting device is selectively engaged by a wire connected through the If the distal end is fitted to the connecting part between the tube element and the tube connecting element on the base end side, the connecting part between the tube element and the tube connecting element on the base end side can be formed. It is possible to effectively prevent the vicinity of the base end from being bent.
  • the operating rod has the above-described configuration, a cup-shaped space that opens rearward is formed at the connecting portion between the tube element and the tube connecting element on the base end side, and an auxiliary operation is provided in this connecting portion.
  • the distal end of the auxiliary operating rod should be approximately the same diameter as the rear end of the connecting part between the base tube element and the tube connecting element.
  • the tip end of the auxiliary operation rod approaches or abuts the rear end, the same operation and effect as described above can be obtained.
  • the device for transporting the transplanting device is configured such that the operating rod and the auxiliary operating rod are made of a material having elasticity capable of bending, and at least one of the operating rods or the auxiliary operating rods is exposed to an external force. If the auxiliary operating rod is configured so that the distal end of the operating rod can be inserted into and out of the operating rod, the distal end of the operating rod should be connected to the auxiliary operating rod.
  • the operating rod When the operating rod is housed at the distal end of the operating rod, the operating rod is corrected to the shape possessed by the assisting operating rod, but when the distal end of the operating rod protrudes forward from the distal end of the assisting operating rod, In, the operating rod is released from the restraint by the assisting operating rod and returns to its originally given predetermined shape. Therefore, while the operating rod has a shape suitable for fixing the transplantation device to the target site, if such a shape of the operation is not suitable for routing the introduction path in the body, the rescue operation is performed. By temporarily storing the operating rod inside this auxiliary operating rod and making the rod a shape suitable for passing through the introduction path, the operation rod can be transported properly on the introduction path to the target location. can do.
  • the operating rod is housed inside the auxiliary operating rod.
  • the control rod is straightened by the auxiliary control rod and retains a substantially linear shape unless external force is applied, facilitating the feeding operation and preventing the bending characteristics from being biased in a specific direction.
  • the operating rod is sent out of the auxiliary operating rod, the operating rod regains its originally given curved shape, while the operating rod can be suitably handled even if it is curved in various directions without limitation.
  • the transplantation device can be suitably sent to the diseased part by advancing only this operating rod from just before the diseased part. be able to.
  • the distal end of the operating rod has a substantially linear shape with no external force applied
  • the distal end of the auxiliary operating rod has a curved shape with no external force applied
  • the operating rod should be inside the auxiliary operating rod.
  • the operating rod is corrected to the auxiliary operating rod and maintains a curved shape unless external force is applied.
  • the curved shape has the above-mentioned curved shape.
  • the introduction can be performed appropriately.
  • the operation rod is sent out of the catching operation rod, the operation rod returns to the substantially linear shape originally given. Therefore, in a case where the affected part is curved and the affected part itself has a linear shape, the transplantation device can be suitably fed into the affected part by advancing only the operating rod from just before the affected part. .
  • the introduction path to the affected part is curved, and the affected part itself is also curved, but the affected part is curved. This method is useful when applied in cases where the degree and the direction of curvature are different from those of the introduction path.
  • the implanting device has a curved shape when restored at a predetermined position, and the operating rod has a curved shape substantially matching the curved shape, the curved shape of the operating rod and the implanting device And the curved shape of the affected area to be transplanted beforehand, so that the operating rod is sent out from just before the affected area and then interferes with the fixation of the transplantation device to the affected area. It can be performed extremely smoothly without any problem.
  • the transplant device is transported in a folded state.
  • the device body is If an elastic body that promotes contraction is provided, the implanting device can be properly housed in a catheter without the influence of the elastic body when folded, and the catheter can be used. While it is easy to follow the curve when passing through the introduction path inside the body, it can be restored to a predetermined shape after being sent out from the inside of the catheter, so the implanting device has such a form Thereby, the function of the transporting device of the present invention which handles this can be exhibited. If the transplanting device has a branch at the site located on the Great Bay side when it is restored, use the operating rod to place the transplanting device at a curved target location in the body.
  • FIG. 1 is a perspective view showing an artificial blood vessel to which a first embodiment of the present invention is applied.
  • FIG. 2 is a partial longitudinal sectional view of the artificial blood vessel.
  • FIG. 3 is an exploded perspective view showing a part of the transportation device of the embodiment.
  • FIG. 4 is an end view taken along the line A-A in FIG. Fig. 5 (a) and (b) are perspective views schematically showing the same transport equipment.
  • FIG. 6 is a perspective view schematically showing the transport device and the artificial blood vessel.
  • Figure 7 shows It is a perspective view which expands and shows a part of the same conveyance apparatus.
  • FIG. 8 is a diagram schematically showing the transport device.
  • FIG. 9 is a diagram schematically showing a traction device used in the embodiment.
  • FIG. 10 is a perspective view showing a procedure for introducing an artificial blood vessel into the catheter using tweezers in the embodiment.
  • FIG. 11 is a perspective view showing a technique for introducing the artificial blood vessel into a funnel-shaped cylinder using tweezers in the embodiment.
  • FIG. 1.2 is an explanatory view showing a state in which the entire artificial blood vessel is bent in the funnel-shaped cylinder in the embodiment.
  • FIG. 13 is a schematic diagram showing a state where each ring-shaped wire portion is bent in the embodiment.
  • FIG. 14 is a view for explaining a procedure when the artificial blood vessel is transplanted to a target site.
  • FIG. 15 is a view for explaining a procedure for transplanting the artificial blood vessel into a target site.
  • FIG. 16 is a view for explaining a procedure for transplanting the artificial blood vessel into a target site.
  • FIG. 17 is a perspective view showing a modification of the transport device.
  • FIG. 18 is a perspective view showing another modification of the transport device.
  • FIG. 19 is a perspective view showing the holding means used in the second embodiment of the present invention in an expanded state.
  • FIG. 20 is a perspective view showing the holding means in a state before use.
  • FIG. 2.1 is a view for explaining a 'step of folding an artificial blood vessel to which the embodiment is applied.
  • FIG. 22 is a diagram illustrating a procedure for folding the artificial blood vessel.
  • FIG. 23 is a diagram for explaining a procedure for folding the same human blood vessel.
  • FIG. 24 is a diagram illustrating a procedure for folding the artificial blood vessel.
  • FIG. 22 is a diagram illustrating a procedure for folding the artificial blood vessel.
  • FIG. 25 is a view for explaining a procedure for folding the artificial blood vessel.
  • FIG. 26 is a perspective view showing a state where the artificial blood vessel is folded and held by holding means.
  • FIG. 27 is a diagram illustrating a procedure for transplanting the artificial blood vessel into a target site.
  • FIG. 28 is a diagram illustrating a procedure for implanting the artificial blood vessel into a target site.
  • FIG. 29 is a diagram for explaining a procedure when the artificial blood vessel is transplanted to a target site.
  • FIG. 30 is a perspective view showing a modification of the holding means.
  • FIG. 31 is a perspective view showing a procedure for folding the artificial blood vessel of the modification in advance using a string.
  • FIG. 32 is a schematic view showing a transport device according to a third embodiment of the present invention.
  • FIG. 34 is an explanatory view of the operation of the same transport device.
  • FIG. 35 is a schematic view showing a modified example of the transport device.
  • FIG. 36 is an explanatory diagram of the operation of the transportation device.
  • FIG. 37 is an explanatory diagram of the operation of the transportation device.
  • FIG. 38 is a schematic view showing another modified example of the transport device.
  • FIG. 1 shows a state before folding an artificial blood vessel 1 as a transplant device to which the present embodiment is applied.
  • the artificial blood vessel 1 is disposed opposite the front ring-shaped wire portion 2 and the front ring-shaped wire portion 2.
  • Ring-shaped wire rod part 3 the front and rear ring-shaped wire rod parts 2 and 3, and a cylindrical surface material 4 connecting the front and rear ring-shaped wire rod parts 2 and 3, and the intermediate ring member disposed between the front and rear ring-shaped wire rod parts 2 and 3.
  • a ring-shaped wire portion 5 Each of the ring-shaped wire portions 2, 3, 5 is provided with bendable elasticity.
  • the ring-shaped wire portion refers to a wire formed mainly of a material having an excellent elastic restoring force such as a titanium nickel alloy.
  • the dressing material 4 is formed by shaping a flexible and taut sheet into a bellows-like cylinder, and has an inner diameter that is normal to that of the blood vessel to be disposed. It is made to substantially correspond to the cross section of the flow path.
  • the sheet of the covering material 4 is formed by knitting, for example, a warp extending in the axial direction of the artificial blood vessel 1 and a weft extending in the circumferential direction of the artificial blood vessel 1, and the warp yarn is formed of a polyester monofilament (15). Denier) and multifilaments (approximately 50 denier) with extra-fine wires twisted over the weft.
  • a polyethylene yarn of about 10 denier is additionally woven into this weft yarn in order to make the sheet of the cover material 4 thinner and stronger.
  • the outer covering material 4 includes a waterproof coating (collagen) for preventing blood leakage as necessary. N-albumin).
  • the front end 4a or the rear end 4b of the front cover material 4 is sewn or adhered to the front and rear ring-shaped wire portions 2 and 3 at locations corresponding to the attachment positions.
  • the auxiliary ring-shaped wire portions 6 and 7 are fixed.
  • the front and rear auxiliary ring-shaped wire portions 6 and 7 are made of a thinner wire than the front and rear ring-shaped wire portions 2 and 3, and provide the artificial blood vessel 1 with a restoring force and a close contact with the human body. Is to be granted. Then, as shown in Fig.
  • hooks 8 and 9 in this embodiment are formed by strings, it is not always necessary to use strings, and if there is no problem, a hole is directly formed in the surface material 4 and used as a hook. You can also.
  • the front and rear ring-shaped wire portions 2 and 3 are arranged so as to be axially separated from each other and opposed to each other, and are installed so that the inner diameter is slightly larger than the outer diameter of the surface material 4.
  • the first (2) As shown in the figure, it is housed in the bag-like membrane member 10 attached to the front end 4a or the rear end 4b of the facing material 4, and moves back and forth within a certain range relative to the facing material 4. It is possible.
  • the membrane member 10 has a bag-like shape in which the entire front and rear ring-shaped wire portions 2 and 3 are wrapped in an internal space. Attached over the entire circumference, the relative longitudinal movement of the front and rear ring-shaped wire parts 2 and 3 is allowed through the deformation of the membrane member 10, and the annular gap between the front mounting material 4 and the ring material is made liquid-tight. Each is attached by sewing or bonding.
  • the film member 10 used in the present embodiment is made of the same material as the sheet constituting the above-described outer cover material 4.
  • the intermediate ring-shaped wire portion 5 has a configuration in which the outer periphery is covered with a protective film such as a cloth, or a structure in which a coil is wound around the outer periphery in the same manner as the above-described front and rear ring-shaped wire portions 2 and 3.
  • a plurality of the wire materials are arranged at positions where the front and rear ring-shaped wire portions 2 and 3 are substantially equally divided in the longitudinal direction. Then, four portions having the same phase as the front hooking portion 8 on the circumference of the intermediate ring-shaped wire portion 5 are intermittently fixed to the surface material 4 by sewing, bonding, or the like.
  • a cylindrical shape-retaining force is applied to the entire surface material 4 together with the ring-shaped wire portions 2 and 3.
  • Each of the two intermediate ring-shaped wire portions 5 A which are disposed in the vicinity of the two ring-shaped wire portions 2 and 3 at the rear, has an inner diameter similar to that of the front and rear ring-shaped wire portions 2 and 3 described above. It is set to be slightly larger than the outer diameter of the end portion, and is housed in a bag-shaped membrane member 10 that covers the entire end intermediate ring-shaped wire portion 5A.
  • the end intermediate ring-shaped wire portion 5 A can be relatively moved back and forth within a certain range via the membrane member 10 and mounted.
  • the inner circumferential end 10a of the membrane member 10 is sewn or adhered over substantially the entire outer periphery of the outer cover material 4 so that the annular gap between the outer cover material 4 and the material 4 is made liquid-tight. I'm attached.
  • the artificial blood vessel 1 is introduced, for example, into a portion where an aneurysm has been formed to stop the blood flow from flowing into the aneurysm.
  • the artificial blood vessel 1 is inserted into the catheter 12 (see FIG. 14) in a folded state, and inserted into, for example, the base of the thigh, and then, as shown in FIGS. 3 to 8 After transporting the inside of the catheter 12 to the target point shown in Fig. 14 using the transport device 13, it is released from the catheter 12 and, if necessary, the traction device shown in Figs. 9 and 14 After the position is adjusted by pulling backward using 14, a tube-based method of releasing the holding and restoring it to a predetermined shape is adopted.
  • the transport device 13 is made of metal, has deformability, and is integrally transported together with the artificial blood vessel 1.
  • Operating rod 18 which can be separated from artificial blood vessel 1, opening 23 provided near tip 18 a of operating rod 18, and both ends secured to opening 23
  • Two strings 24 forming a loop 24a in the middle of the fixing strap with the string 36, and the operating rod 18 integrally with a lock mechanism 20 provided on the proximal end 13a.
  • the operating force applied to the base end 13a, which is transportable and separable from the operating rod 18 and is externally mounted on the operating rod 18, is directly transmitted to the vicinity of the distal end 18a of the operating rod 18.
  • a catching operation rod 19 to be obtained.
  • the operating rod 18 includes a distal tube element 18 A made of a coil spring for a deformable guide and a proximal tube element 18 A.
  • the element 18B and the tube elements 18A and 18B are separated from each other so as to form an opening 23 between them. It comprises a tube connecting element 18C to be connected, and a wire 25 which can pass through the inside of the tube elements 18A and 18B so as to be movable in the longitudinal direction.
  • the two tube elements 18 A, 18 B are fixed to the tube connection element 18 C by fixing cords 36, 37. Of course, they can be fixed by appropriate means other than such a string.
  • the wire 25 is moved relatively in the longitudinal direction with respect to the tube elements 18 ⁇ and ⁇ 8 ⁇ to expose the tip 25 a from the opening 23, and the cord 24 is connected to the artificial hook.
  • loop 2 4a of string 2 4 The artificial blood vessel 1 is integrally transported to the transport device 13 by engaging the distal end 25a with the distal end 25a and drawing the distal end 25a again through the opening 23 into the distal tube element 18A. Mooring is possible.
  • the tube connecting element 18C is composed of three cylinders arranged adjacent to each other along the outer circumference of both tube elements 18A and 18B, and in the middle of the three cylinders.
  • the cylinder to be located is elongated to extend in the longitudinal direction from the ends of the cylinders on both sides.
  • the auxiliary operation rod 19 includes a metal pipe member 21 disposed at a position where the distal end portion of the tube element 18 B on the base end side of the operation rod 18 can be fitted to the outside, and this pipe member 21. And a tube 22 that transmits the operating force applied to the proximal end 13 a to the vicinity of the distal end 18 a of the operating shuttle 18 via the pipe member 21. .
  • the pipe member 21 has a tube element 18 B on the proximal end side penetrating the interior thereof so as to be movable in the longitudinal direction, and has a distal end.
  • 2 la has a large-diameter portion 21A, as shown in Fig. 3, having a diameter that can fit the connecting portion 18c between the proximal tube element 18B and the tube connecting element 18C.
  • a small-diameter base end 21B accommodated in the tube 22 is fixed to the base end side of the large-diameter portion 21A by a fixing string 38. This string can also be replaced by other fastening means
  • the tube 22 is made of a flexible deformable resin material, As shown also in the cross section in FIG. 4, for example, a large-diameter element having a diameter several times that of the tube element 18 B, and the base end 21 B of the pipe member 21 is elongated in the inner space.
  • the lock mechanism 20 is provided near the base end so as to be movable in the direction.
  • the lock mechanism 20 is an inner lock element for selectively locking the base end 21B of the pipe member 21 and the tube element 18B of the operating rod 18.
  • 20 a and an outer locking element 20 b for selectively locking the base end 2 IB of the pipe member 21 and the tube 22.
  • Fig. 5 (b) shows the unlocked state of both lock elements 20a and 20b.
  • the inner lock element 20a is on both sides of the main body 20aX.
  • a base part 20 a Y is provided which can be expanded and contracted, one of which is positioned on the outer circumference of the base end 21 B of the pipe member 21, and the other is positioned on the outer circumference of the tube element 18 of the operating rod 18.
  • the knob 20 a Z attached to the base part 20 a Y is screwed into the base part 20 a Y, so that the base part 20 a Y is connected to the base end 2 of the pipe member 21.
  • the pipe member 21 and the operation rod 18 can be connected by engaging the tube element 18B of the operation rod 18 or 1B.
  • the operation rod 18 can be free from the pipe member 21.
  • the outer lock element 2 Ob is pulled out from the base end 21 B of the tube element 21 by the knob 20 b Y as described above.
  • a main body 2 O b X that is configured to bite around the outer circumference and is fixed, and a luer lock 20 b Z provided at the base end of the tube 22.
  • the protrusion 20bZ1 is formed which is selectively screwed into the projection. By screwing them, the tube 22 and the pipe member 21B can be connected.
  • the tube can be left while the pipe member 21 remains at that position. It is possible to advance 'only 2 2'.
  • the traction device 14 has two strings 29 corresponding to the number of the rear hooks 9 of the artificial blood tube 1 and an auxiliary operation rod. It has the same configuration as the transporter 13 except that it is not described.
  • the wire 27 is housed in the tube 26, and the wire 27 once pulled out from the opening 28 provided in the tube 26 is connected to the rear auxiliary ring-shaped wire portion 7 on the rear end side.
  • the hook part 9 previously attached to a part is engaged, and the hook part 9 is engaged.
  • the drawing part is drawn into the tube 26 again, so that the rear auxiliary ring-shaped wire part 7 is engaged and held, and the artificial blood vessel 1 is transported as described above.
  • the locking mechanism 20 is locked, and the operating rod 18 and the auxiliary operating rod 19, that is, the operating rod 18 and the base end 21 B of the pipe member 21, the base end 21 B
  • the transport device 13 is inserted into the vascular prosthesis 1 in a state in which the tubing 2 and the tubing 2 2 can be transported integrally, and the four cords 24 are respectively divided into the dividing points 6 a and 6 of the vascular prosthesis 1.
  • the front hooking part 8 which forms a loop previously attached to the four intermediate positions between b, 6c, 6d and the dividing points 6b, 6c, 6d, 6a, as shown in FIG.
  • the loop 24 a of the string 24 is sequentially hooked on the tip 25 a of the wire 25 exposed from the opening 23 of the transport device 13. Thereafter, the artificial blood vessel 1 is transported as shown in FIG. 7 by pushing the distal end 25 a of the wire 25 again into the tube element 18 A on the distal end side of the operating rod 18. In a state of being externally fitted to the rice tub 13, it is moored to the transport device 13 via the front hook 8 and the cord 24. At this time, the distal end 22 a of the tube 22 is located on the proximal side of the rear end of the artificial blood vessel 1 as shown in FIG.
  • the tube 22 has a large diameter of the pipe member 21 when its tip 22a is large. It may be advanced to a position where it contacts the part 21A. By doing so, the connection between the tube 22 and the large-diameter portion 21A becomes stronger.
  • the traction device 14 is inserted into the artificial blood vessel 1 in the same manner as the transport device 13, and in this state, the two strings 29 are respectively hooked to the rear portion of the artificial blood vessel 1. Through 9.
  • the traction device 14 and the artificial blood vessel 1 are moored.
  • the artificial blood vessel 1 is inserted into the cartridge 31 using the funnel-shaped cylinder 30 and the pin set 33.
  • the artificial blood vessel 1 is inserted into the cartridge 31 using the tweezers 33, but the user manually folds the artificial blood vessel 1 into the proper shape without using the tweezers and inserts it. It is also possible. In the following, a method of inserting using tweezers 33 will be specifically described.
  • two points (for example, 6a and 6c) facing each other across the axis among the dividing points 6a, 6b, 6c, and 6d of the artificial blood vessel 1 are positioned forward.
  • the distal end side of the artificial blood vessel 1 is inserted into the funnel-shaped tube 30 so that the top of the artificial blood vessel 1 is applied to the top of the chevron, that is, while applying tweezers 33 along a generatrix passing through these division points 6a and 6c. Enter.
  • the cartridge 31 is crushed flat so that the portions picked up by the tweezers 33, that is, the dividing points 6a and 6c of the pre-ring ring-shaped wire portion 6 of the artificial blood vessel 1 are close to each other.
  • the other dividing points 6 b and 6 d are in contact with the tapered surface of the inner periphery of the funnel-shaped cylinder 30, and the follow-up is restricted. Therefore, when the front auxiliary ring-shaped wire portion 6 reaches the vicinity of one end 31 a of the cartridge 31, the dividing points 6 a and 6 c become the top of the chevron toward the front, and the other ⁇ . The points 6b and 6d become the bottoms of the valleys, and the front catching ring-shaped wire portion 6 is bent into a regular wavy shape as a whole. Further, the other ring-shaped wire portions 2, 5, 5A, 6, 7 are also bent in the same phase.
  • each hooking part 8 is not shown in FIG. 10 but is moored to the transport device 13 via the string 24 as shown in FIGS. 11 and 12. It is in the state that was done.
  • a different string is introduced from the side of the cartridge 31 and passed through the front hooking portion 8 of the artificial blood vessel 1, and the artificial blood vessel 1 is pulled into the cartridge 31 by pulling this string. It is also effective to draw in
  • the artificial blood vessel 1 folded as described above is transported to a target position in the body, that is, to the diseased part 34.
  • a catheter 12 having a sealing mechanism 12a on the proximal side is introduced into the body from the hip artery at the base F of the foot, and the distal end is aneurysm. And so on.
  • attach the cap 31 a attached to the cartridge 31 shown in FIG. By pushing the cartridge 31 into the catheter 12, the cartridge 31 is connected to the proximal end of the catheter 12 through the sealing mechanism 12 a in a liquid-tight manner, and the feeding operation to the transport device 13 is performed.
  • the artificial blood vessel 1 is moved from the cartridge 31 to the catheter 12 and is further pushed toward the affected part 34.
  • the situation during this time is described in detail in the above-mentioned document ⁇ PCT / JP96 / 013477 (International Publication No. W096 ⁇ 3663887) ⁇ .
  • the traction device 14 moves following the movement of the artificial blood vessel 1 .
  • the lock mechanism 20 provided at the base end 13a of the transport device 13 and the base end 14a of the traction device 14 are maintained at positions extended outside the body via the seal mechanism 12a. I have.
  • the inner lock element 20a and the outer lock element 20b that constitute the lock mechanism 20 are locked, and the auxiliary operation rod 19 and the operation rod 18 are conveyed integrally. Therefore, the operating force applied to the proximal end of the tube 22 is directly transmitted to the vicinity of the distal end 18 a of the operating rod 18 via the proximal end 21 B of the pipe member 21.
  • the pipe member 21 and the operating rod 18 or the pipe section are provided via the inner lock element 20a and the outer lock element 20b of the lock mechanism 20.
  • the lock between the material 21 and the tube 22 can also be released.
  • the lock between the pipe member 21 and the tube 22 is released via the outer lock element 20b, and only the tube 22 is retracted. It is also possible to carry out the transport operation only with the pipe member 21.
  • the catheter 12 is retracted while the artificial blood vessel 1 is held at that position via the transport device 13. Then, the artificial blood vessel 1 is released from the catheter 12. Before and after this, if necessary, the artificial or blood vessel 1 can be pulled backward by using the pulling device 14 to adjust the arrangement position and the like.
  • FIG. 16 shows a state in which the artificial blood vessel 1. is brought into close contact with the blood vessel as a result.
  • the reason why the ring-shaped wire sections 2, 3, 5, 5A, 6 etc. are not restored to a perfect circle is that the ring-shaped wire sections 2, 3, 5, 5A follow the pulsating blood vessels. , 6 etc. show the state in which a slight scaling operation is caused.
  • the wire 25 is pulled out at the proximal end 13 a of the transport device 13, and further, the wire 27 is pulled out at the proximal end 14 a of the traction device 14, thereby engaging with the artificial blood vessel 1. Is released, and the transport device 13 and the traction device 14 are finally taken out of the body.
  • the affected area 3 4 Therefore, the artificial blood vessel 1 is restored after the transplantation, and functions effectively as a means for preventing occlusion of the blood vessel in the affected part 34.
  • the transport device 13 composed of the operating rod 18 and the wire 25 is detachably engaged with the artificial blood vessel 1 in advance, as shown in Fig. 6, the user can transport it every time. Since the labor of setting the device 13 in the artificial blood vessel 1 can be omitted, the catheter 13 can be immediately inserted into the catheter 12 and used on site.
  • the transport device 13 for the artificial blood vessel 1 is provided with the auxiliary operation rod 19 for catching the operation rod 18, even if the operation rod 18 is flexible, it is fragile. Until it is transported to the target position, the operating force can be directly transmitted to the vicinity of the tip of the operating rod 18 without relying on the strength of the operating rod 18 itself, and the operating rod 18 bends during transportation. Inconvenience can be effectively prevented.
  • auxiliary operation rod 19 can be integrally transported together with the operation rod 18 via the lock mechanism 20 provided on the base end 13a and can be separated from the operation rod 18, The connection between the operating rod 19 and the operating rod 18 can be ensured. If the auxiliary operating rod 19 becomes unnecessary, the connection can be released at any time through the operation on the proximal end 13a. As a result, the auxiliary operation rod 19 can be retracted.
  • the auxiliary operating rod 19 is moved to the tip 18 a of the operating rod 18.
  • a pipe member 21 disposed at a position where the pipe can be fitted to the outside, and an operating force applied to the base end side by connecting the pipe member 21 with the operating member 1 through the pipe member 21. Since it is composed of the tube 22 that transmits near the distal end 18a of the operating rod 8, the operating force is transmitted in a state in which the vicinity of the distal end of the operating rod 18 is reinforced by externally fitting the pipe member 21.
  • a separate tube 22 is connected to the pipe member 21 to transmit the operating force to the pipe member 21, when the strong pipe member 21 is pulled out to the proximal end side as it is.
  • the flexible pipe member 21 which is flexible in the middle of the transmission of the operation force, it is possible to suitably perform the routing in the body.
  • a pipe member 21 is connected to a large-diameter portion 21 A at the distal end thereof and a proximal end of the large-diameter portion 21 A, and has a small-diameter proximal end accommodated in the tube 22.
  • a lock mechanism 20 for selectively locking the base end of the pipe member 21 and the operating rod 18, and a lock mechanism 20 for the pipe member 21 Since it is composed of the outer lock element 20 b for selectively locking the base end and the tube 22, the pipe member 21 and the tube 22 constituting the auxiliary operation rod 19 are bidirectional. Can be more securely connected to the operating rod 18 and can be easily released as required by operating both lock elements 20a and 2Ob. it can.
  • the pipe member 21 is made of metal and Since the valve 22 is made of resin, the strength of the connection between the operating rod 18 and the auxiliary operating rod 19 can be maintained. It is possible to more suitably transmit the operating force to the vicinity of the tip of the operating rod 18.
  • the pipe member 21 constituting the catching operation rod 19 is externally fitted to the connecting portion between the tube element 18B and the tube connecting element 18C on the proximal side, the tube on the proximal side is fitted. It is possible to effectively prevent the vicinity of the base end side of the connecting portion between the tube element 18B and the tube connecting element 18C, for example, bending of a region indicated by a symbol X in FIG.
  • the tube connecting element 18C is made up of three cylinders, and the central cylinder is longer than the others, so that both tube elements 18A, 1 When 8B is used in a curved state, no excessive force is applied to the connecting portion 18c of the tube connecting element 18C and the connecting portions 18A and 18B of the tube and the connecting portion 18c.
  • the elastic force of the entire tube connecting element 18C changes smoothly in the long-hand direction around c, and a natural bending state can be secured between the tube elements 18A and 18B.
  • the connecting portion between the tube element 1 18B on the proximal end of the operating rod 1 18 B and the tube connecting element 1 18 C with a cup-shaped cylindrical body 1 18 BB that opens rearward. It may be configured such that the tip end 121 a of the pipe member 121 of the catching operation rod 119 is inserted into the inside of the cylindrical body 118BB.
  • the transport device 2 13 has a connecting portion 2 1 between the tube element 2 18 B on the base end side of the operating rod 2 18 and the tube connecting element 2 18 C.
  • the configuration may be such that 8c and the tip 22A of the pipe member 221 of the auxiliary operation rod 219 are brought close to each other. Even with such a configuration, the same operation and effect as the above embodiment can be obtained.
  • the tip 222 of the pipe member 221 does not necessarily have to have a large diameter, so that it is not necessary to use a special member for the pipe member 221.
  • the auxiliary operation rod for assisting the operation rod is composed of, for example, the pipe member 21 and the tube 22 in the first embodiment.
  • the pipe member 21 or only the tube 22 is used.
  • the tube 22 a so-called balloon catheter can be used.
  • the transport device may be configured with only the operating rod and a wire penetrating the inner periphery thereof without using a string.
  • the front hook portion of the artificial blood vessel may be formed large, and the front hook portion may be engaged with the wire.
  • the basic artificial blood vessel 1 to which this embodiment is applied and the method of folding the same are almost the same as those in the above embodiment, but from the introduction into the catheter 12 to the release from the catheter 12 at the target position. This process is performed in a state where the artificial blood vessel 1 is folded and held by the holding means 11 as shown in FIG. 27, and the holding state of the holding means 11 is released after release. This is different from the first embodiment.
  • the holding means 11 includes a wrapping material 15 and a linear body 16 which holds the wrapping material 15 in a cylindrical shape.
  • the encapsulating material 15 is for encapsulating the artificial blood vessel 1, and is a stretchable material in which the warp and the weft are woven in a mesh shape as shown in FIG. It becomes almost flat when deployed. Each intersection of the warp and the weft intersects and is woven, and the eyes formed between the intersections expand and contract, thereby realizing the elasticity of the entire wrapping material 15 in the vertical and horizontal directions. It is a manifestation.
  • the linear body 16 is a flexible material made of a nickel-titanium alloy, and the edges of the encapsulating material 15 are overlapped so that the whole becomes substantially cylindrical as shown in FIG.
  • the encapsulating material 15 is held in a cylindrical shape by passing through the linear body 16 so as to sew the overlapped edges 15a and 15b in a broken line shape.
  • the artificial blood vessel 1 is folded by using a cylindrical member 331 having a funnel-shaped cylinder 330 at one end as shown in FIG. 21 inside the wrapping material 15 of the holding means 11. Housed in
  • a tapered surface 3 3 From the front end side of the guide member 3 32 having 2 A, the wrapping material 15 is externally fitted, and is wrapped around the outer periphery of the cylindrical member 33 1 as shown in FIG. . Then, as shown in FIG. 23, the artificial blood vessel 1 is folded and inserted from one end 33 1 a side of the cylindrical member 33 1 along the taper ⁇ of the funnel-shaped cylinder 33. In addition, a transport device 13 is used to move the human blood vessel 1 within the tubular member 331.
  • the two points 6a, 6c facing each other across the axis of the dividing points 6a, 6b, 6c, and 6d of the artificial blood vessel 1 are forward.
  • the leading end of the artificial blood vessel 1 is moved forward by the carrier I draw toward it.
  • the front auxiliary ring-shaped wire portion 6 is directed forward, and the division points 6a and 6c are the tops of the ridges, and the other division points 6b and 6d are the bottoms of the valleys, as a whole. It is folded in a regular wave shape.
  • the other ring-shaped wire portions 2, 5, 5A, 6, 7 are also bent in the same phase.
  • the four front hooks 8 formed in the middle between the dividing points 6a, 6b, 6c, 6d and the dividing points 6b, 6c, 6d, 6a have a chevron shape toward the front. It will be located between the top and the bottom of the valley. In this way, as shown in FIG. 23, the artificial blood vessel 1 is loaded in a folded state on the inner periphery of the force cartridge 331, which corresponds to the mounting position of the enclosing material 15.
  • the wrapping material 15 and a part of the artificial blood vessel 1 are simultaneously picked with a finger at a position indicated by an arrow p in FIG. 24.
  • the cartridges 331, 31 are retracted with respect to their restraints, and the wrapping material 15 and the artificial blood vessel 1 are simultaneously removed from the cartridge 331, respectively. Therefore, the artificial blood vessel 1 is inserted into the inside of the wrapping material 15 sequentially.
  • FIG. 25 by completely removing the cartridge 331, the artificial blood vessel 1 is accommodated in the encapsulating material 15 in a folded state.
  • FIG. 26 shows the artificial blood vessel 1 folded by the holding means 11 as described above.
  • the target position that is, an introduction procedure for transporting to the affected part 34 and transplanting it will be described.
  • a catheter 12 having a sealing mechanism 12a on the proximal side is introduced into the body from the hip artery at the base F of the foot, and the distal end is inserted into the artery. Position it near the affected area 34 causing the aneurysm.
  • the artificial blood vessel 1 folded by the holding means 11 is introduced into the catheter 12 together with the transport device 13 and the traction device 14.
  • the feeding operation is performed on the transport device 13, and the artificial blood vessel 1 is attached to the traction device 14. In this state, it is transported to the target affected part 34.
  • one end 16 a of the linear body 16 of the holding means 11, the locking mechanism 20 provided on the base end 13 a of the transport device 13, and the base end 14 a of the pulling device 14 are It extends out of the body via the sealing mechanism 12a.
  • the artificial blood vessel 1 is transported to the vicinity of the affected part 34 by the transport device 13 with the lock mechanism 20 locked. Then, the artificial blood vessel 1 is released from the force catheter 12. Since the artificial blood vessel 1 is kept in the folded state by the holding means 11 even after the release, it is not always necessary to release the artificial blood vessel at a predetermined position.After the release, the transport device 13 and the traction device 14 are used as necessary. The position can be adjusted using.
  • Fig. 28 As shown in (1), the linear body 16 holding the wrapping material 15 of the holding means 11 is pulled out.
  • one end 16a of the linear body 16 is pulled to release the constraint of the encapsulating material 15 on the artificial blood vessel 1, and each part of the artificial blood vessel 1 is sequentially inflated by ⁇ .
  • the affected part 34 is restored to a state in which it adheres to the inner wall of the blood vessel.
  • FIG. 29 shows a state in which the artificial blood vessel 1 is brought into close contact with the blood vessel as a result.
  • the wire 25 of the transport device 13 and the wire 27 of the traction device 14 are pulled out to release the engagement with the artificial blood vessel 1 and the transport device ⁇ 3
  • the traction device 14 is taken out of the body.
  • the dissociated wrapping material 15 can be left in place with the artificial blood vessel 1 ′, and only the linear body 16 needs to be removed, but if necessary, the wrapping material 15 is separately captured and taken out of the body You can also.
  • the artificial blood vessel 1 is restored after transplantation and functions effectively as a means for preventing occlusion of the blood vessel at the diseased part 34, and the same effect as in the first embodiment is obtained.
  • the artificial blood vessel 1 is folded by the encapsulating material 15 to maintain the state, deformation during the transportation of the artificial blood vessel 1 can be more reliably prevented.
  • the artificial blood vessel 1 is tied in the same manner, if the entire artificial blood vessel 1 is surrounded by such a wrapping material 15, the outer surface of the folded artificial blood vessel 1 will be locally localized. Protrusion is unlikely to occur.
  • the resistance during transportation can be reduced as much as possible, and furthermore, if the wrapping material 15 is deployed at the diseased part 34, which is the target position, the area around the folded artificial blood vessel 1 is widely opened.
  • the returning operation of the blood vessel 1 to the predetermined shape can also be promptly performed.
  • the holding means 11 in this way, the work of folding the artificial blood vessel 1 is not required each time it is used, so that the operation of introducing the artificial blood vessel 1 into the catheter 12 can be performed quickly. It is possible to do.
  • the wrapping material 15 is held in a cylindrical shape by sewing with the linear material 16 and the wrapping material 15 can be developed by pulling out the linear material 16. Therefore, the wrapping material 15 can be easily held in a wound state, and furthermore, the holding state of the wrapping material 15 can be achieved by pulling and pulling the linear body 16 in the longitudinal direction at hand. Can be directly released with a relatively small resistance. In addition, such a release operation can be reliably performed even from a remote location.
  • the holding means 4 11 for holding the artificial blood vessel 1 in a folded state may be as shown in FIGS. 30 and 31. That is, at the position where each of the ring-shaped wire portions 2, 3, 5A, and 5 of the artificial blood vessel 1 is attached, a pair of folds are formed in the ring-shaped wire portions 2, 3, 5A, and 5. Attach the lace 4 1 6a. Specifically at the end This will be described with reference to the intermediate ring-shaped wire portion 5A. First, the center portion of the string 4 16a is hooked on a surgical needle or the like and held in a folded state. Then, the string 4 16 is intermittently sewn clockwise to the middle ring-shaped wire portion 5A at the end as shown in Fig.
  • the holding rod 4 17 has a configuration in which a wire 4 17 b is passed through the inner periphery of the tube 4 17 a, and after holding the artificial blood vessel 1 in a folded state, 'Pull out tube 4 17 a and leave only wire 4 17 b.
  • the artificial blood vessel 1 folded in this manner is transported to the vicinity of the affected part 34 via a catheter as in the first embodiment, and the folding is released by pulling out the wire 4 17 b of the holding rod 4 17. Being restored.
  • the holding means 4 11 having such a configuration, the same effects as in the second embodiment can be obtained.
  • One continuous string may be used for this string.
  • a wire is arranged along the artificial blood vessel, and a string whose one end is fixed to an appropriate part of the artificial blood vessel is wound around the wire clockwise and counterclockwise sequentially to form the end of the string. Insert a loop or the like through the wire. Even in this case, the restraint of the artificial blood vessel by the string can be released remotely by pulling out the wire.
  • an artificial blood vessel is previously folded and housed in a pipe or the like, and the holding is released when the artificial blood vessel is introduced into a catheter.
  • handling can be improved sufficiently.
  • This embodiment is different from the first and second embodiments in that the shape of the artificial blood vessel 301 and the shapes of the operating rod 3118 and the auxiliary operating rod 319 constituting the transport device 313 are different from those of the first and second embodiments. This is almost the same as the first and second embodiments.
  • the transport device 3 13 is, for example, a curved and branched branch artery or brachiocephalic artery as schematically shown in FIG. It is used for transporting the artificial blood vessel 301 to the affected part 334 having a curved shape.
  • the operating rod 318 and the auxiliary operating rod 319 are tube-shaped made of a bendable elastic material. As shown in FIGS. 33 to 34, the operating rod 318 has a curved portion that forms a curved shape without applying any external force to the distal end side thereof, that is, the portion that covers the artificial blood vessel 301. The degree of curvature is approximately matched to the curved shape of the affected part 334 to be transplanted.
  • the auxiliary operation rod 319 has a substantially straight shape with no distal force applied to the distal end side. An auxiliary operation rod 319 is formed so as to cover the outside of the operation rod 318 so that the distal end can be inserted and removed.
  • the artificial blood vessel 301 to which the transport device 3 13 is applied is transported in a folded state, as in the first and second embodiments described above. It has a curved shape, and the degree of curvature is approximately matched to the curved shape of the affected part.
  • This is provided with an elastic body 351, which promotes the contraction of the main body of the artificial blood vessel 301 at the site located on the small bay side 301a when restored, and as shown in Fig. 34.
  • a branch 350 having substantially the same shape as the branch blood vessel existing on the large bay side of the diseased part 334 is provided at the site located on the large bay side 301b when restored.
  • the operating rod 3 18 With the operating rod 3 18 having such a configuration, as shown in FIG. 32, the operating rod 3 18 When it is accommodated, it becomes a substantially linear state similar to the first and second embodiments, and by holding and operating the auxiliary operation rod 31.9, the transportation of the artificial blood vessel 301 in the body is performed in the first and second embodiments. It can be performed easily and completely as in the second embodiment.
  • the auxiliary operating rod 319 is externally attached to the operating rod 318, that is, as shown in FIG. 32, the auxiliary operating rod 319 and the operating rod 318 are substantially linear.
  • the folded artificial blood vessel 301 is transported to a position just before the diseased part 3334 at the target position. Then, as shown in FIG.
  • the operation rod 3 18 anchoring the folded artificial blood vessel 301 is moved forward with the catching operation ⁇ 3 19 standing behind,
  • the curved portion 318a contained in the inside of the operating rod 3 19 is released from the support by the auxiliary operating rod 3 19 and returns to a curved shape. Therefore, the artificial blood vessel 301 wrapped around the operating rod 318 is also arranged along the curved portion 318a, and transplantation to the curved diseased portion 334 is more suitable. Will be able to do so.
  • the branch 350 of the artificial blood vessel 301 is drawn into an appropriate branch blood vessel using a catcher or the like.
  • the transporting device 3 13 of the present embodiment has the operating rod 3 18 in a state where the distal end of the operating rod 3 18 is accommodated in the distal end of the auxiliary operating rod 3 19.
  • the shape is corrected to a substantially linear shape, which is the shape of the auxiliary operation rod 3 19, but when the distal end of the operation 3 18 is projected forward from the distal end of the auxiliary operation rod 3 19, The operating rod 3 18 is released from the restraint by the assisting operating rod 3 19 and returns to its original curved shape.
  • the operating rod 318 has a shape suitable for fixing the artificial blood vessel 301 to the affected area 334, which is the target site, while such a shape of the operating rod 318 is introduced into the body.
  • auxiliary operation rod 319 into a substantially linear shape suitable for passing through the introduction path, and temporarily put the operation rod 318 inside this auxiliary operation rod 319.
  • the operating rod 318 when the operating rod 318 is housed inside the auxiliary operating rod 319, the operating rod 318 is substantially straight unless corrected by the assisting operating rod 319 and an external force is applied. In order to maintain the steering angle, it is possible to prevent the bending characteristic from being biased in a specific direction and to appropriately cope with the case where the introduction path is bent in an unspecified direction. When sent out of 19, the operating rod 3 18 regains its originally given curved shape. For this reason, the degree of curvature is provided in advance. If the degree of curvature of the affected part 3 3 4 is set to correspond to the degree of curvature of the affected part 3 34, the artificial rod 3 18 can be moved forward from just before the affected part 3 3 The blood vessel 301 can be suitably sent to the patient 3334.
  • the artificial blood vessel 301 has a curved shape when restored at the diseased part 334, and the operating rod 318 has a curved shape that substantially matches the curved shape.
  • the curved shape of the rod 318 and the curved shape of the artificial blood vessel 301 are both approximately matched to the curved shape of the diseased part 3 3 4 to be transplanted in advance, so that the operating rods 3 and 18 are sent out from just before the diseased part 3 3 4 and then the artificial blood vessel to the diseased part 3 3 4 3 0 1-Fixing can be performed extremely smoothly 5 without causing interference with each other.
  • the artificial blood vessel 301 is transported in a folded state, when restored, the elasticity that promotes the contraction of the artificial blood vessel 301 at the part located on the small bay side 3 O la Body 3 5 1 is provided. Therefore, when the artificial blood vessel 301 is folded, the influence of the elastic body 351 is eliminated when folded, so that the artificial blood vessel 301 can be suitably accommodated inside the force catheter, and the catheter can be placed inside the body.
  • the elastic body 35 1 can return to a predetermined curved shape by the action of the elastic body 35 1 after being sent out from the catheter.
  • the artificial blood vessel 301 is provided with a branch 350 at a site located at the side of the large bay at the time of restoration, the artificial blood vessel 301 is located at the curved diseased part in the body.
  • the branch 350 always faces a predetermined direction. For this reason, when it is necessary to start over because branch 350 has turned 25 different directions after introduction, Failures are less likely to occur.
  • the shapes of the operating rods 318 and the auxiliary operating rods 319 are not limited to those in the above-described embodiment.
  • the distal end of the auxiliary rod 419 may have a substantially linear shape with no external force applied, and the distal end of the auxiliary operating rod 419 may have a curved shape with no external force applied.
  • the same effects as in the third embodiment can be obtained.
  • the operating rod 418 is housed inside the auxiliary operating rod 419.
  • the operating rod 4 18 is curved by the auxiliary rod 4 19 and maintains a curved shape unless external force is applied, so that the introduction path to the affected part 4 3 4 is curved. If the above-mentioned curved shape is made to conform to the degree of curvature, the introduction can be performed appropriately, and the operation rod 4 18 can be replaced with the auxiliary operation rod 4 1, as shown in FIGS.
  • each of the distal ends of the operating rod 5 18 and the auxiliary operating rod 5 19 may have a curved shape with no external force applied. Even with such a configuration, the same effects as those of the third embodiment and the above-described modification can be obtained. Furthermore, this method is useful when the introduction path to the affected area is curved and the affected area itself is also curved, but the degree of curvature of the affected area and its bending direction are different from those of the introduction path. It becomes something.
  • the artificial blood vessel has a single front ring-shaped wire portion and two rear ring-shaped wire portions facing each other in parallel.
  • the surface material branches into a forked shape and the front ring-shaped wire portion and the rear ring-shaped wire portion are separated.
  • the connection between the ring-shaped wire portion and the ring-shaped wire portion may be Y-shaped.
  • the transport devices 13, 11 3, 21 3, and 31 3 used in the above embodiments are used to pull various devices other than the artificial blood vessels 1 and 301, such as patches for closing holes in the heart. It can be applied when it is introduced into the body. Industrial applicability
  • the device for transporting an implantable device according to the present invention can be suitably used for pulling various devices including artificial blood vessels and transporting them in the body.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un dispositif de transport pour un instrument de transplantation, équipé d'un levier de commande (18) pouvant être déplacé de manière intégrale le long d'un instrument de transplantation (1) et séparé dudit instrument (1). Ce dispositif est caractérisé en ce qu'il est également doté d'un levier de commande auxiliaire (19), enveloppé avec le levier de commande (18) et capable de transmettre directement à l'extrémité de la pointe du levier de commande (18) une force de manoeuvre appliquée à l'extrémité de la base.
PCT/JP2000/004194 2000-06-26 2000-06-26 Dispositif de transport pour instrument de transplantation WO2002000288A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/JP2000/004194 WO2002000288A1 (fr) 2000-06-26 2000-06-26 Dispositif de transport pour instrument de transplantation
JP2002505066A JP4594583B2 (ja) 2000-06-26 2000-06-26 移植用器具の運搬装置

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2000/004194 WO2002000288A1 (fr) 2000-06-26 2000-06-26 Dispositif de transport pour instrument de transplantation

Publications (1)

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WO2002000288A1 true WO2002000288A1 (fr) 2002-01-03

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JP (1) JP4594583B2 (fr)
WO (1) WO2002000288A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
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JP2005535364A (ja) * 2002-05-29 2005-11-24 ウイリアム エー．クック オーストラリア ピティワイ、リミティド． プロテーゼ留置装置用トリガー・ワイヤ・システム
JP2006506107A (ja) * 2002-06-28 2006-02-23 クック　インコーポレイティド 胸部用イントロデューサ
JP2012507344A (ja) * 2008-10-31 2012-03-29 ウィリアム クック ユーロープ アーペーエス 湾曲した管腔内にステント移植片を配備するための導入器及びそのためのステント移植片
AU2007249385B2 (en) * 2006-05-09 2012-09-13 The Curators Of The University Of Missouri Plant artificial chromosome platforms via telomere truncation
JP2013517910A (ja) * 2010-01-29 2013-05-20 クック メディカル テクノロジーズ エルエルシー 機械的に拡張可能な給送装置及び拡張装置
CN108852556A (zh) * 2018-09-14 2018-11-23 武汉麦迪领科医疗科技有限公司 一种用于人工血管的卡箍定位和固定的装置
JPWO2020202715A1 (fr) * 2019-03-29 2020-10-08

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JP2005535364A (ja) * 2002-05-29 2005-11-24 ウイリアム エー．クック オーストラリア ピティワイ、リミティド． プロテーゼ留置装置用トリガー・ワイヤ・システム
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JP4743836B2 (ja) * 2002-06-28 2011-08-10 クック インコーポレイティド 胸部用イントロデューサ
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CN108852556B (zh) * 2018-09-14 2024-01-30 武汉领科医疗管理合伙企业(有限合伙) 一种用于人工血管的卡箍定位和固定的装置
JPWO2020202715A1 (fr) * 2019-03-29 2020-10-08
WO2020202715A1 (fr) * 2019-03-29 2020-10-08 株式会社カネカ Dispositif de distribution de corps tubulaire médical
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