WO2019189759A1 - Dispositif hémostatique et kit hémostatique - Google Patents

Dispositif hémostatique et kit hémostatique Download PDF

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Publication number
WO2019189759A1
WO2019189759A1 PCT/JP2019/013994 JP2019013994W WO2019189759A1 WO 2019189759 A1 WO2019189759 A1 WO 2019189759A1 JP 2019013994 W JP2019013994 W JP 2019013994W WO 2019189759 A1 WO2019189759 A1 WO 2019189759A1
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WIPO (PCT)
Prior art keywords
puncture hole
balloon
insertion end
adhesive
tube
Prior art date
Application number
PCT/JP2019/013994
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English (en)
Japanese (ja)
Inventor
貴史 藤畑
渉 米道
幸治 河尻
Original Assignee
日本ゼオン株式会社
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Publication date
Application filed by 日本ゼオン株式会社 filed Critical 日本ゼオン株式会社
Priority to JP2020511091A priority Critical patent/JPWO2019189759A1/ja
Publication of WO2019189759A1 publication Critical patent/WO2019189759A1/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

Definitions

  • the present invention relates to a hemostasis device used for percutaneously blocking a puncture hole formed into a blood vessel percutaneously and a hemostasis kit including the hemostasis device.
  • a PTCA balloon catheter is percutaneously inserted into the blood vessel through the sheath lumen of a sheath introducer pierced from the body surface into the blood vessel (femoral artery). Inserted. After treatment, it is necessary to stop bleeding from the puncture hole leading to the blood vessel from the body surface formed by removal of the sheath introducer.
  • manual compression is performed, but the diameter of the puncture hole is relatively large Since manual compression may require a long time for hemostasis, a hemostasis device that can stop hemostasis in a relatively short time has been proposed (see Patent Document 1 and Patent Document 2).
  • the hemostatic device described in Patent Document 1 has two balloons arranged at the front and rear of the distal end of a tube, inflates the front balloon in the blood vessel, and inflates the rear balloon outside the blood vessel (in the subcutaneous tissue). Then, the periphery of the puncture hole in the blood vessel wall is sandwiched from inside and outside with the two inflated balloons to stop bleeding.
  • the subcutaneous tissue may be damaged as the rear balloon expands in the subcutaneous tissue. Therefore, in the hemostatic device described in Patent Document 2, the rear balloon is inflated on the body surface. Both ends of the puncture hole from the inside of the blood vessel to the body surface are closed with two inflated balloons so as to promote the generation of a thrombus.
  • Patent Documents 1 and 2 are provided with two balloons and require two systems of fluid supply systems for inflating the balloons, so that the configuration is complicated and the cost is high. There is a problem of becoming.
  • the present invention has been made in view of such a point, and an object thereof is to provide a hemostasis device capable of reducing the cost and a hemostasis kit including the hemostasis device.
  • a hemostatic device includes: A hemostatic device for closing a puncture hole formed percutaneously into a blood vessel, A tube having a first flow path and a second flow path, and having an insertion end inserted into the puncture hole; A balloon that is attached to the distal end of the insertion end and that is inflatable in a blood vessel by supplying fluid through the first flow path in a state where the insertion end is inserted into the puncture hole; Have The tube includes an injection port that is formed near the proximal end side of the balloon at the insertion end, and injects a biological adhesive supplied through the second flow path into the puncture hole. It is a hemostatic device.
  • the hemostatic device is used, for example, as follows. First, the insertion end of the tube is inserted into the puncture hole, the balloon is positioned in the blood vessel, and then the balloon is inflated by supplying fluid through the first flow path to close the blood vessel side of the puncture hole In this state, an adhesive is injected into the puncture hole through the second channel. Next, after the adhesive is solidified, the insertion end is removed from the adhesive by deflating the balloon.
  • the solidified adhesive remains a cylindrical space due to the presence of the insertion end, but for example, a cylindrical plug member having an outer diameter that is the same as or slightly larger than the outer diameter of the insertion end.
  • the puncture hole can be completely closed by inserting and closing the cylindrical space.
  • the cylindrical space portion remaining in the solidified adhesive is thinner than the inner diameter of the puncture hole, the cylindrical space portion is closed by manual compression or the like without using such a plug member. You may make it hemostasis by coagulation
  • the balloon for closing the inside of the blood vessel of the puncture hole is provided, as in the prior art, the outside of the blood vessel of the puncture hole or the body surface side of the puncture hole Since it is not necessary to provide a balloon for closing, the configuration can be simplified. Therefore, cost reduction can be achieved.
  • an adhesive to be injected into the puncture hole it is also possible to use an adhesive that can coagulate in a shorter time than the coagulation of the blood itself, compared with the conventional technology that waits for coagulation of the blood itself in the puncture hole, The time required for hemostasis can be shortened.
  • a plurality of the injection ports can be provided on the side surface of the insertion end.
  • the adhesive can be injected into the puncture hole uniformly and in a short time.
  • the tube may include a passage through which a guide wire is inserted.
  • the hemostatic device according to the present invention may further include a cover tube through which the tube is slidably inserted.
  • a cover tube through which the tube is slidably inserted.
  • the insertion end portion of the tube may include a narrow diameter portion on the distal end side that is smaller in diameter than the large diameter portion on the proximal end side.
  • a stepped surface is formed in the cylindrical space formed in the solidified adhesive due to the shape transfer between the large diameter portion and the small diameter portion. Therefore, for example, when a cylindrical plug member having an outer diameter the same as or slightly larger than the outer diameter of the insertion end portion is inserted into the cylindrical space portion (portion relating to the transfer of the large diameter portion), It is possible to suppress the plug member from being pushed through and pushed into the blood vessel.
  • the injection port can be provided on the side surface of the small-diameter portion or on the step surface at the tip of the large-diameter portion.
  • a hemostasis kit includes: The hemostatic device according to the first aspect of the present invention described above; In the state where the insertion end of the hemostatic device is inserted into the puncture hole, and the balloon is inflated by supplying a fluid through the first flow path to close the blood vessel side of the puncture hole, After injecting the adhesive into the puncture hole through the second flow path, the balloon is contracted and the insertion end is removed to be inserted into a cylindrical space formed in the solidified adhesive. And a columnar stopper member having an outer diameter that is the same as or slightly larger than the outer diameter of the insertion end.
  • a hemostasis kit including a hemostasis device and a stopper member can be provided at a low cost.
  • FIG. 1A is an overall view showing a configuration of a hemostasis kit including a hemostasis device and a stopper member according to an embodiment of the present invention.
  • FIG. 1B is an enlarged view of a main part of the hemostatic device of FIG. 1A.
  • 1C is a cross-sectional view taken along line Ic-Ic in FIG. 1B.
  • FIG. 2A is a diagram showing a first step of a hemostasis procedure using the hemostasis kit of FIG. 1A.
  • FIG. 2B is a diagram showing a second step subsequent to FIG. 2A.
  • FIG. 2C is a diagram showing a third step subsequent to FIG. 2B.
  • FIG. 2D is a diagram showing a fourth step that follows FIG. 2C.
  • FIG. 1A is an overall view showing a configuration of a hemostasis kit including a hemostasis device and a stopper member according to an embodiment of the present invention.
  • FIG. 1B is an enlarged view
  • FIG. 2E is a diagram showing a fifth step subsequent to FIG. 2D.
  • FIG. 2F is a diagram showing a sixth step that follows FIG. 2E.
  • FIG. 2G is a diagram showing a seventh step that follows FIG. 2F.
  • FIG. 2H is a diagram showing an eighth step that follows FIG. 2G.
  • FIG. 2I is a diagram showing a ninth step that follows FIG. 2H.
  • FIG. 2J is a diagram showing a final step subsequent to FIG. 2I.
  • FIG. 3A is an enlarged view of a main part showing a modification of the hemostatic device of FIG. 1A.
  • 3B is a cross-sectional view taken along line IIIb-IIIb in FIG. 3A.
  • FIG. 4A is an enlarged view of a main part showing another modification of the hemostatic device of FIG. 1A.
  • 4B is a cross-sectional view taken along line IVb-IVb in FIG. 4A.
  • FIG. 5A is an enlarged view of a main part showing still another modified example of the hemostatic device of FIG. 1A, and shows a state in which the insertion end is exposed by sliding the cover tube to the proximal end side.
  • FIG. 5B is a diagram illustrating a state in which the insertion end portion is accommodated by sliding the cover tube of the hemostatic device of FIG. 5A toward the distal end side.
  • FIG. 6 is an enlarged view of a main part showing another modification of the hemostatic device of FIG. 1A.
  • This hemostasis kit is an instrument used for the procedure of hemostasis by closing a puncture hole formed percutaneously into a blood vessel.
  • a sheath introducer punctured percutaneously into a femoral artery was used.
  • An example will be described in which a puncture hole extending from the body surface formed in connection with the removal of the sheath introducer to the inside of the blood vessel is closed after the procedure is performed.
  • the hemostasis kit of this embodiment includes a hemostasis device 1 and a plug member 7.
  • the hemostatic device 1 includes a catheter tube (tube) 2, a balloon 3, a cover 4, two branch pipes 5a and 6a, and two ports 5b and 6b.
  • the catheter tube 2 is a tubular member having a distal end portion inserted into the body and a proximal end portion disposed outside the body.
  • a two-lumen type single tube having a balloon lumen (first flow path) 22 and an adhesive lumen (second flow path) 23 is used as the catheter tube 2 .
  • a tube having a double tube structure including an outer tube and an inner tube inserted with a gap in the lumen of the outer tube may be used.
  • the inner sheath lumen is used as a balloon lumen
  • the gap between the outer sheath and inner sheath is used as an adhesive lumen.
  • the distal end portion of the catheter tube 2 is an insertion end portion 21 to be inserted into the puncture hole, and the balloon 3 is attached to the distal end portion of the insertion end portion 21.
  • the insertion end portion 21 has a large diameter portion 21a continuous to the proximal end portion side of the catheter tube 2 and a small diameter portion 21b formed to be smaller than the large diameter portion 21a.
  • a balloon 3 is provided at the tip of the diameter portion 21b.
  • the small-diameter portion 21b is formed substantially coaxially with the large-diameter portion 21a. Therefore, the distal end surface of the large-diameter portion 21a (the portion around the base end of the small-diameter portion 21b) is a step surface 21c. .
  • the adhesive lumen 23 is a flow path for distributing a biological adhesive.
  • the distal end of the adhesive lumen 23 does not reach the tip of the small diameter portion 21b, but opens as an injection port 23a on the side near the base end side of the balloon 3 of the small diameter portion 21b.
  • the injection port 23a is formed at a position where the living body adhesive supplied through the adhesive lumen 23 can be injected into the puncture hole with the insertion end 21 inserted into the puncture hole.
  • a medical cyanoacrylate instantaneous adhesive for example, medical Aron Alpha (registered trademark)
  • fibrin glue or the like
  • the balloon lumen 22 is a flow path for circulating a fluid for inflating the balloon 3.
  • the distal end of the balloon lumen 22 does not reach the tip of the small-diameter portion 21b, and opens as a supply / exhaust port 22a on the side of the small-diameter portion 21b on the distal end side of the injection port 23a.
  • the supply / discharge port 22 a is formed at a position where fluid can be supplied or discharged with respect to the inside of the balloon 3.
  • the fluid for inflating the balloon 3 is preferably a fluid that does not interfere with leakage into the blood vessel, and examples thereof include physiological saline and a contrast medium.
  • the procedure can be advanced while confirming the position and inflated state of the balloon 3 by X-ray contrast.
  • air or the like can be used as the fluid when sufficient measures are taken to prevent the fluid for inflating the balloon 3 from leaking into the blood vessel.
  • Examples of the material constituting the catheter tube 2 include polyvinyl chloride resin, urethane resin such as polyurethane, polyolefin resin such as polyethylene, polypropylene, and ethylene-propylene copolymer, polyamide resin, polytetrafluoroethylene, tetrafluoroethylene- Examples thereof include various synthetic resin materials such as perfluoroalkyl vinyl ether copolymer, tetrafluoroethylene-hexafluoropropylene copolymer, fluororesin such as polyvinylidene fluoride, and ethylene-vinyl acetate copolymer.
  • the size of the catheter tube 2 is not particularly limited, but the length of the portion on the tip side of the cover 4 can be set to 20 to 300 mm, for example.
  • the outer diameter of the catheter tube 2 (large diameter portion 21a) is related to the inner diameter of the puncture hole to be occluded (hemostatic) or the outer diameter of the sheath introducer used to form the puncture hole. It is set to a small diameter, and can be set within a range of 0.5 to 5.0 mm, for example.
  • the length excluding the portion to which the balloon 3 of the small diameter portion 21b is attached can be set in the range of 0 to 5 mm, preferably 1 to 5 mm, and the outer diameter of the small diameter portion 21b is 0.3 to 4 mm. It can be set within a range of 0 mm.
  • the balloon 3 expands when a fluid is supplied (injected) into the balloon 3 and contracts when discharged (sucked) in the opposite direction.
  • the catheter tube 2 (the small diameter portion 21b of the insertion end 21). It is attached so that it may be near the front-end
  • the balloon 3 is a rotating body-shaped balloon having the axis of the catheter tube 2 as a rotation axis.
  • the balloon 3 is provided so as to be inflated in a blood vessel when fluid is supplied through the balloon lumen 22 with the insertion end 21 inserted into the puncture hole.
  • the stretchable material forming the balloon 3 is preferably 100% modulus (measured according to JIS K 6251) of 0.1 to 10 MPa, particularly preferably 1 to 5 MPa. If the 100% modulus is too small, the strength of the balloon 3 may be insufficient, and if it is too large, the balloon 3 may not be expanded to a sufficient size.
  • Specific examples of the stretchable material suitable for forming the balloon 3 include natural rubber, silicone rubber, polyurethane elastomer, and the like.
  • the balloon 3 is generally cylindrical in a deflated state, and is joined to the outer peripheral surface of the catheter tube 2 (the small diameter portion 21b of the insertion end portion 21) at both ends thereof.
  • the portions 3a and 3b are formed, and between the joint portions 3a and 3b at both ends thereof, an expansion portion 3c that expands when a fluid is supplied to the inside is formed.
  • the method for joining the joint portions 3a and 3b of the balloon 3 and the catheter tube 2 (thin diameter portion 21b) is not particularly limited. For example, adhesion with an adhesive, thermal fusion, welding with a solvent, ultrasonic fusion, Examples include high-frequency fusion.
  • the outer diameter of the balloon 3 (inflatable portion 3c) when it is inflated may vary depending on the pressure of the fluid supplied to the inside, but in order to close the inside of the blood vessel of the puncture hole, the outer diameter may be at least 1 mm or more. preferable.
  • the length of the inflatable portion 3c in the balloon 3 (the length along the axial direction of the catheter tube 2) is set in relation to the inner diameter of the blood vessel, but is preferably 0.5 to 10 mm, and the wall thickness is It is preferably 0.01 to 0.50 mm.
  • the wall thickness of the balloon 3 is preferably uniform along the circumferential direction.
  • the method for producing the balloon 3 is not particularly limited, and a known method may be used as a method for forming the stretchable material, but it is preferable to use a dipping method.
  • a stretchable material and various additives as necessary are dissolved in a solvent to form a solution or suspension, and a mold having an outer shape substantially equal to the desired balloon shape is formed in this solution (suspension). It is immersed and a solution (suspension) is applied to the surface of the mold, and the solvent is evaporated to form a film on the surface of the mold. By repeating this immersion and drying, a balloon having a desired thickness can be formed.
  • crosslinking is performed after film formation, if necessary.
  • the surface of the balloon 3 is preferably provided with a fluorine coating or the like in order to suppress adhesion of the adhesive injected into the puncture hole.
  • the distal end of the catheter tube 2 (the small diameter portion 21b of the insertion end portion 21) has a smooth, substantially hemispherical shape so that the insertion into the puncture hole is performed smoothly. It may be. In addition, you may provide a front-end
  • branch pipes 5a and 6a are connected to the proximal end side of the catheter tube 2 at the cover 4 portion.
  • the branch pipe 5 a is a tube whose distal end is connected to the proximal end of the balloon lumen 22 of the catheter tube 2
  • the branch pipe 6 a is a tube whose distal end is connected to the proximal end of the adhesive lumen 23 of the catheter tube 2. It is.
  • the material of the branch pipes 5a and 6a is not particularly limited, but a polymer material is preferably used.
  • a port 5b having a stopcock is connected to the proximal end of the branch pipe 5a, and a port 6b having a stopcock is connected to the proximal end of the branch pipe 6a.
  • a syringe or the like is connected to the port 5 b so that a fluid for inflating the balloon 3 can be sent to the balloon lumen 22.
  • a syringe or the like is connected to the port 6b so that a biological adhesive to be injected into the puncture hole can be fed into the adhesive lumen 23.
  • the material of the ports 5b and 6b is not particularly limited, but it is preferable to use a transparent polymer material.
  • the connecting method between the branch pipe 5a and the balloon lumen 22, and the branch pipe 6a and the adhesive lumen 23 is not particularly limited.
  • the distal ends of the branch pipes 5a and 6a are formed into a tapered shape, and the outer peripheral surface thereof is formed.
  • Adhesive may be applied to the end of the catheter tube 2 and the end portions thereof inserted into the corresponding lumens 22 and 23 of the catheter tube 2.
  • the connecting portion between the catheter tube 2 and each branch pipe 5a, 6a is reinforced and protected by a cover 4.
  • the cover 4 is provided so as to cover the connection portion between the catheter tube 2 and the branch pipes 5a and 6a.
  • the shape of the cover 4 is not particularly limited, but is usually a box shape or a cylindrical shape.
  • the material of the cover 4 is not particularly limited, but a polymer material is preferably used. It is also possible to use a heat shrinkable tube as the cover 4.
  • a plug member 7 is a member that is inserted into a cylindrical space portion formed in an adhesive that is injected into a puncture hole, which will be described later, and solidified, and closes this, and insertion of the catheter tube 2
  • This is a columnar member having an outer diameter that is the same as or slightly larger than the outer diameter of the large-diameter portion 21 a of the end portion 21.
  • the axial length of the plug member 7 can be set in the range of 1 to 50 mm.
  • the material of the plug member 7 is not particularly limited, and biodegradable polymers such as polylactic acid, collagen, gelatin and the like can be used.
  • the puncture hole extending from the body surface into the blood vessel formed by removing the sheath introducer punctured into the blood vessel (femoral artery) percutaneously is blocked ( The procedure of the hemostasis procedure will be described with reference to FIGS. 2A to 2J.
  • the puncture hole is usually formed to be inclined obliquely in the direction in which the blood vessel extends.
  • the puncture hole is in the direction in which the blood vessel extends. It is drawn so as to intersect at a substantially right angle with respect to.
  • FIG. 2A when the sheath introducer 81 is removed from the state where the sheath introducer 81 is percutaneously penetrated through the skin tissue 82 and the blood vessel wall 83, the sheath introducer 81 is shown in FIG. 2B. As is done, a puncture hole 84 that penetrates the skin tissue 82 and the blood vessel wall 83 is formed. In FIG. 2A to FIG. 2H, drawing of blood is omitted.
  • the insertion end portion 21 (the large diameter portion 21a and the small diameter portion 21b) of the hemostatic device 1 in a state where the balloon 3 is deflated is inserted into the puncture hole 84.
  • a syringe (not shown) connected to the port 5b (see FIG. 1A) is operated to supply a fluid into the balloon 3 via the balloon lumen 22, the balloon 3 is shown in FIG. 2D. Is expanded in the blood vessel, and the blood vessel side of the puncture hole 84 is blocked by a part of the proximal end side of the inflated balloon 3.
  • a syringe (not shown) connected to the port 6b (see FIG. 1A) is operated to supply a biological adhesive to the adhesive lumen 23, as shown in FIG. 2E.
  • An adhesive 85 is injected into the puncture hole 84 from the inlet 23a.
  • a syringe (not shown) connected to the port 5b (see FIG. 1A) is operated to suck the fluid in the balloon 3 through the balloon lumen 22, As shown in FIG. 2F, the balloon 3 is deflated.
  • the insertion end portion 21 of the catheter tube 2 is removed from the puncture hole 84, the insertion end portion 21 (the large diameter portion 21a, the small diameter portion 21b, A shape corresponding to the shape of the step surface 21c), that is, a cylindrical space portion having a large diameter space portion 85a, a small diameter space portion 85b, and a step surface 85c is formed.
  • the plug member 7 is inserted and installed in the large-diameter space portion 85a of the cylindrical space portion.
  • the end surface on the distal end side of the plug member 7 comes into contact with the stepped surface 85c. Is prevented from being pushed into the blood vessel.
  • the narrow space portion 85b of the cylindrical space portion is pressed while pressing the plug member 7 (and surrounding skin tissue 82) with fingers 86 (may be a member such as a balloon).
  • fingers 86 may be a member such as a balloon.
  • the plug member 7 is removed using tweezers or the like, whereby the puncture hole 84 is completely closed as shown in FIG. 2J, and the hemostasis is completed.
  • the plug member 7 may be formed of a biodegradable polymer or the like and left as it is until it is decomposed without being removed.
  • the balloon 3 for closing the blood vessel side of the puncture hole 84 is provided, a balloon for closing the outside of the blood vessel of the puncture hole or the body surface side of the puncture hole is provided as in the prior art. Since it is not necessary, the configuration is simple and the cost can be reduced.
  • the adhesive 85 to be injected into the puncture hole 84 an adhesive that can be coagulated in a shorter time than the coagulation of blood itself can be used. Compared to the conventional technology that waits for coagulation of the blood itself in the puncture hole, The time required for hemostasis can be shortened.
  • one adhesive inlet 23a is provided on the side of the small diameter portion 21b of the insertion end 21 of the catheter tube 2, as shown in FIGS. 3A and 3B.
  • two or a plurality of small diameter portions 21b may be provided.
  • the plurality of inlets 23a can be provided by forming a plurality of branch holes that open from the adhesive lumen 23 to the side surface.
  • a guide wire lumen (passage) 24 through which the guide wire 8 is slidably inserted into the catheter tube 2 is provided so as to penetrate from the proximal end to the distal end. Also good. With this configuration, the guide wire 8 can be used to smoothly insert the insertion end portion 21 of the catheter tube 2 into the puncture hole 84.
  • the entire catheter tube 2 from the proximal end to the distal end is defined as a small diameter portion 21b (or a large diameter portion 21a) so that the catheter tube 2 can slide.
  • a cover tube 9 to be inserted may be provided.
  • the insertion end including the balloon 3 slid so as to push out the cover tube 9 when the insertion end portion 21 is removed after the injection / coagulation of the adhesive 85 into the puncture hole 84 and the cover tube 9 is contracted.
  • the adhesive inlet 23a is provided so as to open to the side portion of the insertion end portion 21 (small diameter portion 21b). However, as shown in FIG. You may provide so that it may open to the front end surface (step surface 21c) of the part 21a.
  • the injection port 23a is provided so as to open to the side portion of the small diameter portion 21b
  • the adhesive agent is introduced from the small diameter portion 21b side of the insertion end portion 21. Since 85 is injected, the adhesive 85 can be uniformly filled in the puncture hole 84.
  • a plurality of injection ports 23a may be provided on the step surface 21c, or both the injection port 23a of the step surface 21c and the injection port 23a on the side surface of the small diameter portion 21b may be provided.
  • the injection port 23 a may be provided in the large diameter portion 21 a of the insertion end portion 21. Note that one or more of the modifications described above may be combined as appropriate.

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Abstract

Le problème décrit par la présente invention est de pourvoir à un dispositif hémostatique dont le coût peut être réduit. La solution selon l'invention porte sur un dispositif hémostatique permettant de bloquer un trou de perforation percutané (84) formé de façon à s'étendre dans un vaisseau sanguin. Ce dispositif comporte un tube (2) pourvu : d'une partie extrémité d'insertion (21) qui est insérée dans un trou de perforation (84) et qui est pourvue d'un premier canal d'écoulement et d'un second canal d'écoulement ; et d'une lumière (3) qui est fixée à l'extrémité distale de la partie d'insertion (21) et qui est alimentée en fluide par l'intermédiaire du premier canal d'écoulement dans un état dans lequel la partie extrémité d'insertion (21) est insérée dans le trou de perforation (84), moyennant quoi la lumière (3) peut se dilater dans un vaisseau sanguin (83). Le tube (2) est pourvu d'un orifice d'injection (23) destiné à l'injection d'un adhésif biologique (85) introduit par l'intermédiaire du second canal d'écoulement dans le trou de perforation (84), l'orifice d'injection (23) étant formé plus près du côté extrémité proximale de la partie extrémité d'insertion (21) que la lumière (3).
PCT/JP2019/013994 2018-03-30 2019-03-29 Dispositif hémostatique et kit hémostatique WO2019189759A1 (fr)

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JP2012501220A (ja) * 2008-08-26 2012-01-19 セント ジュード メディカル インコーポレイテッド 経皮穿刺部を封止するための方法およびシステム
WO2012148745A1 (fr) * 2011-04-25 2012-11-01 St. Jude Medical Puerto Rico Llc Fixation de ballonnet distal pour dispositif et procédés de localisation d'obturation temporaire
JP2013516279A (ja) * 2010-01-06 2013-05-13 セント ジュード メディカル インコーポレイテッド 経皮穿刺部位を封止する方法およびシステム
US20130190808A1 (en) * 2012-01-24 2013-07-25 St. Jude Medical Puerto Rico Llc Bioadhesive delivery catheter manifold with mixing fixture and methods
US20140236223A1 (en) * 2013-02-20 2014-08-21 St. Jude Medical Puerto Rico Llc Bioresorbable detachable tip design for adhesive-based extravascular closure device

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JP2013516279A (ja) * 2010-01-06 2013-05-13 セント ジュード メディカル インコーポレイテッド 経皮穿刺部位を封止する方法およびシステム
WO2012148745A1 (fr) * 2011-04-25 2012-11-01 St. Jude Medical Puerto Rico Llc Fixation de ballonnet distal pour dispositif et procédés de localisation d'obturation temporaire
US20130190808A1 (en) * 2012-01-24 2013-07-25 St. Jude Medical Puerto Rico Llc Bioadhesive delivery catheter manifold with mixing fixture and methods
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