WO2010137583A1 - 管状治療具留置装置及び管状治療具留置装置用先端チップ - Google Patents
管状治療具留置装置及び管状治療具留置装置用先端チップ Download PDFInfo
- Publication number
- WO2010137583A1 WO2010137583A1 PCT/JP2010/058818 JP2010058818W WO2010137583A1 WO 2010137583 A1 WO2010137583 A1 WO 2010137583A1 JP 2010058818 W JP2010058818 W JP 2010058818W WO 2010137583 A1 WO2010137583 A1 WO 2010137583A1
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- Prior art keywords
- tip
- tubular treatment
- sheath
- treatment instrument
- placement device
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Classifications
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- 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
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
-
- 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
- A61F2/07—Stent-grafts
-
- 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
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
- A61F2002/9665—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
Definitions
- the present invention relates to a tubular treatment device such as a stent or a stent graft used for treating an aneurysm or the like in order to treat an arterial dilatation disease (aneurysm), an arterial stenosis disease or other disease occurring in a blood vessel or lumen.
- the present invention relates to a tubular therapeutic device indwelling device and a distal tip for a tubular therapeutic device indwelling device for safely and surely indwelling an affected part.
- a stent is a tubular medical device used to expand a stenosis and secure a necessary lumen region when a blood vessel or other in-vivo lumen is narrowed or occluded.
- the structure is formed in a cylindrical shape (tubular shape) while being folded back into a zigzag shape or in a mesh shape.
- a stent graft is formed by covering and stitching a cylindrical body made of, for example, polyester on the inside or outside of a cylindrical stent.
- the stent graft is inserted into the body with a small diameter, delivered to the affected area where an aneurysm or the like has occurred, and expanded and placed in the radial direction at the affected area, so that the stent graft becomes a kind of artificial blood vessel.
- the aneurysm can be closed and the blood channel can be secured.
- a stent graft indwelling device in which a tip is disposed at the tip of a rod member (also referred to as a pushing rod or a dilator) has been known (for example, Patent Document 1). See ⁇ 3.) A hook engaging groove that can be engaged with a hook attached to the distal end portion of the stent graft is formed in the distal tip.
- the engaged state is released after positioning the stent graft indwelling position in the engaged state.
- the stent graft By moving the distal tip, the stent graft can be placed relatively easily at the target position.
- the conventional stent graft indwelling device has the following problems. That is, in the conventional stent graft indwelling device, when the distal end portion of the tubular sheath that accommodates the stent graft is sealed with the distal tip, the hook engaging groove is exposed to the outside. May be caught on the blood vessel wall or the like, damaging the blood vessel or the like, or releasing the wall thrombus or wall atheroma.
- Such a problem is not limited to the stent graft placement device.
- a tubular treatment instrument placement device for placing a tubular treatment tool other than a stent graft such as a stent placement device for placing a radially expandable stent in the affected part.
- the present invention has been made to solve such problems found by the present inventors, and is a tubular treatment instrument placement device for placing a tubular treatment tool such as a stent or a stent graft in an affected area.
- An object of the present invention is to provide a tubular treatment instrument placement device and a distal tip for a tubular treatment tool placement device capable of suppressing the occurrence of damage to blood vessels and the like and the release of mural thrombus and mural atheroma.
- the tubular treatment instrument indwelling device 1 of the present invention comprises: A tubular treatment instrument placement device 1 for delivering a radially expandable tubular treatment tool SG to an affected area and placing it in the affected area, A tubular sheath 10 having flexibility and configured to accommodate the tubular treatment device SG; A rod member 30 configured to move inside and outside the sheath 10 along the axial direction of the sheath; A distal end tip 40 provided with an engaged portion 42 which is disposed at the distal end portion of the rod member 30 and can be engaged with an engaging portion H provided in the tubular treatment instrument SG; The distal tip 40 is capable of sealing the distal end portion of the sheath 10 in a state where the tubular treatment tool SG is engaged, and The engaged portion 42 is formed at a position hidden within the sheath 10 when the distal end portion of the sheath 10 is sealed with the distal tip 40.
- the engaged portion 42 of the distal tip 40 is formed at a position hidden within the sheath when the distal portion of the sheath 10 is sealed with the distal tip. Therefore, the engaged portion 42 is not exposed to the outside when moving in the blood vessel or the like. As a result, it is possible to suppress the engaged portion 42 from being caught on the blood vessel wall and damaging the blood vessel or the like, or releasing the wall thrombus or wall atheroma.
- tubular treatment instrument indwelling apparatus of the present invention a tubular treatment instrument indwelling apparatus capable of suppressing the occurrence of damage to blood vessels and the like and the release of mural thrombus / mural atheroma is provided.
- the distal tip 40 is disposed on the distal end side and formed so that the outer diameter increases from the distal end side toward the proximal end side.
- the joining portion 42 is preferably formed on the body portion 54.
- the engaged portion 42 can be hidden in the sheath by covering the body portion 54 with a sheath 10 up to a predetermined position (a position closer to the distal end than the position of the engaged portion). It becomes possible.
- the body portion 54 is formed with a groove portion 66 extending from the base end portion 56 toward the distal end side taper portion 52. Is preferred.
- the engaged portion 42 is preferably a groove having a predetermined depth.
- the hook H can be reliably hooked with a relatively simple configuration by configuring as described above. Further, since the engaged portion 42 is a groove having a predetermined depth (hook engaging groove), the outer diameter of the tip is increased as compared with the case where the engaged portion is a protrusion having a predetermined height. Nor.
- the proximal end portion 56 has an outer diameter that decreases from the distal end side toward the proximal end side. It is preferably formed in a tapered shape.
- This configuration facilitates insertion of the distal tip when the distal tip 40 is inserted into the sheath 10.
- the distal tip 40 for a tubular treatment instrument indwelling device of the present invention comprises: A distal end side tapered portion 52 disposed on the distal end side and formed so that an outer diameter increases from the distal end side toward the proximal end side; a proximal end portion 56 disposed on the proximal end side; and the distal end side tapered portion And a body portion 54 disposed between the base end portion and an engaged portion 42 that is engageable with an engaging portion H provided on the tubular treatment instrument SG is formed on the body portion 54. It is characterized by.
- the distal tip 40 for the tubular treatment instrument placement device of the present invention since the engaged portion is formed in the trunk portion, the distal tip of the present invention is attached to the tubular treatment device placement device, and the trunk portion By covering with a sheath up to a predetermined position (position closer to the distal end than the position of the engaged portion), the engaged portion can be hidden in the sheath.
- the distal tip of the present invention for the tubular treatment device placement device the engaged portion is not exposed to the outside when moving in the blood vessel or the like, and therefore the engaged portion is caught on the blood vessel wall or the like.
- the engaged portion 42 is preferably a groove having a predetermined depth.
- the hook can be reliably hooked with a relatively simple structure by configuring as described above. Further, since the engaged portion is a groove having a predetermined depth (hook engaging groove), the outer diameter of the tip is larger than that in the case where the engaged portion is a protruding portion made of a protrusion having a predetermined height. It will never be.
- tubular treatment instrument placement device described in [5] above can also be applied to the distal tip for the tubular treatment tool placement device of the present invention.
- FIG. 1 is a view for explaining a tubular treatment instrument placement device 1 according to Embodiment 1 of the present invention.
- FIG. 2 is a view for explaining the distal tip 40.
- FIG. 3 is a view for explaining the first member 50 of the tip 40.
- FIG. 4 is a view for explaining the second member 70 of the tip 40.
- FIG. 5 is a view for explaining the distal tip 40.
- FIG. 6 is a view for explaining a tip 40a according to Embodiment 2 of the present invention.
- tubular treatment device placement device and a distal tip for a tubular treatment device placement device of the present invention (hereinafter, also simply referred to as a “tip tip”) will be described based on the embodiments shown in the drawings.
- FIG. 1 (a) to 1 (c) are views for explaining the tubular treatment instrument placement device 1 according to the first embodiment.
- FIG. 1 (a) is a view showing each member and stent graft SG constituting the tubular treatment instrument placement device 1
- FIG. 1 (b) is a view showing the stent graft SG further assembled by assembling each member.
- FIG. 1C is an enlarged cross-sectional view showing the vicinity of the distal end portion of the tubular treatment instrument placement device 1 (the peripheral portion of the distal tip 40).
- the size (length, diameter, etc.), shape, dimensional ratio, etc. of each member and stent graft SG constituting the tubular treatment instrument placement device 1 are described. However, they are not necessarily shown accurately and are schematically shown.
- the “tip side” refers to the distal side from the viewpoint of the user of the tubular treatment instrument placement device 1, and refers to the tip tip 40 side in FIG.
- the “proximal side” means a proximal side from the viewpoint of the user of the tubular treatment instrument placement device 1, and in FIG. Refers to that.
- a tubular treatment device placement device 1 according to Embodiment 1 is a stent graft placement device for placing a stent graft SG (tubular treatment device) expandable in the radial direction in an affected area, and as shown in FIG. (Sheath)
- the rod member 30 is configured to be able to advance and retract along the axial direction of the sheath 10 (the longitudinal direction of the sheath 10) inside the sheath 10 (the lumen of the sheath 10), and the distal end portion of the rod member 30.
- the tip tip 40 is provided.
- the stent graft SG as a tubular treatment device loaded in the tubular treatment device placement apparatus 1 is partially omitted from illustration, but, for example, a self-expanded metal wire is folded back in a zigzag shape and formed into a substantially cylindrical shape.
- the material constituting the stent portion of the stent graft SG can be formed of a resin, but is preferably formed of a thin metal wire.
- the material of the fine metal wires constituting such a stent portion include known metals represented by stainless steel such as SUS316L, Ni—Ti alloys, Cu—Zn alloys, Ni—Al alloys, titanium alloys and the like. An alloy can be preferably used.
- a fluororesin such as PTFE (polytetrafluoroethylene) or a polyester resin such as polyethylene terephthalate can be preferably used. Graft parts made of these resin materials have relatively high biocompatibility and durability, and are chemically stable.
- the stent graft that can be used for the tubular treatment instrument placement device 1 according to the first embodiment is not limited to the stent graft composed of the above-described configuration and material, and is described above. You may use the well-known stent graft which consists of a structure and material different from.
- the sheath 10 in the present invention is a long tubular member formed of a flexible material, and is a member configured to accommodate the rod main body 32 and the stent graft SG in the tube.
- a synthetic resin or an elastomer thereof
- a resin compound in which other materials are mixed, or a multilayer tubular structure obtained by multilayer extrusion molding of these synthetic resins, a composite tubular body of these synthetic resins and metal wires, or the like can be preferably used.
- a sheath base 20 is provided on the proximal end side of the sheath 10 as shown in FIG.
- the sheath base 20 is provided with a liquid filling port 22 for filling the sheath 10 with a liquid such as physiological saline.
- a cap with a valve (not shown) is attached to the proximal end side of the sheath base portion 20 so that blood or the like when the rod member 30 is inserted into the sheath 10 is sealed and there is no leakage. It is preferable.
- the internal diameter of the sheath 10 is comprised so that it may become larger than the outer diameter of the rod main-body part 32 of the rod member 30 mentioned later. Thereby, the rod member 30 can be disposed inside the sheath 10.
- the stent graft SG is delivered to the indwelling site (affected part) in the blood vessel in a reduced diameter state, and the rod member 30 is used for the intended indwelling of the stent graft SG in the reduced diameter state. It is a member for exposing from the front-end
- the rod member 30 includes a rod main body portion 32 and a wire introduction port 34 disposed on the proximal end side of the rod main body portion 32. The rod member 30 is configured so that the stent graft SG in a reduced diameter state is held in the vicinity of the distal end portion of the rod main body portion 32.
- the material constituting the rod main body 32 various materials having appropriate hardness and flexibility, such as resin or metal such as plastic or elastomer, can be preferably used.
- the guide wire lumen for inserting a guide wire and the trigger wire for expanding the stent graft SG of a reduced diameter state in an affected part are inserted.
- a trigger wire lumen or the like is preferably formed along the axial direction of the rod member 30 (longitudinal direction of the rod member 30).
- FIG. 2 is a view for explaining the tip 40 in a general manner.
- 2A is a plan view of the tip 40 as viewed from above
- FIG. 2B is a side view of the tip 40 as viewed from the side
- FIG. 2D is a view of the distal tip 40 viewed from the proximal end side (the sheath 10 side)
- FIG. 2E is a perspective view of the distal tip 40.
- the distal tip 40 is fitted into a first member 50 that defines the basic form of the distal tip 40 and a recess 64 that is formed in a body portion 54 to be described later of the first member 50. And the second member 70 that forms the engaged portion 42.
- the configuration of the tip 40 (the first member 50 and the second member 70) will be described in more detail with reference to FIGS. 3 to 5 below.
- FIG. 3 is a view for explaining the first member 50 of the tip 40.
- 3A is a plan view of the first member 50 viewed from above
- FIG. 3B is a side view of the first member 50 viewed from the side
- FIG. 3C is the first member 50.
- 3 (d) is a cross-sectional view taken along line AA of FIG. 3 (b)
- FIG. 3 (e) is an enlarged view of a portion indicated by reference numeral P in FIG. 3 (d).
- FIG. 3 (f) is a cross-sectional view taken along line BB of FIG. 3 (b).
- FIG. 4 is a view for explaining the second member 70 of the tip 40.
- 4A is a plan view of the second member 70 viewed from above
- FIG. 4B is a side view of the second member 70 viewed from the side
- FIG. 4C is the second member 70.
- FIG. 4D is a cross-sectional view of the second member 70.
- FIG. 4A to 4C in order to facilitate understanding of the arrangement position of the second member 70 with respect to the first member 50, the first member 50 is illustrated by a broken line, and the second member 70 is illustrated. Is shown by a solid line.
- FIG. 5 is a view for explaining the tip 40.
- FIG. 5A is an exploded view of the first member 50 and the second member 70
- FIG. 5B is a crossing of the tip tip 40 when the second member 70 is fitted into the first member 50.
- FIG. 5A is an exploded view of the first member 50 and the second member 70
- FIG. 5B is a crossing of the tip tip 40 when the second member 70 is fitted into the first member 50.
- the distal tip 40 basically has a function of sealing the distal end of the sheath 10 to prevent body fluid such as blood from entering the sheath 10 and the stent graft SG.
- the tip 40 is basically composed of a first member 50 and a second member 70 configured to be fitted into a part of the first member 50 as shown in FIGS. It consists of two members.
- the first and second members 50 and 70 will be described later in detail, but the hook H of the stent graft SG (see FIG. 1A) is formed on the engaged portion 42 formed by the first member 50 and the second member 70.
- FIG.1 (c) is comprised so that engagement is possible.
- the first member 50 is disposed on the distal end side, and is disposed on the proximal end side, with the distal end side tapered portion 52 formed so that the outer diameter increases from the distal end side toward the proximal end side.
- a proximal end portion 56 formed in a tapered shape so that an outer diameter decreases from the distal end side toward the proximal end side, and a body portion 54 disposed between the distal end side tapered portion 52 and the proximal end portion 56.
- the notch 62 will be specifically described.
- the notch 62 is provided from the body 54 at the center of the first member 50 to the base end 56.
- the body portion 54 is notched so as to reach a predetermined depth from the distal end side toward the proximal end side.
- the base end portion 56 is notched in a substantially V shape on both sides, leaving the center portion C.
- the groove 66 is formed from a part of the notch 62 formed in the body part 54 to a part of the tip side taper part 52. As shown in FIGS. 3D and 3E, the groove 66 is a groove having a V-shaped cross section.
- the second member 70 has a hook-like portion 72 having a shape in which the top end portion of the upper portion extends like a hook, and the lower part of the hook-like portion 72. Extends downward and can be fitted into the recess 64 of the first member 50.
- a through hole 74 is provided at a predetermined position of the second member 70. The through hole 74 is configured to communicate with the through hole 60 of the first member 50 when the second member 70 is fitted in the recess 64 of the first member 50 (see FIG. 5B). ).
- the through holes 60 and 74 are used as a guide wire lumen for inserting a guide wire, for example.
- first and second members 50 and 70 for example, a suitable hardness such as a synthetic resin (or an elastomer thereof) composed of a polyamide resin, a polyurethane resin, a polyvinyl chloride resin, or the like, and Various materials having flexibility can be preferably used.
- the first member 50 and the second member 70 may be made of the same material or different materials.
- a contrast agent such as barium sulfate can be added to the first member 50 and the second member 70 as an auxiliary material.
- a difference may be provided in the addition concentration of the contrast agent blended in the first member and the second member, and for example, the second member 70 may be lower than the first member 50.
- the difference in the added concentration may be reversed. Since barium sulfate or the like is a radiopaque substance, the position and orientation of the distal tip can be grasped at the time of contrast based on the concentration difference between the first member and the second member.
- the tip (first member and second member) in the present invention can be formed, for example, by melt injection molding these materials.
- a groove (hook engaging groove) having a predetermined depth is formed between the first member 50 and the second member 70. It is formed.
- This groove fulfills the function of the engaged portion 42 of the tip 40.
- the engaged portion 42 is located at the body portion 54 (and the base end portion 56) of the first member 50.
- the distal end tip 40 is formed between the distal end side tapered portion 52 and the trunk portion 54 of the first member 50.
- the sheath 10 is covered to the vicinity of the boundary portion.
- the engaged portion 42 is located on the body portion 54 of the first member 50, the engaged portion 42 is covered with the sheath 10. In other words, it can be said that the engaged portion 42 is formed at a position hidden within the sheath 10 when the distal end portion of the sheath 10 is sealed with the distal tip 40.
- the engaged portion 42 of the distal tip 40 seals the distal portion of the sheath 10 with the distal tip 40. Since it is formed at a position hidden in the sheath 10 when the body is being moved, the engaged portion 42 is not exposed to the outside when moving inside the blood vessel or the like. As a result, it is possible to prevent the engaged portion 42 from being caught on the blood vessel wall and damaging the blood vessel or the like, or releasing the wall thrombus / wall atheroma. Therefore, the tubular treatment instrument placement device 1 according to the first embodiment is a tubular treatment tool placement device capable of suppressing the occurrence of damage to blood vessels and the like, and the release of mural thrombus and mural atheroma.
- the engaged portion 42 is formed on the trunk portion 54, a predetermined position of the trunk portion 54 (a position closer to the distal end than the position of the engaged portion 42). It is possible to hide the engaged portion 42 in the sheath 10 by covering with the sheath 10 to the position).
- a groove 66 is formed in the body 54.
- the groove 66 is formed from a part of the notch 62 formed in the body part 54 to a part of the tip side taper part 52 (see FIGS. 3A and 3B).
- the air remaining in the sheath is notched 62. And it comes out of the sheath 10 through the groove 66. For this reason, it is possible to improve the escape of air in the sheath 10 (degree of omission).
- purge conduit purge notch 62, purge groove 66
- the engaged portion 42 of the distal tip 40 is a groove having a predetermined depth, so that the hook H of the stent graft SG can be provided with a relatively simple configuration. It is possible to hook it securely. Further, since the engaged portion 42 is a groove having a predetermined depth, the outer diameter of the tip 40 is not increased as compared with the case where the engaged portion 42 is a protrusion having a predetermined height.
- the proximal end portion 56 of the distal tip 40 is tapered so that the outer diameter decreases from the distal end side toward the proximal end side. When the distal tip 40 is inserted into the sheath 10, the distal tip 40 is easily inserted.
- the distal tip 40 according to the first embodiment since the engaged portion 42 is formed in the trunk portion 54, the distal tip 40 according to the first embodiment is attached to the tubular treatment instrument placement device, and By covering the portion 54 with a sheath up to a predetermined position (a position closer to the distal end than the position of the engaged portion 42), the engaged portion 42 can be hidden in the sheath. That is, when the distal tip 40 according to the first embodiment is used in the tubular treatment instrument placement device, the engaged portion is not exposed to the outside when moving in the blood vessel or the like, and thus the engaged portion is the blood vessel wall. It is possible to prevent the blood vessels from being damaged by being caught on the wall or releasing the wall thrombus or wall wall atheroma.
- FIG. 6 is a view for explaining a tip 40a according to Embodiment 2 of the present invention.
- FIG. 6A is a side view of the tip 40a as viewed from the side
- FIG. 6B is a bottom view of the tip 40a as viewed from below.
- the same members as those in FIG. 3 are denoted by the same reference numerals, and detailed description thereof is omitted.
- the distal tip 40a according to the second embodiment basically has a configuration similar to that of the distal tip 40 according to the first embodiment, but the position of the groove 66a is different from that of the distal tip 40 according to the first embodiment.
- the two groove portions 66a are formed in the lower portion of the distal tip 40a.
- the groove part 66a is formed from the front end side taper part 52a to the base end part 56a.
- the groove part 66a is a groove
- the distal tip 40a according to the second embodiment is different from the distal tip 40 according to the first embodiment in the position of the groove, but the engaged portion 42 of the distal tip 40a has a body portion 54a (the distal end of the sheath 10). Since the portion is formed in a position hidden in the sheath 10 when the portion is sealed with the tip tip 40a), as in the case of the tip tip 40 according to the first embodiment, when moving in the blood vessel or the like Thus, the engaged portion 42 is not exposed to the outside. As a result, it is possible to suppress the engaged portion from being caught on the blood vessel wall and damaging the blood vessel or the like, or releasing the mural thrombus / mural atheroma.
- the distal tip 40a according to the second embodiment has the same configuration as that of the distal tip 40 according to the first embodiment except that the position of the groove is different, and therefore corresponds to the effect of the distal tip 40 according to the first embodiment. Has the effect as it is. (Note that the tubular treatment instrument placement device provided with the distal tip 40 can be referred to as 1, and the case where the distal tip 40a is provided as 1a.)
- tubular treatment instrument placement devices 1 and 1a and the distal tips 40 and 40a for the tubular treatment tool placement device of the present invention have been described based on the above embodiments, but the present invention is limited to the above embodiments. However, the present invention can be implemented in various modes without departing from the gist thereof, and for example, the following modifications are possible.
- the tip tips 40, 40a are constituted by two members, the first member and the second member, has been described as an example, but the present invention is limited to this. Instead, it may be a single member (a single member having a portion corresponding to the first member and a portion corresponding to the second member) in which the first member and the second member are integrally formed.
- the case where the groove portions 66 and 66a are formed on the tip tips 40 and 40a has been described as an example, but the above-described groove portions 66 and 66a are not necessarily formed. Even in the tip tips 40, 40a formed with the groove portions 66, 66a, since the unevenness of the portion actually contacting the blood vessel is relatively small, the blood vessels and the like are damaged due to the presence of the groove portions 66, 66a. However, in the case of a tip having no grooves 66, 66a, it is possible to eliminate irregularities in the portion that actually contacts the blood vessel. Therefore, the risk due to the presence of such irregularities can be made as close to zero as possible.
- the shape of the grooves 66 and 66a is substantially V-shaped has been described as an example, but the present invention is not limited to this.
- the shape of the groove may be, for example, a substantially U shape or a substantially semicircular shape.
- the sheath base 20 provided with the liquid filling port 22 has been described as an example of the sheath base, but the present invention is not limited to this.
- One or more ports different from the liquid filling port 22 may be provided in the sheath base.
- the engaging portion of the tubular treatment device is a hook
- the present invention is not limited to this, and has claw-shaped locking means.
- Other engaging parts such as an engaging part, may be sufficient.
- the engaged portion formed on the tip is not limited to the above-described groove having a predetermined depth (hook engaging groove), and it is made of a type / shape that matches the type / shape of the engaging portion. It may be an engaging portion (for example, a protrusion having a predetermined height).
- the stent graft SG provided with the hook H is exemplified as the tubular treatment tool, and the case where the tubular treatment tool provided with such an engaging portion is placed in the affected part has been described. It is not limited to. Needless to say, even when a tubular treatment device not provided with an engaging portion is placed in an affected area, the tubular treatment device placement device including the distal tip for the tubular treatment device placement device of the present invention may be used.
- the stent graft indwelling device for indwelling the stent graft in the affected part has been described as an example, but the present invention is not limited to this.
- the present invention can also be applied to a tubular treatment device indwelling device (for example, a stent indwelling device for placing a stent in an affected part) for placing a tubular treatment tool other than a stent graft in the affected part.
- the engaged portion is not exposed to the outside, and damage to blood vessels or the like, release of wall thrombus / wall atheroma Therefore, the industrial applicability is extremely large.
Abstract
Description
[1]本発明の管状治療具留置装置1は、
径方向に拡張可能な管状治療具SGを患部まで送達し、当該患部に留置するための管状治療具留置装置1であって、
可撓性を有し、前記管状治療具SGを収容可能に構成された管状のシース10と、
前記シース10の内側を前記シースの軸方向に沿って進退可能に移動するように構成されたロッド部材30と、
前記ロッド部材30の先端部に配設され、前記管状治療具SGに設けられた係合部Hと係合可能な被係合部42が形成された先端チップ40とを備え、
当該先端チップ40は、当該管状治療具SGを係合した状態において、前記シース10の先端部を封止しうるものであり、かつ、
前記被係合部42は、前記シース10の先端部を前記先端チップ40で封止しているときに、前記シース10内に隠れる位置に形成されていることを特徴とする。
[6]本発明の管状治療具留置装置用先端チップ40は、
先端側に配置され、先端側から基端側に向けて外径が大きくなるように形成された先端側テーパ部52と、基端側に配置された基端部56と、前記先端側テーパ部と前記基端部との間に配置された胴部54とを備え、管状治療具SGに設けられた係合部Hと係合可能な被係合部42が、前記胴部54に形成されていることを特徴とする。
まず、本発明の実施形態1に係る管状治療具留置装置1の構成について、図1を用いて詳細に説明する。
次に、先端チップ40の構成について説明する。
図2は、先端チップ40を総括的に説明するために示す図である。図2(a)は先端チップ40を上から見た平面図であり、図2(b)は先端チップ40を横から見た側面図であり、図2(c)は先端チップ40を先端側から見た図であり、図2(d)は先端チップ40を基端側(シース10側)から見た図であり、図2(e)は先端チップ40の斜視図である。
先端チップ40(第1部材50及び第2部材70)の構成について、以下の図3~図5をもとにしてさらに詳細に説明する。
第1部材50は、図3に示すように、先端側に配置され、先端側から基端側に向けて外径が大きくなるように形成された先端側テーパ部52と、基端側に配置され、先端側から基端側に向けて外径が小さくなるようテーパ状に形成された基端部56と、先端側テーパ部52と基端部56との間に配置された胴部54と、先端側開口部58と、基端側開口部59と、第1部材50の上部に形成された切欠き部62と、当該切欠き部62の底部に設けられた凹部64と、2つの溝部66とを有する。また、第1部材50の内部には、先端側開口部58と基端側開口部59とをつなぐ(連通する)貫通孔60が形成されている。
切欠き部62について具体的に説明すると、当該切欠き部62は、第1部材50中央の胴部54から基端部56にかけて設けられている。胴部54においては、図3(b)に示すように、先端側から基端側に向けて所定の深さまでえぐるように切り欠かれている。基端部56においては、図3(a)及び図3(f)に示すように、中央部Cを残して両脇が略V字状に切り欠かれている。
第2部材70は、図4(b)及び図4(d)に示すように、上部の先端側部分が庇状に伸び出た形状の庇状部72を有し、庇状部72の下部が下方に伸びて、第1部材50の凹部64と嵌合可能に構成されている。また、図4(c)及び図4(d)に示すように、第2部材70の所定位置に貫通孔74が設けられている。この貫通孔74は、第1部材50の凹部64に第2部材70を嵌め込んだときに、第1部材50の貫通孔60と連通するように構成されている(図5(b)参照。)。
なお、第1部材50と第2部材70とを同一の材料で構成してもよいし、異なる材料で構成してもよい。
(1)以上のように構成された実施形態1に係る管状治療具留置装置1によれば、先端チップ40の被係合部42が、シース10の先端部を先端チップ40で封止しているときに、シース10内に隠れる位置に形成されているため、血管内等を移動させているときに被係合部42が外部に露出しなくなる。その結果、当該被係合部42が血管壁に引っ掛かって血管等を損傷させてしまったり壁在血栓・壁在粥腫を遊離させてしまったりするのを抑制することが可能となる。
したがって、実施形態1に係る管状治療具留置装置1は、血管等の損傷や壁在血栓・壁在粥腫の遊離の発生を抑制することが可能な管状治療具留置装置となる。
次に、本発明の別の実施形態、すなわち管状治療具留置装置における先端チップが、実施形態1におけるものとは異なる構成のもの(実施形態2)について説明する。
なお、図6において、図3と同一の部材については同一の符号を付し、詳細な説明は省略する。
10 シース
20 シース基部
22 液体充填ポート
30 ロッド部材
32 ロッド本体部
34 ワイヤ導入口
40,40a 先端チップ
42 被係合部
50,50a 第1部材
52,52a 先端側テーパ部
54,54a 胴部
56,56a 基端部
58 先端側開口部
59 基端側開口部
60,74 貫通孔
62 切欠き部
64 凹部
66,66a 溝部
70 第2部材
72 庇状部
H フック
C 基端部の中央部
SG ステントグラフト
Claims (7)
- 径方向に拡張可能な管状治療具(SG)を患部まで送達し、当該患部に留置するための管状治療具留置装置(1)であって、
可撓性を有し、前記管状治療具(SG)を収容可能に構成された管状のシース(10)と、
前記シース(10)の内側を前記シースの軸方向に沿って進退可能に移動するように構成されたロッド部材(30)と、
前記ロッド部材(30)の先端部に配設され、前記管状治療具(SG)に設けられた係合部(H)と係合可能な被係合部(42)が形成された先端チップ(40)とを備え、
当該先端チップ(40)は、当該管状治療具(SG)を係合した状態において、前記シース(10)の先端部を封止しうるものであり、かつ、
前記被係合部(42)は、前記シース(10)の先端部を前記先端チップ(40)で封止しているときに、前記シース(10)内に隠れる位置に形成されていることを特徴とする管状治療具留置装置(1)。 - 請求項1に記載の管状治療具留置装置において、
前記先端チップ(40)は、
先端側に配置され、先端側から基端側に向けて外径が大きくなるように形成された先端側テーパ部(52)と、
基端側に配置された基端部(56)と、
前記先端側テーパ部と前記基端部との間に配置された胴部(54)とを有し、
前記被係合部(42)は、前記胴部(54)に形成されていることを特徴とする管状治療具留置装置(1)。
- 請求項2に記載の管状治療具留置装置において、
前記胴部(54)には、前記基端部(56)から前記先端側テーパ部(52)に向けて伸びる溝部(66)が形成されていることを特徴とする管状治療具留置装置(1)。
- 請求項1~3のいずれか一項に記載の管状治療具留置装置において、
前記被係合部(42)は、所定深さの溝であることを特徴とする管状治療具留置装置(1)。
- 請求項1~4のいずれか一項に記載の管状治療具留置装置において、
前記基端部(56)は、先端側から基端側に向けて外径が小さくなるようテーパ状に形成されていることを特徴とする管状治療具留置装置(1)。
- 管状治療具留置装置用先端チップ(40)であって、
先端側に配置され、先端側から基端側に向けて外径が大きくなるように形成された先端側テーパ部(52)と、
基端側に配置された基端部(56)と、
前記先端側テーパ部と前記基端部との間に配置された胴部(54)とを備え、
管状治療具(SG)に設けられた係合部(H)と係合可能な被係合部(42)が、前記胴部(54)に形成されていることを特徴とする管状治療具留置装置用先端チップ(40)。
- 請求項6に記載の管状治療具留置装置用先端チップにおいて、
前記被係合部(42)は、所定深さの溝であることを特徴とする管状治療具留置装置用先端チップ(40)。
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JP2000262632A (ja) | 1999-03-18 | 2000-09-26 | Arata Ishimaru | ステント(又はステントグラフト)留置装置 |
JP2000350785A (ja) | 1999-06-11 | 2000-12-19 | Arata Ishimaru | ステント(又はステントグラフト)留置装置 |
JP2005099806A (ja) | 2003-09-25 | 2005-04-14 | Samsung Electronics Co Ltd | スキャンドライバーと、これを有する表示装置及びその駆動方法 |
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US20120116413A1 (en) | 2012-05-10 |
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