JP2001526574A - プロテーゼ及び該プロテーゼを配置する方法及び手段 - Google Patents
プロテーゼ及び該プロテーゼを配置する方法及び手段Info
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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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/9517—Instruments specially adapted for placement or removal of stents or stent-grafts handle assemblies therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
-
- 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
- A61F2/89—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
-
- 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
- A61F2002/065—Y-shaped blood vessels
-
- 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
- A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
- A61F2002/9665—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/005—Rosette-shaped, e.g. star-shaped
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0054—V-shaped
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0067—Three-dimensional shapes conical
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Prostheses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Graft Or Block Polymers (AREA)
Abstract
Description
Claims (1)
- 【特許請求の範囲】 1. 膨張性血管内膜プロテーゼ(20)を患者の管腔に配置する誘導針であ って、プロテーゼは近位部分および遠位部分を有し、誘導針が、プロテーゼが患 者の管腔の所望の部位に配置されるとプロテーゼから選択的に解放できるプロテ ーゼ配置機構(2、3)と、プロテーゼの近位部分の少なくとも縦方向の位置を 制御する第1の制御部材(22、24)と、プロテーゼの遠位部分の少なくとも 縦方向の位置を制御する第2の制御部材(44、25)とを備えることを特徴と する誘導針。 2. 前記プロテーゼ配置機構が遠位取付領域(2)および/または近位取付 領域(3)を含むことを特徴とする請求項1に記載の誘導針。 3. 前記遠位取付領域が遠位取付器具(10)を含むことを特徴とする請求 項2に記載の誘導針。 4. 前記近位取付領域が近位取付器具(10)を含むことを特徴とする請求 項2または3に記載の誘導針。 5. プロテーゼ配置機構が、プロテーゼの長さを制御する制御装置(15、 41)を有することを特徴とする請求項1から4のいずれかに記載の誘導針。 6. プロテーゼ配置機構が、プロテーゼの近位および遠位部分の相対的角方 向を調節することができる回転装置(15、41)を備えることを特徴とする請 求項1から4のいずれかに記載の誘導針。 7. プロテーゼ配置機構が、プロテーゼの角方向を調節することができる回 転装置(15、41)を有することを特徴とする請求項1から4のいずれかに記 載の誘導針。 8. 誘導針が、プロテーゼが患者の管腔の所望の部位に配置されると、プロ テーゼの膨張を制御する膨張制御機構(10、30)をさらに有することを特徴 とする請求項1から7のいずれかに記載の誘導針。 9. 患者の管腔の所望の位置に膨張性プロテーゼを配置する血管内膜装置で あって、 前記装置が、 患者の体外に維持される制御区間(1)と、 管腔の所望の位置にプロテーゼを移動させ、これを操作するために制御 区間によって制御可能なプロテーゼ配置機構(2、3)とを有し、 第1の部材(15)が制御区間から配置機構の近位領域(3)へと延在 し、配置機構の近位領域がプロテーゼの近端を制御する手段(10)を有し、 第2の部材(41)が制御区間から配置機構の遠位領域(2)へと延在 し、遠位領域が第2の部材と協力してプロテーゼの遠端を制御する手段(40) を有することを特徴とする血管内膜装置。 10. 前記装置が、プロテーゼ配置機構を管腔に挿入する間にプロテーゼの 自己膨張性ステントを含む後退手段および/またはプロテーゼが患者の管腔の所 望の部位に配置されると、プロテーゼの膨張性ステントを膨張させる膨張手段を 更に有することを特徴とする請求項9に記載の血管内膜装置。 11. 後退手段が、制御区間から配置機構まで延在して、配置機構を管腔に 挿入する間にプロテーゼを含み、管状手段を第1および第2の部材に対して遠位 方向に移動させた時に、プロテーゼの遠端を制御する働きをする管状手段(30 )を有し、第1の部材と第2の部材間の相対運動によって、プロテーゼが管腔内 にある時にこれを操作できることを特徴とする請求項10に記載の装置。 12. 前記膨張手段が、プロテーゼが管腔の所望の位置に配置された時にプ ロテーゼのステントを半径方向に膨張可能な、少なくともラジアル手段を有する ことを特徴とする請求項10または11に記載の装置。 13. 前記膨張手段が膨張可能なバルーンを有することを特徴とする請求項 12に記載の装置。 14. 第1および第2の部材が前記管状手段の中に含まれることを特徴とす る請求項12に記載の装置。 15. 手段(39)が、プロテーゼの挿入中に第1の部材と第2の部材とを 合わせて締め付け、操作する前に第1および第2の部材を解放するため設けられ ることを特徴とする請求項12または14に記載の装置。 16. 非自己膨張性プロテーゼの膨張が、第1の部材の周囲でプロテーゼの 中に配置されたバルーンの膨張によって実行することができ、前記バルーンが制 御区間から膨張可能であることを特徴とする請求項12、14または15に記載 の装置。 17. 取付機構の前記近位領域が、プロテーゼを最終的に配置する前にその 近端を含む管状手段(10)を含み、プロテーゼの管状手段(10)からの解放 が、第1の部材の近位方向への運動によって達成されることを特徴とする請求項 12、14、15または16に記載の装置。 18. 前記第2の部材が、ステントの遠端が管状手段(30)の内側にある 間、これを制御する手段(40)を有することを特徴とする請求項9から17の いずれかに記載の装置。 19. 前記装置が、プロテーゼの個々のステントへと延在する線(22、4 4)を制御するため、制御区間内に解放機構(24、25)を更に有することを 特徴とする請求項9から18いずれか一項に記載の装置。 20. 前記プロテーゼ配置機構がプロテーゼの長さを制御する制御装置(1 5、41)を有することを特徴とする請求項9から19のいずれかに記載の装置 。 21. 前記プロテーゼ配置機構が、プロテーゼの近位および遠位部分の相対 的角度方向を調節することができる回転装置(15、41)を有することを特徴 とする請求項9から19のいずれかに記載の装置。 22. 前記プロテーゼ配置機構が、プロテーゼの角度方向を調節することが できる回転装置(15、41)を有することを特徴とする請求項9から19のい ずれかに記載の装置。 23. 前記誘導針が、プロテーゼが患者の管腔の所望の部位に配置されると 、プロテーゼの膨張を制御する膨張制御機構(10、30)を更に有することを 特徴とする請求項9から19のいずれかに記載の装置。 24. 自己膨張性血管内膜プロテーゼを患者の管腔に誘導するようになって いる誘導針であって、プロテーゼが近端および遠端を有し、誘導針が、 a.プロテーゼの近端に取り付けるようになっている近位取付器具と、 b.プロテーゼの遠端に取り付けるようになっている遠位取付器具と、 c.プロテーゼの間に張力をかけてこれを保持することができ、プロテ ーゼの各端を個々に近位および遠位方向に移動し、回転することができるような 方法でプロテーゼに取り付けられる近位および遠位取付器具それぞれと、 d.プロデーゼの近端および遠端を選択的に解放できるよう、近位取付 器具に関連した近位解放手段と、遠位取付器具に関連した遠位解放手段とを有す ることを特徴とする誘導針。 25. 前記近位取付手段が、近端に長い可撓性性延長部を有し、誘導針の体 内への挿入および管腔に沿った前進を容易にすることを特徴とする請求項24に 記載の誘導針。 26. 前記近位取付器具が、近位取付器具から患者の体外に残るようになっ ている誘導針の外部操作区間まで遠位方向に延在する可撓性性肉薄管に装着され ることを特徴とする請求項25に記載の誘導針。 27. 肉薄金属管が、患者の体外に流体接続手段を有し、医薬品を誘導でき ることを特徴とする請求項26に記載の誘導針。 28. 長い可撓性性延長部が、肉薄金属管と流体連絡する中空の管と、プロ テーゼの近位側で医薬品を分散できる複数の側穴とを有することを特徴とする請 求項27に記載の誘導針。 29. 遠位取付器具が、可撓性性肉厚管に装着され、肉薄管と同軸上にあり 、外部操作区間まで遠位方向に延在し、個々の管を一緒に移動するか、別個に移 動できるように装着されることを特徴とする請求項26に記載の誘導針。 30. 操作区間の肉薄管と肉厚管との間に止血シールを有することを特徴と する請求項29に記載の誘導針。 31. 医薬品を、肉薄管と肉厚管との間に規定された環状空間に誘導する手 段を有することを特徴とする請求項30に記載の誘導針。 32. 近位取付器具から操作区間へと延在する近位トリガー線を含み、近位 トリガー線が近位解放手段を起動するようになっていることを特徴とする請求項 24に記載の誘導針。 33. 遠位取付器具から操作区間へと延在する遠位トリガー線を含み、遠位 トリガー線が遠位解放手段を起動するようになっていることを特徴とする請求項 24に記載の誘導針。 34. 近位トリガー線および遠位トリガー線のそれぞれの外部解放機構を含 み、外部解放機構が、トリガー線の偶発的な解放を防止し、近位解放手段の解放 後にのみ遠位解放手段を解放できるようになっていることを特徴とする請求項2 4に記載の誘導針。 35. 操作区間の個々のトリガー線の周囲に止血シールを有することを特徴 とする請求項34に記載の誘導針。 36. 患者の体外から延在し、誘導針を患者に誘導する間にプロテーゼを覆 って、これを圧縮し、患者の体外から縦方向に移動してプロテーゼを露出できる 外鞘を有することを特徴とする請求項24に記載の誘導針。 37. 外鞘が肉厚管と同軸上にあり、それと滑り嵌めすることを特徴とする 請求項36に記載の誘導針。 38. 外鞘が、先細で、平滑にされ、挿入中に誘導針の前進に対して抵抗が 少ない近端を有することを特徴とする請求項37に記載の誘導針。 39. 外鞘の近端が、近位取付器具に締り嵌めするようになっていることを 特徴とする請求項36に記載の誘導針。 40. 遠位取付器具が流線形であり、近位取付器具へと前進するようになっ ていて、それにより患者から取り外すために解放されたプロテーゼを通って外鞘 へと滑らかに後退できることを特徴とする請求項24に記載の誘導針。 41. プロテーゼが二叉プロテーゼであることを特徴とする請求項24に記 載の誘導針。 42. 患者の管腔が動脈であり、プロテーゼが大動脈瘤を治療するようにな っていることを特徴とする請求項1から41のいずれかに記載の誘導針。 43. 挿入アセンブリによってプロテーゼを体内管腔に配置する方法であっ て、 (a)プロテーゼを含む挿入アセンブリを体内管腔に挿入するステップ と、 (b)挿入アセンブリから鞘を引き抜いてプロテーゼを露出させるステ ップと、 (c)挿入アセンブリからプロテーゼを解放するステップと、 (d)鞘を挿入アセンブリ上に戻すステップと、 (e)挿入アセンブリを後退させるステップと、 を含むことを特徴とする方法。 44. プロテーゼが近端および遠端を有し、挿入アセンブリが、プロテーゼ の近端および遠端をそれぞれ保持するようになっている近位取付器具および遠位 取付器具を含み、プロテーゼを解放するステップが、近端を解放してから遠端を 解放するステップを含むことを特徴とする請求項43に記載の方法。 45. 鞘を挿入アセンブリ上に戻すステップが、遠位取付器具を近位取付器 具まで前進させ、2つの器具を一緒に引き抜くステップを含むことを特徴とする 請求項44に記載の方法。 46. ステップ(b)と(c)との間で、プロテーゼが近位取付器具および 遠位取付器具のそれぞれの運動によって操作され、プロテーゼを正確に配置する ことを特徴とする請求項44に記載の方法。 47. プロテーゼが二叉プロテーゼであり、鞘を引き抜くステップが、プロ テーゼのサイド・アームが露出する第1の位置へと鞘を引き抜くステップと、延 長プロテーゼをサイド・アームに挿入するステップと、次に鞘をプロテーゼから 完全に外すステップとを含むことを特徴とする請求項43に記載の方法。 48. 延長プロテーゼをサイド・アームに挿入するステップが、 (f)延長挿入アセンブリをサイド・アームに挿入するステップを含み 、前記延長挿入アセンブリが、カテーテルに装着された頂部ガイドと、カテーテ ル上の延長プロテーゼと、延長プロテーゼを保持して頂部ガイド上に延在する鞘 とを有し、さらに、 (g)鞘を引き抜いて延長プロテーゼを露出させ、配置するステップと 、 (h)鞘、頂部ガイドよびカテーテルを一緒に引き抜くステップとを有 することを特徴とする請求項47に記載の方法。 49. 頂部ガイドが長い近位ノーズ延長部を有することを特徴とする請求項 48に記載の方法。 50. カテーテルが遠位止め具を有し、延長プロテーゼが遠位止め具と頂部 ガイドとの間に装着されることを特徴とする請求項48に記載の方法。 51. プロテーゼが二叉プロテーゼであり、鞘を引き抜くステップが、プロ テーゼの第1のサイド・アームが露出する第1の位置へと鞘を引き抜くステップ と、第1の延長プロテーゼを第1のサイド・アームに挿入するステップと、鞘を プロテーゼから完全に外して第2のサイド・アームを露出させるステップと、次 に第2の延長プロデーゼを第2のサイド・アームに挿入するステップを含むこと を特徴とする請求項43に記載の方法。 52. 第1の延長プロテーゼをサイド・アームに挿入するステップが、 (f)第1の延長挿入アセンブリを第1のサイド・アームに挿入するス テップを含み、第1の延長挿入アセンブリが、カテーテルに装着された頂部ガイ ドと、カテーテル上の延長プロテーゼと、延長プロテーゼを保持して頂部ガイド 上に延在する鞘とを含み、さらに、 (g)鞘を引き抜いて延長プロテーゼを露出させ、配置するステップと 、 (h)鞘、頂部ガイドおよびカテーテルを一緒に引き抜くステップとを 含み、 第2の延長アームを挿入するステップが、 (i)第2延長挿入アセンブリを第2サイド・アームに挿入するステッ プを有し、第2の延長挿入アセンブリが、カテーテルに装着された頂部ガイドと 、カテーテル上の延長プロテーゼと、延長プロテーゼを保持して頂部ガイド上に 延在する鞘とを有し、さらに、 (j)鞘を引き抜いて延長プロテーゼを露出させ、配置するステップと 、 (k)鞘、頂部ガイドおよびカテーテルを一緒に引き抜くステップと、 を有することを特徴とする請求項51に記載の方法。 53. 頂部ガイドがそれぞれ長い近位ノーズ延長部を有することを特徴とす る請求項52に記載の方法。 54. カテーテルがそれぞれ遠位止め具を有し、延長プロテーゼが遠位止め 具と頂部ガイドとの間に装着されることを特徴とする請求項52に記載の方法。 55. 管状グラフトと複数の自己膨張性ステントとを有する管内プロテーゼ であって、グラフトの長さに沿ってプロテーゼは近端および遠端を有し、近端お よび遠端にあるステントが管状グラフトの内側にあり、残りのステントがグラフ トの外側にあることを特徴とするプロテーゼ。 56. グラフトの近端に装着され、前記近端より先まで延在する別の自己膨 張性ステントを更に有することを特徴とする請求項55に記載の管内プロテーゼ 。 57. 前記別の自己膨張性ステントが取付器具を含むことを特徴とする請求 項56に記載の管内プロテーゼ。 58. 前記取付器具が、プロテーゼの遠端に向かって延在する返しを備える ことを特徴とする請求項57に記載の管内プロテーゼ。 59. プロテーゼが遠端で二叉になり、短い方のプロテーゼ脚部と長い方の プロテーゼ脚部とをもたらすことを特徴とする請求項55に記載の管内プロテー ゼ。 60. 前記短脚がプロテーゼの外側に末端ステントを有し、前記長脚が内部 遠位ステントを有することを特徴とする請求項55に記載の管内プロテーゼ。 61. プロテーゼ短脚に挿入する延長プロテーゼを更に有し、延長プロテー ゼが管状延長プロテーゼおよび複数の自己膨張性ステントを有し、延長プロテー ゼが近端および遠端を有し、近端および遠端のステントが管状延長プロテーゼの 内側にあり、残りのステントがプロテーゼの外側にあることを特徴とする請求項 59または60に記載の管内プロテーゼ。 62. 前記短脚および長脚が両方とも、各脚の外部末端ステントと延長プロ テーゼとを有し、各延長プロテーゼが管状延長プロテーゼおよび複数の自己膨張 性ステントを備え、延長プロテーゼが近端および遠端を有し、近端および遠端の ステントが管状延長プロテーゼの内側にあり、残りのステントがプロテーゼの外 側にあることを特徴とする請求項56に記載の管内プロテーゼ。 63. 各ステントがジグザグ形ステントであることを特徴とする請求項55 に記載の管内プロテーゼ。
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Also Published As
Publication number | Publication date |
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ATE409444T1 (de) | 2008-10-15 |
AUPO700897A0 (en) | 1997-06-19 |
ES2316164T3 (es) | 2009-04-01 |
JP4368428B2 (ja) | 2009-11-18 |
CA2283782A1 (en) | 1998-12-03 |
CA2283782C (en) | 2009-08-04 |
JP4414450B2 (ja) | 2010-02-10 |
DK1014888T3 (da) | 2008-12-15 |
WO1998053761A1 (en) | 1998-12-03 |
EP1014888A4 (en) | 2003-03-19 |
JP2007125415A (ja) | 2007-05-24 |
JP4685802B2 (ja) | 2011-05-18 |
AU736368B2 (en) | 2001-07-26 |
EP1014888B1 (en) | 2008-10-01 |
US7435253B1 (en) | 2008-10-14 |
AU7513298A (en) | 1998-12-30 |
JP2007313353A (ja) | 2007-12-06 |
DE69840072D1 (de) | 2008-11-13 |
EP1014888A1 (en) | 2000-07-05 |
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