WO2020065743A1 - ステントおよびステントグラフト - Google Patents
ステントおよびステントグラフト Download PDFInfo
- Publication number
- WO2020065743A1 WO2020065743A1 PCT/JP2018/035548 JP2018035548W WO2020065743A1 WO 2020065743 A1 WO2020065743 A1 WO 2020065743A1 JP 2018035548 W JP2018035548 W JP 2018035548W WO 2020065743 A1 WO2020065743 A1 WO 2020065743A1
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- Prior art keywords
- wire
- stent
- fixing portion
- fiber
- tubular
- Prior art date
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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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/02—Inorganic materials
- A61L31/022—Metals or alloys
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
Definitions
- the present invention relates to a stent applied to a tubular organ in a body such as a digestive tract or a blood vessel, and a stent graft provided with such a stent.
- stent grafts provided with such stents have been used for the following applications, for example. That is, for example, it is used for prevention of dilatation, rupture, and stenosis accompanying deterioration of a tubular organ. It is also used, for example, to push open the lumen of a tubular organ in the body that has been squeezed out by the tumor of the tubular organ and its adjacent organs.
- a stent applied to a tubular organ in the body generally has a network structure using one or a plurality of wires (for example, see Patent Document 1).
- the stent according to one embodiment of the present invention is provided with a mesh structure having a tubular structure formed using one or a plurality of wires and extending along the axial direction of the stent.
- the mesh structure has a wire fixing portion for fixing an end of the wire and the same or another wire to the wire.
- the wire fixing portion is formed using a fiber wire in which an end of the wire and the same or another wire are wound around each other.
- a stent graft according to an embodiment of the present invention includes a tubular member, and at least one stent according to the embodiment of the present invention, which is disposed on at least a part of the tubular member. is there.
- the wire fixing portion for fixing the end of the wire and the same or another wire to each other uses a fiber wire obtained by winding the wires together. It is configured. Thereby, as compared with a case where the wires are fixed to each other using mechanical coupling of metal parts (so-called “crimping”), for example, an edge portion or a projection portion is less likely to be generated in the wire fixing portion (desirably, Will not occur).
- the wire including the straight portion and the bent portion forms a top portion at the bent portion, and the corrugated shape is formed, and the wire is formed.
- the fixing portion may be arranged in a region including the top in the corrugated shape. In this case, the displacement of the wire fixing portion is suppressed (preferably prevented), so that the end portion of the wire hardly comes off from the wire fixing portion. As a result, the risk of damaging the inner wall of the tubular organ in the body is further reduced.
- At least a part of the fiber wire in the wire fixing portion may be a molten layer.
- the outer surface and the entire knot of the fiber wire at the wire fixing portion are melted, so that the fiber wire at the wire fixing portion is difficult to unravel (preferably, does not unravel).
- the projections and projections are less likely to be generated at the wire rod fixing portion. As a result, the risk of damaging the inner wall of the tubular organ in the body is further reduced.
- the fiber wire may be formed using the same type of fiber material as the tubular member.
- the same type of material fiber material
- the manufacture of the stent graft is facilitated and the manufacturing cost is reduced.
- the wire fixing portion is configured using the fiber wire, an edge portion and a protrusion are less likely to be generated in the wire fixing portion ( If desired). Therefore, the risk of damaging the inner wall of the tubular organ in the body can be reduced.
- FIG. 1 is a schematic perspective view illustrating a schematic configuration example of a stent according to an embodiment of the present invention.
- FIG. 2 is a schematic development view illustrating a detailed configuration example of a main part of the stent illustrated in FIG. 1.
- FIG. 3 is a schematic diagram illustrating a detailed configuration example near a wire rod fixing portion illustrated in FIG. 2.
- FIG. 4 is a schematic diagram illustrating an example of a method of forming a wire fixing portion illustrated in FIG. 3. It is a schematic diagram showing the example of a structure near the fixing
- Embodiment an example of a stent in which a wire fixing portion for fixing an end of a wire is made of a fiber wire
- Application example example in which the stent of the embodiment is applied to a stent graft
- Other modifications
- FIG. 1 is a perspective view schematically illustrating a schematic configuration example of a stent (stent 11) according to an embodiment of the present invention.
- the stent 11 is a device applied to a tubular organ in the body (for example, a gastrointestinal tract such as the large intestine or a blood vessel such as the aorta). As described later, for example, the lumen of the tubular organ in the body narrowed by a tumor is used. It is used to push open. Specifically, the stent 11 is placed at a site to be treated (in the tubular organ in the body as described above).
- the stent 11 corresponds to a specific example of the “stent” in the present invention, and has a concept including a covered stent.
- the stent 11 has a tubular (cylindrical) structure extending along the axial direction Z (Z-axis direction).
- the stent 11 has two end regions (end regions Aea and Aeb) and a non-end region (an intermediate region located between the end regions Aea and Aeb) along the axial direction Z. (See FIG. 1).
- the length of the stent 11 along the axial direction Z is, for example, about 3 to 25 cm.
- the outer diameter of the stent 11 when expanded is, for example, about 10 to 50 mm.
- the stent 11 is configured using one type of wire W1 (element wire), and has a cylindrical structure as described above.
- this tubular structure is formed of a mesh structure, and such a tubular mesh structure forms the wire W1 in a predetermined pattern (a mesh pattern described later).
- Each is formed by braiding.
- the details of the mesh structure (braided pattern of the wire W1) and the like in the stent 11 will be described later (FIG. 2).
- a metal wire is preferable, and a shape memory alloy to which a shape memory effect or superelasticity is given by heat treatment is particularly preferably used.
- a shape memory alloy to which a shape memory effect or superelasticity is given by heat treatment is particularly preferably used.
- stainless steel, tantalum (Ta), titanium (Ti), platinum (Pt), gold (Au), tungsten (W), or the like may be used as the material of the wire W1.
- a wire obtained by coating a surface of a metal wire with Au, Pt, or the like by plating or a composite wire in which a core material made of a radiopaque material such as Au, Pt is covered with an alloy is used. It may be used as W1.
- FIG. 2 is a developed view schematically showing a detailed configuration example of a main part (near the above-mentioned end regions Aea and Aeb) of the stent 11, and shows an axial direction Z and a circumferential direction R shown in FIG. Along each direction.
- the stent 11 is configured by using one type of network structure 111. That is, the stent 11 is constituted by the network-like structure 111 formed using the wire W1 described above.
- the mesh structure 111 constitutes the above-described tubular structure, and extends along the axial direction Z of the stent 11 (over the entire length).
- the wire diameter of such a wire W1 is, for example, about 0.30 mm.
- a corrugated shape is formed in which the wire W1 including the straight portion s1 and the bent portion b1 forms a top portion at the bent portion b1. Further, the mesh structure 111 is formed by such wires W1 intersecting each other at the straight portion s1. Therefore, in the mesh structure 111, an intersection (wire intersection), which is a portion where the straight portions s1 of the wire W1 intersect, is formed.
- a connecting portion C1 (engagement portion) formed by connecting (engaging) the wires W1 to each other at the bent portion b1 is formed. That is, the mesh-like structure 111 is configured by connecting along the axial direction Z a mesh pattern formed by advancing the wire W1 forming the above-described waveform shape along the circumferential direction R.
- each mesh pattern is formed by the wire W1 making two turns while forming a waveform along the circumferential direction R.
- the mesh pattern of each row is composed of a first loop, which is a first loop, and a second loop, which is a second loop.
- the phases of the waveforms are shifted from each other by half a pitch (1 / pitch) along the circumferential direction R in the mesh pattern of each row.
- the above-mentioned intersections are arranged side by side along the circumferential direction R. In such an intersection, the first loop and the second loop intersect so as to alternately go up and down.
- Wire fixing part Fw (Wire fixing part Fw)
- a wire fixing portion Fw for fixing the end of the wire W1 is provided in such a network-like structure 111.
- the wire fixing portion Fw is formed as follows. That is, first, when the second loop is formed in the mesh pattern of the first row, the wire W1 forms the waveform having the same phase as that of the first loop until shifting to the mesh pattern of the second row. It travels along the circumferential direction R in parallel with one loop. Therefore, the wire W1 advances while being adjacent to the wire forming the first loop until the transition to the mesh pattern of the second row after the formation of the second loop. The end of the wire W1 is fixed to such an adjacent wire at the wire fixing portion Fw. In other words, the wire fixing portion Fw fixes the end of the wire W1 (the wire W1a in the example of FIG. 2) and the same wire W1 (the wire W1b in the example of FIG. 2) of the wire W1a to each other. It has become.
- the stent 11 of the present embodiment is configured using one type of wire W1 at least in the end regions Aea and Aeb as described above, the wire W1a and the wire W1b are the same. It has become a wire rod.
- the above-described wires W1a and W1b may be formed of different wires. That is, in this case, the wire fixing portion Fw fixes the end of the wire W1a and another wire W1b different from the wire W1a to each other.
- FIG. 3 schematically shows a detailed configuration example in the vicinity of such a wire fixing portion Fw. Specifically, in the example shown in FIG. 3, the end of the wire W1a and the non-end of the wire W1b are fixed to each other at a wire fixing portion Fw.
- the wire rod fixing portion Fw is configured by using a fiber wire rod Wf obtained by winding an end of the wire rod W1a and a (non-end part) of the wire rod W1b.
- the fiber wire Wf has a configuration in which the wires W1a and W1b are wound a plurality of times along the circumferential direction of the wires W1a and W1b.
- at least a part of the fiber wire Wf in the wire fixing portion Fw is a melting layer, which will be described in detail later.
- the wire fixing portion Fw is disposed in a region including the top (bent portion b1) in the above-described waveform.
- the wire rod fixing portion Fw is configured to fix the wire rod W1 (W1a, W1b) in a region including the bent portion b1 of the wire rod W1.
- the wire fixing portion Fw is arranged so that the wire W1a includes the region of the straight portion s1 after the end of the wire W1a exceeds the top portion (bent portion b1) of the waveform. Have been.
- the wire fixing portion Fw is arranged over the region of the straight portion s1 at the left side of the bent portion b1).
- such a fiber wire Wf can be configured using, for example, the following materials (fiber materials). That is, examples of the fiber material constituting the fiber wire Wf include polyolefins such as polyethylene terephthalate (PET), polyethylene, polypropylene, and ethylene- ⁇ -olefin copolymer, polyamide, polyurethane, polybutylene terephthalate, polycyclohexane terephthalate, and polyethylene.
- PET polyethylene terephthalate
- PET polyethylene
- polypropylene polypropylene
- ethylene- ⁇ -olefin copolymer polyamide, polyurethane, polybutylene terephthalate, polycyclohexane terephthalate, and polyethylene.
- Polyesters such as 2,6-naphthalate, vinyl resins such as polyvinyl chloride, vinyl acetate and ethylene-vinyl acetate copolymer, fluororesins such as polyfluoroethylene and polypropylenepropylene, polyamides, polyamide elastomers, polyurethanes and silicones Resins, natural rubber, and other resins having low durability and tissue reaction can be used.
- polyesters such as polyethylene terephthalate, fluororesins such as polyfluoroethylene and polyfluoropropylene, and silicone resins can be preferably used, which are chemically stable, have high durability, and have little tissue reaction. .
- FIGS. 4A and 4B schematically illustrate an example of a method of forming the wire fixing portion Fw.
- the ends of the wires W1a and the ends (or the non-ends) of the wires W1b are bundled in a state where they are bundled.
- the fiber wire Wf is wound a plurality of times along the circumferential direction. At this time, the ends of the fiber wire Wf wound a plurality of times are tied to each other (see the knot Pk shown in FIG. 4A).
- the fiber wire Wf thus wound is melted.
- a molten layer of the fiber wire Wf is formed.
- the entire knot Pk and the outer surface of the fiber wire Wf are each melted, so that a melting layer is formed only on the outer surface of the fiber wire Wf, and the inner side of the fiber wire Wf is not melted.
- the wire fixing portion of the stent 11 is formed.
- This stent 11 is indwelled in a treatment target site (in the above-mentioned tubular organ) when treating a tumor or the like in the vicinity of a tubular organ (a gastrointestinal tract such as the large intestine or a blood vessel such as the aorta) in a patient.
- a tubular organ a gastrointestinal tract such as the large intestine or a blood vessel such as the aorta
- the stent 11 is stored in a predetermined delivery sheath in a reduced diameter state, and the delivery sheath is inserted into the tubular organ, whereby the stent 11 is carried to the vicinity of the affected part. Then, the stent 11 is deployed from the inside of the delivery sheath and expanded in diameter, so that the stent 11 is placed at the affected part (the part to be treated).
- FIG. 5 schematically illustrates a configuration example near a fixing portion (fixing portion 101) of a wire W1 (W1a, W1b) in a stent (stent 100) according to a comparative example.
- the end of the wire W1a and the (non-end) of the wire W1b used a mechanical connection of metal parts (so-called “crimping”).
- they are fixed to each other (see reference numeral M in FIG. 5).
- the wire W1a and the wire W1b are fixed by “crimping” using a SUS (stainless steel) pipe, for example.
- the stent 100 of the comparative example since the wire W1a and the wire W1b are fixed in the fixing portion 101 using the mechanical connection of the metal components, the edges and the projections of the metal components are fixed. This will occur in the unit 101. Therefore, in the stent 100 of the comparative example, the risk of damaging the inner wall (for example, a blood vessel wall) of the tubular organ in the body may be increased.
- the inner wall for example, a blood vessel wall
- the wire fixing portion Fw of the present embodiment is configured using the flexible fiber wire Fw, the wire fixing portion Fw can have a flexible structure. Therefore, it is possible to make it difficult to prevent the deformation of the stent 11 (and the stent graft 1 described later).
- the wire rod fixing portion Fw of the present embodiment unlike the fixing portion 101 (fixing method using so-called “caulking”) in the comparative example, for example, the hardness does not change suddenly. Bending due to stress concentration caused by a rapid change in hardness is unlikely to occur (desirably, does not occur). Further, in the wire fixing portion Fw of the present embodiment, unlike the fixing portion 101 in the comparative example, for example, since no metal material is used, it is possible to prevent the occurrence of corrosion due to contact between dissimilar metals. It becomes possible.
- the wire fixing portion Fw of the present embodiment is arranged in a region including the top portion (bent portion b1) in the above-described waveform shape. Accordingly, the displacement of the wire fixing portion Fw is suppressed (preferably, prevented), so that the end of the wire W1a described above does not easily come off from the wire fixing portion Fw. As a result, the risk of damaging the inner wall of the tubular organ in the body can be further reduced.
- the present embodiment As described above, when the fixing portion 101 is arranged in the region including the bent portion b1, the following problem occurs. That is, in this comparative example, since the hardness of the fixed portion 101 is high, if the fixed portion 101 is arranged in the region including the bent portion b1, the bent portion b1 becomes difficult to bend (or cannot be bent). For this reason, the diameter of the stent 100 cannot be sufficiently reduced, and the stent 100 cannot be housed in the delivery catheter.
- the fixing portion 101 cannot be arranged in the region including the bent portion b1 due to “crimping” using a SUS pipe.
- the wire rod fixing portion Fw is configured using the fiber wire rod Wf, the hardness of the wire rod fixing portion Fw does not increase, and the wire rod fixing portion Fw is formed in a region including the bent portion b1. Even when the wire fixing portion Fw is arranged, the bent portion b1 can be easily bent. Therefore, the diameter of the stent 11 can be sufficiently reduced, and the stent 11 can be housed in the delivery catheter.
- the wire fixing portion Fw can be arranged in a region including the bent portion b1.
- such a wire fixing portion Fw is arranged such that the end of the wire W1a includes the region of the linear portion s1 after exceeding the top in the above-described waveform shape. become that way.
- the displacement of the wire fixing portion Fw is further suppressed (desirably). Will be prevented). This makes it more difficult for the end of the wire W1a to come off from the wire fixing portion Fw, so that the risk of damaging the inner wall of the tubular organ in the body can be further reduced.
- At least a part of the fiber wire Wf in such a wire fixing portion Fw is formed as a molten layer, and thus, the following is performed. That is, for example, by melting the outer surface of the fiber wire Wf and the entire knot Pk in the wire fixing portion Fw, it is possible to make the fiber wire Wf in the wire fixing portion Fw difficult to unravel (preferably, not to unravel).
- the edge portions and the projection portions described above are less likely to be generated in the wire fixing portion Fw. As a result, the risk of damaging the inner wall of the tubular organ in the body can be further reduced.
- FIG. 6 is a schematic perspective view illustrating a schematic configuration example of a stent graft (stent graft 1) according to the application example.
- the stent graft 1 includes the stent 11 described in the embodiment and a tubular member 12 described below.
- the stent graft 1 is a medical device applied to a blood vessel such as the aorta described above, for example.
- the tubular member 12 has a tubular (cylindrical) shape as shown in FIG. 6, and is arranged so as to cover (cover) at least a part of the stent 11. Specifically, in this example, the tubular member 12 is arranged so as to cover the outer peripheral side of the stent 11.
- the cylindrical member 12 is connected to the stent 11 by means of, for example, sewing, adhesion, welding, or the like, and covers the stent 11.
- a connection portion between the tubular member 12 and the stent 11 is appropriately provided in, for example, end regions Aea and Aeb and a non-end region (intermediate region) of the stent 11.
- the stent 11 is arranged in all regions (end regions Aea, Aeb and non-end regions) along the axial direction Z of the tubular member 12.
- the present invention is not limited to this example, and the stent 11 may be arranged only in a part of the cylindrical member 12 along the axial direction Z.
- the stent graft 1 has, along the axial direction Z, a region where the stent 11 is arranged (stent arrangement region) and a region where the stent 11 is not arranged (stent non-arrangement region). You may.
- a tubular member 12 for example, a resin formed into a tubular shape by a molding method such as extrusion molding or blow molding, a knitted fabric made of a resin-made fiber or a fine metal wire formed into a tubular shape, a tubular shape, or the like. It is possible to use a non-woven fabric made of a resin or an ultrafine metal formed in a shape, a resin sheet or a porous sheet formed in a cylindrical shape, a structure formed in a thin cylindrical shape using a resin dissolved in a solvent, and the like. it can.
- a known knitted fabric or woven fabric such as a plain weave or a twill weave can be used.
- a material with a fold such as crimping can be used.
- Examples of the above-mentioned resin include polyolefins such as polyethylene, polypropylene, and ethylene- ⁇ -olefin copolymers, polyamides, polyurethanes, polyesters such as polyethylene terephthalate, polybutylene terephthalate, polycyclohexane terephthalate, and polyethylene-2,6-naphthalate. , Vinyl resin such as polyvinyl chloride, vinyl acetate, ethylene-vinyl acetate copolymer, fluororesin such as polyfluoroethylene and polyfluoropropylene, polyamide, polyamide elastomer, polyurethane, silicone resin, natural rubber, etc. A resin or the like having a small tissue reaction can be used.
- polyolefins such as polyethylene, polypropylene, and ethylene- ⁇ -olefin copolymers
- polyamides such as polyethylene terephthalate, polybutylene terephthalate, polycyclohexane
- polyesters such as polyethylene terephthalate, fluororesins such as polyfluoroethylene and polyfluoropropylene, and silicone resins can be preferably used, which are chemically stable, have high durability, and have little tissue reaction. .
- the material (fibrous material) that constitutes such a tubular member 12 and the material (fibrous material) that constitutes the fiber wire Wf in the wire fixing portion Fw described in the embodiment. May match each other. That is, the fiber wire Wf in the wire fixing portion Fw may be configured using, for example, the same type of fiber material as the material forming the tubular member 12 as described above.
- the fiber wire Wf in the wire fixing portion Fw is configured using the same type of fiber material as the tubular member 12, the following is obtained. That is, since the same type of material (fiber material) is used for the fiber wire Wf and the tubular member 12, the production of the stent graft 1 becomes easy and the production cost can be reduced.
- the shape, arrangement position, size, number, material, and the like of each member described in the above embodiment and the like are not limited, and may be other shapes, arrangement positions, sizes, numbers, materials, and the like.
- the tubular member may cover the inner peripheral side of the stent, or may cover both the inner peripheral side and the outer peripheral side of the stent.
- the fiber wire in the wire fixing portion has been described as an example in which the molten layer is a melting layer.
- the fiber wire may not be the molten layer.
- the fiber wire in the wire fixing portion may be configured using a fiber material different from the tubular member in the stent graft.
- the arrangement of the wire fixing portion may be, for example, a configuration as shown in FIG. FIG. 7 schematically illustrates an example of a configuration near a wire rod fixing portion Fw in a stent (stent 11A) according to another modification.
- the wire rod fixing portion Fw is arranged in the region of the straight line portion s1 after the end of the wire rod W1a has passed over the top portion (bent portion b1) in the above-described waveform shape. More specifically, in the waveform shape, not the area near the apex or the area near the apex (the part on the right side of the bent part b1 in FIG. 7) but the area beyond the apex (see FIG. 7). 7, the wire fixing portion Fw is arranged only in the region of the linear portion s1 at the left portion of the bent portion b1).
- each wire in the stent is not limited to the one described in the above embodiment, and may be another arrangement shape.
- the present invention is not limited to this, and two or more stents are separately provided in the stent graft (for example, an axial shaft). (In a state separated from each other along the direction Z).
- a stent in the above-described embodiment and the like, basically, the case where the stent is configured using one type of wire (element wire) has been described, but the present invention is not limited to this case. That is, for example, a stent may be configured using a plurality of types (two or more types) of wires (element wires) having different wire diameters.
- the stent and the stent graft applied to the treatment of the digestive tract such as the large intestine and the blood vessel such as the aorta are mainly described as examples, but the present invention is not limited thereto. That is, each of the stent and the stent graft of the present invention can be applied to the treatment of, for example, other digestive tracts other than the large intestine and other blood vessels other than the aorta (other tubular organs in the body). .
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Abstract
Description
1.実施の形態(線材端部を固着する線材固着部を繊維線材で構成したステントの例)
2.適用例(実施の形態のステントをステントグラフトへ適用した場合の例)
3.その他の変形例
[A.概略構成]
図1は、本発明の一実施の形態に係るステント(ステント11)の概略構成例を、模式的に斜視図で表したものである。ステント11は、体内の管状器官(例えば、大腸等の消化管や、大動脈等の血管など)に適用される器具であり、後述するように、例えば、腫瘍によって狭窄した体内の管状器官の内腔を押し開けるために使用されるものである。具体的には、ステント11は、治療対象の部位(上記したような体内の管状器官内)に留置されるようになっている。なお、このステント11は、本発明における「ステント」の一具体例に対応しており、カバードステントを含む概念のものである。
続いて、図2~図4を参照して、図1に示したステント11の詳細構成例(上記した網目状構造等の構成例)について説明する。図2は、ステント11における要部(前述した端部領域Aea,Aeb付近)の詳細構成例を、模式的に展開図で表したものであり、図1に示した軸方向Zおよび周方向Rの各方向に沿って表している。
ここで、本実施の形態のステント11では、図2に示したように、このような網目状構造体111において、線材W1の端部を固着する線材固着部Fwが設けられている。
(A.基本動作)
このステント11は、患者における体内の管状器官(大腸等の消化管や、大動脈等の血管など)付近の腫瘍等の治療の際に、その治療対象の部位(上記した管状器官内)に留置されることで、以下のようになる。すなわち、例えば、管状器官の劣化に伴う拡張および破裂、狭窄の予防や、管状器官およびこれに近接する器官の腫瘍によって圧排されて狭窄した体内の管状器官の内腔を押し開けることが可能となる。
次いで、図1~図4に加えて図5を参照して、ステント11における作用および効果について、比較例と比較しつつ、詳細に説明する。
図5は、比較例に係るステント(ステント100)における、線材W1(W1a,W1b)の固定部(固定部101)付近の構成例を、模式的に表したものである。
これに対して本実施の形態のステント11では、図2~図4に示したように、線材W1(W1a)における端部と線材W1(W1b)とを互いに固着している線材固着部Fwが、それらの線材W1a,W1b同士を互いに巻回した繊維線材Wfを用いて構成されている。これにより本実施の形態では、例えば、線材W1a,W1b同士を金属部品の機械的な結合を用いて固定した、上記比較例等の場合と比べ、エッジ部分や突起部分が、線材固着部Fwに生じにくくなる(望ましくは、生じなくなる)。よって、本実施の形態では上記比較例等の場合と比べ、前述した体内の管状器官の内壁を傷付けるリスクを、低減することが可能となる。
続いて、上記実施の形態に係るステント(ステント11)の、ステントグラフトへの適用例について説明する。
図6は、本適用例に係るステントグラフト(ステントグラフト1)の概略構成例を、模式的に斜視図で表したものである。ステントグラフト1は、実施の形態で説明したステント11と、以下説明する筒状部材12とを備えている。このステントグラフト1は、例えば、前述した大動脈等の血管に適用される医療機器である。
筒状部材12は、図6に示したように筒状(円筒状)の形状を有しており、ステント11の少なくとも一部分を覆う(被覆する)ように配置されている。具体的には、この例では、筒状部材12がステント11の外周側を覆うように配置されている。
本適用例のステントグラフト1においても、基本的には、実施の形態と同様の作用により、同様の効果を得ることが可能である。
以上、実施の形態および適用例を挙げて本発明を説明したが、本発明はこれらの実施の形態等に限定されず、種々の変形が可能である。
Claims (5)
- 体内の管状器官に適用されるステントであって、
1または複数の線材を用いて形成され、前記ステントの軸方向に沿って延在する筒状構造を有する網目状構造体を備え、
前記網目状構造体は、前記線材における端部と、その線材と同一または他の線材とを、互いに固着する線材固着部を有しており、
前記線材固着部が、前記線材における端部と前記同一または他の線材とを互いに巻回した、繊維線材を用いて構成されている
ステント。 - 前記網目状構造体において、直線部および屈曲部を含む前記線材が前記屈曲部において頂部を構成する、波形形状が形成されており、
前記線材固着部が、前記波形形状における前記頂部を含む領域に配置されている
請求項1に記載のステント。 - 前記線材固着部において、前記繊維線材の少なくとも一部が、融解層となっている
請求項1または請求項2に記載のステント。 - 筒状部材と、
前記筒状部材の少なくとも一部分に配置された、少なくとも1つのステントと
を備え、
前記ステントは、1または複数の線材を用いて形成され、前記ステントの軸方向に沿って延在する筒状構造を有する網目状構造体を備え、
前記網目状構造体は、前記線材における端部と、その線材と同一または他の線材とを、互いに固着する線材固着部を有しており、
前記線材固着部が、前記線材における端部と前記同一または他の線材とを互いに巻回した、繊維線材を用いて構成されている
ステントグラフト。 - 前記繊維線材が、前記筒状部材と同種類の繊維材料を用いて構成されている
請求項4に記載のステントグラフト。
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JP2005110778A (ja) * | 2003-10-03 | 2005-04-28 | Piolax Medical Device:Kk | ステント及びステントグラフト |
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US5609627A (en) * | 1994-02-09 | 1997-03-11 | Boston Scientific Technology, Inc. | Method for delivering a bifurcated endoluminal prosthesis |
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JPH09173469A (ja) * | 1995-12-27 | 1997-07-08 | Sumitomo Bakelite Co Ltd | 管腔ステント及びその製造方法 |
FR2750853B1 (fr) * | 1996-07-10 | 1998-12-18 | Braun Celsa Sa | Prothese medicale, en particulier pour anevrismes, a liaison perfectionnee entre sa gaine et sa structure |
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