WO2018012398A1 - Dispositif de coupe et procédé de traitement - Google Patents

Dispositif de coupe et procédé de traitement Download PDF

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Publication number
WO2018012398A1
WO2018012398A1 PCT/JP2017/024807 JP2017024807W WO2018012398A1 WO 2018012398 A1 WO2018012398 A1 WO 2018012398A1 JP 2017024807 W JP2017024807 W JP 2017024807W WO 2018012398 A1 WO2018012398 A1 WO 2018012398A1
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WO
WIPO (PCT)
Prior art keywords
state
unit
cutting device
shaft
contact
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Application number
PCT/JP2017/024807
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English (en)
Japanese (ja)
Inventor
野村治
関根佑輔
Original Assignee
テルモ株式会社
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 テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2018012398A1 publication Critical patent/WO2018012398A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for

Definitions

  • the present invention relates to a cutting device and a treatment method.
  • Patent Document 1 proposes a cutting balloon catheter in which a metal or resin cutting member is provided on the surface of the balloon. The cutting balloon catheter can appropriately expand the blood vessel even at a low pressure by concentrating the expansion pressure of the balloon on the cutting member.
  • Patent Document 2 there is also known a method for expanding a living body lumen by using a plurality of long wire portions that bend radially outward by receiving a contraction force in an axial direction without using a balloon. It has been.
  • JP2016-52452A Japanese Patent Laying-Open No. 2015-226731
  • the present invention has been made to solve the above-described problems, and an object of the present invention is to provide a cutting device and a treatment method that can cut a hard object in a living body lumen.
  • the cutting device that achieves the above object is provided with a long shaft portion and an operation that is provided at a distal portion of the shaft portion and can be deformed from the first state to the second state by jumping buckling. And a contact portion for moving an impact force on an object by moving the working portion, and a jumping buckling caused by acting on the working portion by moving relative to the working portion. And an operation unit to be operated.
  • the cutting device configured as described above can apply an impact force to an object in a living body lumen by using jump buckling. For this reason, it is possible to cut into a hard object in the living body lumen.
  • the actuating portion is provided at a distal portion of the tubular shaft portion, and at least a part thereof protrudes outside the shaft portion by jumping and buckling from a first state where the operating portion enters the inside of the shaft portion.
  • the operation portion may be movable inside the shaft portion and may contact the operating portion in the first state. As a result, the operating portion comes into contact with the operating portion in the first state from the inside of the shaft portion, and the operating portion can jump and buckle so that the operating portion is in the second state.
  • the cutting device has a recovery unit that is movable with respect to the operating unit and that can be deformed to the first state by applying a force to the operating unit in the second state. May be.
  • the operating part that has been operated to be in the second state can be returned to the original first state, and can be easily recovered outside the living body.
  • the recovery part may be a tubular body that is movable in the axial direction with respect to the shaft part and surrounds the shaft part. Thereby, an action
  • the collecting unit may be a wire connecting the operating unit and the operating unit. Thereby, the contact part can be returned to a 2nd state also using the operation part which act
  • the contact portion may have a shape protruding in the direction from the first state to the second state.
  • the contact part can concentrate the force which acts on a contact object, and can cut into a hard object in a living body lumen effectively.
  • the contact part should just be a shape which protrudes in either or both of the cross section along the axial direction of a shaft part, and the cross section orthogonal to an axial direction.
  • the cutting device may have an extended portion that is provided at a distal portion of the shaft portion and can be expanded and contracted in a radial direction of the shaft portion. Thereby, the operation part can be accurately positioned at the target position by the extension part. For this reason, it is possible to cut accurately and effectively into a hard object in the living body lumen, and operability is improved.
  • An end portion is located between the position in the first state and the position in the second state of the contact portion, and a distance defining portion that defines the distance of the contact portion with respect to the contact target may be provided.
  • the distance with respect to the contact object of a contact part can be prescribed
  • the distance defining unit can appropriately define the distance of the contact unit to the contact target even when the living body lumen is curved.
  • a treatment method according to the present invention that achieves the above object is a treatment method for incising a lesion in a living body lumen using the above-described cutting device, wherein the operating part and the contact part are placed in the living body lumen. Inserting into the lesion part to reach the lesioned part, moving the operating part to actuate the actuating part to give an impact to the lesioned part by the contact part, and connecting the actuating part and the contact part to the biological tube Removing from the cavity.
  • the treatment method configured as described above can apply an impact force to a lesion using jump buckling. For this reason, it is possible to make a cut into a hard lesion in the living body lumen, and the living body lumen can be easily expanded.
  • the cutting device 10 is a so-called PTCA (Percutaneous Transluminal) treatment that expands and expands a calcified lesion (stenosis) in a coronary artery or a peripheral blood vessel.
  • PTCA Percutaneous Transluminal
  • a calcified lesion stenosis
  • PTA Percutaneous Transluminal Angioplasty
  • the cutting device 10 includes a long shaft portion 20, an operating portion 30 provided at the distal end portion of the shaft portion 20, and a cutting member 70 (contact portion) disposed in the operating portion 30. And have. Further, the cutting device 10 has a recovery unit 50 disposed outside the shaft unit 20, an operation unit 60 disposed inside the shaft unit 20, and a hub 40 fixed to the proximal end of the shaft unit 20. is doing. Inside the operation unit 60, a guide wire lumen 62 into which a guide wire can be inserted is provided.
  • the shaft part 20 is a long tubular body, and has three openings 21 in which the operating part 30 is disposed at the distal part.
  • the three openings 21 are arranged uniformly in the circumferential direction.
  • the operating part 30 has three plate members 31 extending from the distal side to the proximal side of each opening 21.
  • the operating portion 30 is bent from the first state (see FIGS. 1 and 2) bent toward the inside of the shaft portion 20 to the second state (see FIG. 3) bent toward the outside of the shaft portion 20. ), And is a part that deforms by using jumping buckling (jumping phenomenon).
  • jumping buckling means a buckling (phenomenon) that dynamically shifts from a certain balance point to another stable balance point that is not continuous with it.
  • Each plate member 31 has a curved portion 32 that is curved so that the central portion protrudes toward the center of the shaft portion 20 in a first state in which no force is applied from the outside.
  • the plate material 31 is plate-shaped, the deformation direction in the jumping buckling is stabilized.
  • the plate material 31 is fixed to the inner surface side of the shaft portion 20, but may be fixed to the outer surface side or may be embedded in the shaft portion 20.
  • the operating unit 30 may be integrally formed of the same material as the shaft unit 20 as a part of the shaft unit 20.
  • the number of cutting members 70 provided on each plate member 31 is not particularly limited.
  • the cutting member 70 is a member for concentrating force in order to give an impact to the calcified lesion A (see FIG. 8) and make a cut.
  • the cutting member 70 preferably has a sharp blade 71 that narrows radially outward of the shaft portion 20.
  • the cutting member 70 is not specifically limited, For example, the structure arrange
  • the taper part 72 is provided.
  • the cutting member 70 is easily moved to the inside of the shaft portion 20 by contact with the distal portion of the recovery portion 50 that moves in the distal direction.
  • the taper portion 72 of the cutting member 70 is tapered toward the proximal side.
  • the cutting member 70 is easily in contact with the distal portion of the collection portion 50 that moves in the distal direction and easily moves to the inside of the shaft portion 20.
  • the operation part 60 is a tubular body that enters the inside of the shaft part 20 from the proximal side, as shown in FIGS.
  • the operation part 60 moves to the distal side with respect to the shaft part 20, so that the distal end 61 comes into contact with the inner surface side (center side of the shaft part 20) of the plate material 31 in the first state.
  • the plate member 31 is moved to the operation unit 60 as shown in FIG.
  • it is deformed to the outside of the shaft portion 20 by jumping and buckling to be in the second state.
  • the operation unit 60 may be structured to move from the distal side to the proximal side.
  • the collection unit 50 is a tubular body that covers the outside of the shaft unit 20.
  • the collection part 50 moves distally with respect to the shaft part 20, so that the collection end 51 located at the distal end is the taper part 72 of the cutting member 70 or the plate material in the second state. 31 is in contact with the outer surface side (outside of the shaft portion 20).
  • the plate material 31 is moved to the collection portion 50 as shown in FIG. Receiving the force from the shaft, it is deformed to the inside of the shaft portion 20 by jumping and buckling, and returns to the first state.
  • the collection unit 50 moves to the distal side, the space where the plate material 31 can exist is insufficient outside the shaft portion 20, and the plate material 31 is deformed to the inside of the shaft portion 20 where a more stable balance point exists. To do. At this time, the collection end 51 comes into contact with the tapered portion 72, whereby the cutting member 70 can be easily deformed with as little force as possible.
  • the collection unit 50 may be configured to move from the distal side to the proximal side.
  • the hub 40 includes a proximal end opening 41 that communicates with the guide wire lumen 62 of the operation unit 60.
  • the shaft part 20, the recovery part 50, and the operation part 60 have a structure having flexibility and appropriate rigidity.
  • the constituent material of the shaft portion 20, the recovery portion 50, and the operation portion 60 is, for example, polyolefin (for example, polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or two or more kinds thereof.
  • the operating unit 30 preferably has a structure having flexibility and moderate rigidity so that jumping and buckling occur.
  • Examples of the operating unit 30 include metals (including alloys) and resins.
  • the metals include spring steel, stainless steel, brass, white, phosphor bronze, beryllium steel, aluminum, aluminum alloy, titanium, titanium alloy, copper, copper alloy, tantalum, and cobalt alloy.
  • the resin include polyvinyl chloride, polyethylene, polypropylene, cyclic polyolefin, polystyrene, poly- (4-methylpentene-1), polycarbonate, acrylic resin, acrylonitrile-butadiene-styrene copolymer, polyethylene terephthalate, polyethylene naphthalate, etc. Polyester, butadiene-styrene copolymer, and polyamide (for example, nylon 6, nylon 6,6, nylon 6,10, nylon 12).
  • the constituent material of the operating unit 30 may be, for example, a shape memory alloy to which a shape memory effect or superelasticity is imparted by heat treatment.
  • a shape memory alloy Ni—Ti, Cu—Al—Ni, Cu—Zn—Al, and the like can be preferably used.
  • Examples of the constituent material of the cutting member 70 include metals (including alloys) and resins.
  • Examples of the metals include spring steel, stainless steel, brass, white, phosphor bronze, beryllium steel, aluminum, aluminum alloy, titanium, titanium alloy, copper, copper alloy, tantalum, and cobalt alloy.
  • Examples of the resin include polyvinyl chloride, polyethylene, polypropylene, cyclic polyolefin, polystyrene, poly- (4-methylpentene-1), polycarbonate, acrylic resin, acrylonitrile-butadiene-styrene copolymer, polyethylene terephthalate, polyethylene naphthalate, etc. Polyester, butadiene-styrene copolymer, and polyamide (for example, nylon 6, nylon 6,6, nylon 6,10, nylon 12).
  • the guide wire 90 is introduced into the blood vessel percutaneously by, for example, the Seldinger method.
  • the guide wire 90 is inserted into the guide wire lumen 62 of the cutting device 10 from the distal end side, and the cutting device 10 is inserted into the blood vessel.
  • the cutting device 10 is in the first state with the plate material 31 positioned inside the shaft portion 20.
  • the guide wire 90 is advanced to the target lesion A, and the lesion A is passed and placed. Then, the cutting device 10 is advanced along the guide wire 90, and the operating unit 30 is positioned at the lesion A as shown in FIG.
  • the operation unit 60 is moved more proximally than the operation unit 30.
  • the collection unit 50 is moved to the distal side
  • the collection end portion 51 of the collection unit 50 moving in the distal direction comes into contact with the cutting member 70 as shown in FIG.
  • the plate 31 moves to the inside of the shaft portion 20.
  • operation part 30 returns to a 1st state.
  • the process of giving an impact to the lesioned part A by the cutting member 70 can be repeated as necessary.
  • the operation unit 60 is moved to the distal side.
  • a balloon catheter or a catheter equipped with a stent is inserted into the blood vessel, and the lesion A is spread.
  • the lesioned part A can be favorably spread and expanded in diameter.
  • the balloon expansion pressure required for expansion can be reduced, and the procedure is efficient.
  • the cutting device 10 is provided in the long shaft portion 20 and the distal portion of the shaft portion 20 and is deformed from the first state to the second state by jumping and buckling.
  • an operation unit 60 that causes the buckling to occur and cause buckling.
  • the cutting device 10 configured as described above can apply an impact force to a contact target using jump buckling. For this reason, it is possible to make a cut in the hard lesioned part A (object) in the living body lumen, so that the living body lumen can be easily expanded.
  • the actuating portion 30 is provided at the distal portion of the tubular shaft portion 20, and at least a portion of the operating portion 30 is jumped and buckled from the first state where at least a portion enters the inside of the shaft portion 20. It can be deformed so as to protrude to the outside. And the operation part 60 can move the inner side of the shaft part 20, and can contact the action
  • the cutting device 10 has the collection
  • operated and was in the 2nd state can be returned to the original 1st state, and collection
  • the collection unit 50 is a tubular body that is movable in the axial direction with respect to the shaft unit 20 and surrounds the shaft unit 20. Thereby, the cutting member 70 (contact part) can be returned to a 2nd state by moving the collection
  • the cutting member 70 (contact part) is a shape which protrudes in the direction which goes to a 2nd state from a 1st state.
  • the cutting member 70 may have a shape that protrudes in one or both of a cross section along the axial direction of the shaft portion 20 and a cross section orthogonal to the axial direction.
  • the direction from the first state toward the second state is the radially outward direction of the shaft portion 20.
  • the present invention also includes a treatment method for making an incision in a lesion A of a biological lumen using the cutting device 10.
  • the operating unit 30 and the cutting member 70 contact unit
  • the operating unit 60 is moved to move the operating unit 30 to perform cutting.
  • the treatment method configured as described above can apply an impact force to the lesion A using jump buckling. For this reason, it is possible to make a cut in the hard lesioned part A in the living body lumen, so that the living body lumen can be easily expanded.
  • the cutting device 100 according to the second embodiment is different from the first embodiment only in the configuration of the collection unit.
  • symbol is attached
  • the collection unit 110 of the cutting device 100 includes a plurality of wires 111 that connect the operation unit 60 and the respective plate materials 31 as shown in FIG.
  • the distal end of the wire 111 is fixed to the inner surface of each plate 31.
  • the proximal end of the wire 111 is fixed to the distal portion of the operation unit 60.
  • the cutting device 100 moves the operation unit 60 to the distal side with respect to the shaft unit 20 and deforms the plate material 31, thereby changing the first state from the first state.
  • the cutting member 70 can be projected.
  • plate material 31 is pulled inside the shaft part 20 via the wire 111 by moving the operation part 60 to the proximal side with respect to the shaft part 20.
  • FIG. Thereby, the board
  • recovery part 50 which covers the shaft part 20 like 1st Embodiment is unnecessary, since an outer diameter can be made small, it becomes applicable also to a thin blood vessel, and cost can be reduced.
  • the cutting device 120 according to the third embodiment is different from the first embodiment in that a balloon 160 (expansion portion) is provided at the distal portion of the shaft portion 130.
  • a balloon 160 expansion portion
  • symbol is attached
  • the shaft portion 130 of the cutting device 120 has a lumen 131 for accommodating the operation portion 60 and an expansion lumen 132 for circulating a fluid for expanding the balloon 160.
  • An operating portion 150 having only one plate material 31 is provided at the distal portion of the shaft portion 130.
  • Two cutting members 70 are provided on the plate 31.
  • a hub 140 having an opening 141 communicating with the expansion lumen 132 is provided at the proximal portion of the shaft portion 130.
  • the balloon 160 is provided on the opposite side in the circumferential direction from the position where the operating part 150 of the shaft part 130 is provided.
  • the edge of the balloon 160 is fixed to the outer peripheral surface of the shaft portion 130, and fluid can flow into the balloon 160 via the expansion lumen 132. Since the balloon 160 is provided on the side opposite to the operation unit 150, the balloon 160 can be expanded to the side opposite to the protruding direction of the cutting member 70.
  • the guide wire 90 is advanced to the target lesion A under fluoroscopy, and the lesion A is passed and placed. Then, the cutting device 120 is advanced along the guide wire 90, and the operating unit 150 is positioned at the lesion A as shown in FIG.
  • an expansion fluid is supplied from the opening 141 of the hub 140.
  • the expansion fluid reaches the inside of the balloon 160 through the expansion lumen 132, and the balloon 160 is expanded.
  • the operation part 150 is appropriately positioned in front of the lesioned part A.
  • the plate material 31 jumps and buckles, and enters the second state, and the cutting member moves radially outward of the shaft part 130. 70 protrudes instantaneously. Thereby, the cutting member 70 gives an impact force to the lesioned part A. Therefore, the lesioned part A is likely to be damaged such as cuts.
  • the expansion fluid is discharged from the balloon 160 through the expansion lumen 132, and the balloon 160 is deflated. Thereafter, similarly to the first embodiment, the plate member 31 of the operating unit 150 is set to the first state using the recovery unit 50. Thereafter, the cutting device 120 and the guide wire 90 are removed, and the procedure is completed.
  • the cutting device 120 has the balloon 160 (expanded portion) that is provided at the distal portion of the shaft portion 130 and can be expanded and contracted in the radial direction of the shaft portion 130. .
  • the operation part 150 can be accurately positioned to the target position by the balloon 160, and the operability is improved.
  • the shaft part 130 is fixed by the balloon 160, the impact force of the operating part 150 can be applied to the lesioned part A to the maximum extent. For this reason, it is possible to accurately cut the hard lesion A in the living body lumen.
  • the balloon 160 is further expanded, so that the living body lumen can be expanded without using another balloon catheter, and the cost can be reduced.
  • the expansion part provided in the distal part of the shaft part 130 and can be expanded and contracted in the radial direction of the shaft part 130 may not be a balloon.
  • the expansion portion may be configured by forming a superelastic material such as a shape memory alloy in a mesh shape like a self-expanding stent.
  • Such an expansion part can be configured to expand by self-expanding force by being restrained in an elastically contracted state and inserted into a living body lumen and releasing the restraint in the living body lumen. .
  • the cutting device 170 according to the fourth embodiment is different from the first embodiment in that the operating unit 30 having the plate material 31 is disposed between the shaft unit 180 and the operation unit 60.
  • symbol is attached
  • the shaft part 180 of the cutting device 170 is a tubular body arranged outside the operation part 60 as shown in FIGS.
  • the distal portion of the plate 31 of the operating portion 30 is fixed to an annular fixing portion 190 provided at the distal portion of the operation portion 60.
  • the proximal portion of the plate 31 of the operating portion 30 is fixed to the distal portion of the shaft portion 180.
  • An operation unit 60 is located inside the operation unit 30.
  • the operation unit 60 when the operation unit 60 is moved to the proximal side relative to the shaft unit 180, contraction force in the axial direction acts on the plate material 31 in the first state. Since the operation unit 60 is located inside the operation unit 30, the plate 31 is deformed in contact with the operation unit 60 as shown in FIG. 17. When the operation part 60 is moved further proximally with respect to the shaft part 180, as shown in FIG. 18, the plate material 31 is deformed to the outside of the shaft part 180 by jumping and buckling, and enters the second state. . That is, a space where the plate material 31 can exist is insufficient inside the shaft portion 180, and the plate material 31 is deformed to the outside of the shaft portion 180 where a more stable balance point exists.
  • the plate material 31 moves instantaneously, and the cutting member 70 provided with the plate material 31 also moves instantaneously.
  • the cutting member 70 protrudes momentarily toward the outer side of the shaft part 180, and can give an impact force with respect to a contact target.
  • the cutting device 170 does not require a collection unit for returning the operation unit 30 from the second state to the first state, and has high operability. In addition, since no recovery unit is required, the cost can be reduced.
  • the present invention is not limited to the above-described embodiment, and various modifications can be made by those skilled in the art within the technical idea of the present invention.
  • the present invention is applicable to catheters other than PTCA dilatation catheters, for example, catheters for improving lesions formed in living organs such as other blood vessels, bile ducts, trachea, esophagus, urethra, and other organs. Is possible.
  • the tapered portion 201 of the cutting member 200 may be formed of a concave curved surface.
  • distance defining portions 210 are provided on the distal side and the proximal side of the position where the operating portion 30 of the shaft portion 20 is provided. May be.
  • the distance defining portion 210 is formed in a ring shape, and the outer surface 211 (end portion) is located between the first state and the second state of the cutting member 70 (contact portion).
  • the distance defining unit 210 defines the distance of the cutting member 70 with respect to the contact target to an appropriate value. Thereby, the cutting member 70 can ensure an appropriate run-up distance with respect to the lesioned part A, and can effectively exert an impact force on the lesioned part A.
  • the position of the outer surface 211 of the distance defining portion 210 is preferably set to a position where the impact force can be most effectively exhibited when the cutting member 70 is deformed from the first state to the second state.
  • the distance defining part 210 also plays a role of guiding the cutting member 70 to an appropriate position when the operating part 30 is located in a curved region of the blood vessel. That is, for example, in the curved region of the blood vessel, even if the outer peripheral surface of the shaft portion 20 is strongly pressed against the inner wall surface of the blood vessel, the distance defining portion 210 protruding from the shaft portion 20 An appropriate distance can be ensured between the wall surface. Thereby, the cutting member 70 can cut into the lesioned part A effectively.
  • the distance defining portion 210 that protrudes from the shaft portion 20 on the proximal side of the operating portion 30 a distance that can accommodate the distance defining portion 210 is ensured between the collection portion 50 and the shaft portion 20. The For this reason, when the collection part 50 located on the proximal side of the expanded cutting member 70 in the second state is moved in the distal direction, the collection end 51 is formed on the top 73 of the taper part 72 of the cutting member 70. Contact nearby. For this reason, the cutting member 70 can receive a strong force from the collection end 51 and can easily return to the first state.
  • the operation part 220 may be disposed inside the shaft part 20 on the distal side of the operation part 30 as in another modification of the first embodiment shown in FIG.
  • the operation unit 220 is a tubular body, and the pulling wire 221 is fixed.
  • the pulling wire 221 penetrates the inside of the shaft portion 20 and is led out to the outside from the proximal end opening 41 (see FIG. 1) of the hub 40.
  • the operation unit 220 comes into contact with the inner surface side of the plate 31.
  • the plate material 31 receives a force from the operation part 220 and can be deformed to the outside of the shaft part 20 by jumping and buckling.
  • the operation part 220 is moved by pulling with the pulling wire 221, the protrusion of the cutting member 70 by jump buckling can be performed only once and cannot be repeatedly performed.
  • the pulling wire 221 has sufficient rigidity and the operation unit 220 can be moved to the distal side by pushing in the pulling wire 221, the cutting member 70 is repeatedly projected by jumping buckling. be able to.
  • the cutting device 10 may be used in another method.
  • the collection unit 50 is disposed outside the operation unit 30 in a state where the operation unit 60 is disposed inside the operation unit 30.
  • the operating unit 30 receives the force from the operation unit 60 and attempts to shift from the first state to the second state, but is covered by the recovery unit 50 and cannot shift to the second state. Yes. From this state, by moving the collection unit 50 to the proximal side, the operating unit 30 can shift to the second state as shown in FIG.
  • the collection unit 50 also functions as an operation unit for operating the operation unit 30.
  • an operation unit 230 that is a tubular body partially fixed to the shaft unit 20 may be provided. In this case, since the structure can be simplified, the cost can be reduced.
  • the cutting member 70 may be partially fixed to the plate material 31. By being partially fixed, the movement of the plate material 31 can be prevented from being hindered. Moreover, at least a part of the shaft portion, the operation portion, and the recovery portion may not be a tubular body.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention concerne un dispositif de coupe et un procédé de traitement avec lesquels il est possible de pratiquer une incision dans un objet dur à l'intérieur d'une lumière corporelle. Un dispositif de coupe (10) comprend : une partie arbre allongée (20) ; une partie actionnement (30) qui est disposée dans une partie distale de la partie arbre (20) et est capable de se déformer d'un premier état à un second état par un flambement rapide ; un élément de coupe (70) qui est déplacé en raison de la déformation de la partie actionnement (30) afin d'amener une force d'impact à agir sur une lésion ; et une partie manipulation (60) qui est déplacée par rapport à la partie actionnement (30), ce qui provoque l'action d'une force sur la partie actionnement (30) pour provoquer un flambement rapide.
PCT/JP2017/024807 2016-07-13 2017-07-06 Dispositif de coupe et procédé de traitement WO2018012398A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2016138260A JP2019146601A (ja) 2016-07-13 2016-07-13 カッティングデバイスおよび処置方法
JP2016-138260 2016-07-13

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WO2018012398A1 true WO2018012398A1 (fr) 2018-01-18

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2022500097A (ja) * 2018-08-06 2022-01-04 シー・アール・バード・インコーポレーテッドC R Bard Incorporated 能動的なスライス／切り込みのための、ガイド付きの平行移動可能なカッターを有するカテーテル、および関連方法
WO2022264744A1 (fr) * 2021-06-17 2022-12-22 株式会社グッドマン Cathéter à ballonnet
JP7488204B2 (ja) 2021-01-28 2024-05-21 株式会社グッドマン 医療用デバイス

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2011098061A (ja) * 2009-11-06 2011-05-19 Nipro Corp カッティングバルーンカテーテル
JP2014531243A (ja) * 2011-09-13 2014-11-27 ジョン・ピー・ピゴット 拡張可能切開部分を有する血管内カテーテル

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2011098061A (ja) * 2009-11-06 2011-05-19 Nipro Corp カッティングバルーンカテーテル
JP2014531243A (ja) * 2011-09-13 2014-11-27 ジョン・ピー・ピゴット 拡張可能切開部分を有する血管内カテーテル

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2022500097A (ja) * 2018-08-06 2022-01-04 シー・アール・バード・インコーポレーテッドC R Bard Incorporated 能動的なスライス／切り込みのための、ガイド付きの平行移動可能なカッターを有するカテーテル、および関連方法
JP7198343B2 (ja) 2018-08-06 2022-12-28 シー・アール・バード・インコーポレーテッド 能動的なスライス／切り込みのための、ガイド付きの平行移動可能なカッターを有するカテーテル、および関連方法
JP7488204B2 (ja) 2021-01-28 2024-05-21 株式会社グッドマン 医療用デバイス
WO2022264744A1 (fr) * 2021-06-17 2022-12-22 株式会社グッドマン Cathéter à ballonnet

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